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Rev Esp Quimioter 2024, October 29

Strengths and weaknesses of computerized clinical decision support systems: insights from a digital control center (C3 COVID-19) for early and personalized treatment for COVID-19

TOMMASO FRANCESCO AIELLO, CHRISTIAN TEIJON-LUMBRERAS, ANTONIO GALLARDO-PIZARRO, PATRICIA MONZÓ-GALLO, ANA MARTINEZ-URREA, GUILLERMO CUERVO, ANA DEL RIO, MARTA HERNÁNDEZ-MENESES, LAURA MORATA, JOSEP MENSA, ALEX SORIANO, CAROLINA GARCIA-VIDAL

Published: 29 October 2024

http://www.doi.org/10.37201/req/088.2024

Clinical Decision Support Systems (CDSS) are computer-based tools that leverage the analysis of large volumes of health data to assist healthcare professionals in making clinical decisions, whether preventive, diagnostic, or therapeutic. This review examines the impact of CDSS on clinical practice, highlighting both their potential benefits and their limitations and challenges. We detail the experience of clinical medical professionals in the development of a virtual control center for COVID-19 patients (C3 COVID-19) in Spain during the SARS-CoV-2 pandemic. This tool enabled real-time monitoring of clinical data for hospitalized COVID-19 patients, optimizing personalized and informed medical decision-making. CDSS can offer significant advantages, such as improving the quality of inpatient care, promoting evidence-based clinical and therapeutic decision-making, facilitating treatment personalization, and enhancing healthcare system efficiency and productivity. However, the implementation of CDSS presents challenges, including the need for physicians to become familiar with the systems and software, and the necessity for ongoing updates and technical support of the systems.

Rev Esp Quimioter 2024; October 29 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(6): 486-497

Diagnostic power of LIAISON MeMed VB® for bacterial infection in adults patients seen in Emergency Departments due to infections

JAVIER CABAÑAS MORAFRAILE, ELENA DE RAFAEL GONZÁLEZ, LAURA SERRANO MARTÍN, RAFAEL RUBIO DÍAZ, MARÍA TORRES FERNÁNDEZ, EVA HEREDERO GÁLVEZ, WILLIAM ESNEIDER LÓPEZ FORERO, LAURA MORELL JURADO, RAÚL CANABAL BERLANGA, M. FRANCISCA CALAFELL MAS, ELIA CHAVES PRIETO, M. REMEDIOS ASENSIO NIETO, ÁLVARO THOMAS-BALAGUER CORDERO, MARÍA CARMEN LORENZO LOZANO, AGUSTÍN JULIÁN-JIMÉNEZ, EN NOMBRE DEL GRUPO URGEN-LABQMIC DEL CHUT (IDISCAM)

Published: 16 October 2024

http://www.doi.org/10.37201/req/078.2024

Objectives. To analyze the diagnostic accuracy of the new MeMed® test to predict bacterial infection in adult patients seen in emergency departments (ED) with clinical suspicion of infection, as well as to compare its performance with other commonly used biomarkers (protein C reactive-PCR-, procalcitonin -PCT-).
Methods. A prospective, observational and analytical study was carried out on adult patients who were treated in an ED with the clinical diagnosis of an infectious process. Follow-up was carried out for 30 days. The diagnosis of bacterial infection (BI) was considered as the dependent variable. The predictive ability was analyzed with the area under the curve (AUC) of the receiver operating characteristic (COR) and the values of sensitivity (Se), specificity (Es), positive predictive value (PPV) and negative predictive value (NPV) of the PCR, PCT, leukocyte count and the LIAISON® MeMed® test.
Results. The study included 258 patients, 54 (15.6%) of whom died within 30 days of visiting the ED. The mean age was 68.28 (SD 19.53) years, 57.4% (148) were men. At 30 days, the group with the IB diagnosis had 137 patients, the viral infection group 68 cases and 17 in the indeterminate group. The AUC-COR achieved by MeMed® in the group that analyzes all patients was 0.920 (95% CI: 0.877-0.962) and the PCT was 0.811 (95% CI: 0.754-0.867). With a cut-off point (PC) > 65 points of the MeMed® test, achieves a Se: 79.2% and Es: 91.2% and with PC > 90 points a Se: 57% and Es: 95.9%. Applying the Youden index, the PC > 50 points achieves Se:84.1% and Es:88.2%.
Conclusions. In adult patients treated with clinical suspicion of infection in the ED, the LIAISON MeMed® test has a great ability to diagnose its bacterial origin and achieves better performance than PCT, PCR and leukocyte count.

Rev Esp Quimioter 2024; 37(6): 486-497 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(6): 509-511

La importancia de un diagnóstico precoz. Tinea capitis producida por Trichophyton tonsurans en un adolescente

LAURA EVA FRANCO-FOBE, MARÍA LUISA MONFORTE, MARÍA VICTORIA FUENTELSAZ DEL BARRIO, ROCÍO CEBOLLADA, CONCEPCIÓN LÓPEZ-GÓMEZ, CARMEN ASPIROZ

Published: 15 October 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/007.2024

Rev Esp Quimioter 2024; 37(6): 509-511 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(6): 523-526

Nocardia and mucoral co-infection in heart transplant recipient

MARINA FAYOS, ANDREA SEVERO, MARÍA DOLORES GARCÍA-COSÍO, CARLOS PRADOS, MARINA ALONSO, FRANCISCO LÓPEZ-MEDRANO

Published: 10 October 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/075.2024

Rev Esp Quimioter 2024; 37(6): 523-526 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(6): 518-520

Erupción mucocutánea infecciosa reactiva (RIME) en pacientes pediátricos: afectación extrapulmonar de Mycoplasma pneumoniae

CRISTINA GONZÁLEZ, BORJA CROCHE, EMILIO GÓMEZ

Published: 8 October 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/061.2024

Rev Esp Quimioter 2024; 37(6): 518-520 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(6): 479-485

Integrase strand transfer inhibitors resistance-associated mutations in HIV-infected pregnant women

DIEGO CECCHINI, JAVIER SFALCIN, INÉS ZAPIOLA, ALAN GOMEZ, SILVINA FERNANDEZ-GIULIANO, CLAUDIA RODRIGUEZ, LILIA MAMMANA, ANALÍA SERAVALLE, FABIÁN FAY, MARÍA CECILIA TORROIJA GABRIELA BUGARÍN, MARÍA BELÉN BOUZAS

Published: 4 October 2024

http://www.doi.org/10.37201/req/074.2024

Objective. To date, no data exist regarding the prevalence of integrase inhibitor (INSTI) resistance-associated mutations (HIVDRM) in HIV-infected pregnant women (HPW) in Latin America. We describe the prevalence and transmissibility of integrase HIVDRM in a historical cohort of INSTI-naïve HPW from Argentina (n=56) with Next Generation Sequencing (NGS).
Material and methods. Bioinformatics analysis was performed by HyDRA software for 20%, 10%, 5%, 2%, and 1% sensitivity thresholds. We calculated the mutational viral load for each INSTI-HIVDRM, considering those with >1000 c/mL as of high risk of transmissibility.
Results. The predominant HIV subtype was BF (78.5%). Major HIVDRM were not detected with the population sequencing 20% filter. With a 1% threshold, the prevalence increased to 8.9%; Y143C/S, E92G, E138K, and T66I mutations were found. The median (range) mutational load (expressed in c/mL) was: 355 (50.2-11705); with only 1 case >1000 c/mL Accessory mutations (G163R/K, T97A) were detected mostly with a 20% sensitivity threshold with an overall prevalence of 23.2%; the median (IQR) mutational load was: 23929 (4009-63158) c/mL; all of them above 1000 c/mL.
Conclusion. Our results show evidence of the presence of major INSTI-HIVDRM as aleatory mutations and a high frequency of accessory mutations with potential transmissibility in HPW.

Rev Esp Quimioter 2024; 37(6): 479-485 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(6): 504-508

Antibiotic use in Barcelona in 2023 in primary care and the potential reduction by adjusting box sizes to current guidelines

CARL LLOR, CRISTINA RODRÍGUEZ-BERNUZ, AMELIA TRONCOSO-MARIÑO

Published: 1 October 2024

http://www.doi.org/10.37201/req/054.2024

Introduction. Prior research has not examined the size of antibiotic packages prescribed. We assessed 2023 prescription rates in Barcelona and the most prescribed presentations in pharmacies, while evaluating potential reductions if all amoxicillin and amoxicillin/clavulanate containers had 20 doses.
Methods. Antibiotics prescribed by primary care doctors working for the Catalonian Health Institute in Barcelona in 2023 were analysed by calculating the defined daily doses per 1,000 inhabitants and day (DID).
Results. The observed prescribing rate was 8 DID, with penicillins accounting for 4.6 DID (57.2%). The most frequently prescribed antibiotics were amoxicillin and amoxicillin/clavulanate, making up 4.4 DID. If all the 30-dose presentations of amoxicillin and amoxicillin/clavulanate had been 20-dose containers, the total number of DIDs would have been 3.3, resulting in a reduction of 1.1 DID (25.4% less).
Conclusions. Antibiotic prescribing rate in Barcelona was low. Aligning the dosage of antibiotics with established guidelines could further reduce antibiotic consumption.

Rev Esp Quimioter 2024; 37(6): 504-508 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(6): 515-517

Threat of preterm labor and preterm birth in the presence of Lachnoanaerobaculum gingivalis

LUCÍA IGLESIAS-LINARES, ANA ROMÁN-DE-LA-TORRE, MARÍA AGUILERA-FRANCO, ALBERTO PUERTAS-PRIETO, MARÍA JOSÉ MEDINA-PASCUAL, JOSÉ GUTIÉRREZ-FERNÁNDEZ

Published: 30 September 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/050.2024

Rev Esp Quimioter 2024; 37(6): 515-517 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(6): 521-522

Lesiones en diana y fiebre, un microorganismo inesperado

PATRICIA ANDRES-IBARROLA, LAURA GUÍO CARRIÓN

Published: 27 September 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/065.2024

Rev Esp Quimioter 2024; 37(6): 521-522 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(6): 472-478

A 5-year study of bloodstream infections caused by carbapenemase-producing Gram-negative bacilli in southern Spain

FERNANDO COBO, JUAN ANTONIO REGUERA-MÁRQUEZ, JOSÉ ANTONIO MARÍN-RODRÍGUEZ, FRANCISCO JOSÉ MARTÍN-PÉREZ, PATRICIA PÉREZ-PALACIOS, ESTHER RECACHA, JOSÉ MARÍA NAVARRO-MARÍ

Published: 19 September 2024

http://www.doi.org/10.37201/req/045.2024

Introduction. The aim of this study was to evaluate the microbiological epidemiology of carbapenemase-producing Gram-negative bacilli (CPGNB) isolated from blood during a 5-year period.
Methods. A total of 80 isolates from 78 patients were finally included; fifty-five (70.5%) were men and the mean age was 60 years. Detection of carbapenemase production was
performed by immunocromatography (IC) and polymerase chain reaction (PCR). Genotyping was carried-out by pulsedfield gel electrophoresis (PFGE) and multi-locus sequence typing (MLST), and characterization of carbapenemase-producing isolates was performed by whole genome sequencing (WGS).
Results. The main microorganisms isolated were K. pneumoniae (29.4%), E. cloacae (28.2%), A. baumannii (17.9%) and P. aeruginosa (15.3%). Overall, the most common carbapenemase in Enterobacterales was OXA-48 group (57.7%). The most common carbapenemase in non-fermenting bacilli was OXA-23 (60.8%). The most common ST in K. pneumoniae producing OXA-48 types was ST45 and in E. cloacae ST114, while in E. cloacae producing VIM types was ST78. In OXA-23 types, the most common clone in A. baumannii was ST2, whereas in P. aeruginosa producing IMP types was ST253.
Conclusions. There was an increase in cases recorded in the years of highest incidence and severity of the SARS-CoV-2 pandemic, with a significant number of cases in patients admitted to the ICU. All bacteremias caused by A. baumannii were caused by the same clone, and 12 of the 14 cases caused by A. baumannii were part of outbreaks in the ICU.

Rev Esp Quimioter 2024; 37(6): 472-478 [Full-text PDF]


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