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Rev Esp Quimioter 2024, 37(5): 401-408

Use of noninvasive measurement of the indocyanine green plasma disappearance rate in patients with septic shock

ISABEL GUTIÉRREZ-MORALES, ANA LOZA-VÁZQUEZ, JOSÉ ANTONIO SÁNCHEZ-ROMÁN, ANTONIO GRILO-REINA, MARÍA ASUNCIÓN NAVARRO-PUERTO

Published: 28 June 2024

http://www.doi.org/10.37201/req/029.2024

Introduction. Our aim was to analyse the relation between serial values of the indocyanine green plasma disappearance rate (ICG-PDR) with hospital mortality in the first 48 hours of ICU admission in patients with septic shock.
Methods. A prospective observational study was carried out over 12 months of patients admitted to the ICU with septic shock. Each patient underwent noninvasive determination of ICG-PDR at 24 and 48 hours with the LiMON® module. Follow-up was performed until hospital discharge or exitus.
Results. 63 patients. Age 61.1±12.3 years. 60.3% men. SOFA score on admission 8.7±3.3, APACHE II score was 27.9±10.7 points. A total of 44.4% of patients died. The ICG-PDR values in the first 24 hours of ICU admission were lower in nonsurvivors: 10.5 (5.7-13.0)%/min vs. 15.9 (11.4-28.0)%/min, p <0.001. Furthermore, in nonsurvivors, there was no improvement in ICG-PDR between 24 h and 48 h, while in survivors, there was an increase of 25%: 15.9 (11.4-28.0)%/min and 20.9 (18.0-27.0)%/min, p=0.020. The silhouette measure of ICG-PDR cohesion and separation for the clusters analysed (nonsurvivors and survivors) was satisfactory (0.6). ICG-PDR<11.7%/min was related to in-hospital mortality, ICG-PDR> 18%/min to survival, and the interval between 11.7% and 18%/min covered a range of uncertainty. In the two-stage cluster, ICG-PDR, SOFA and APACHE II present satisfactory predictive scores 24 hours after patient admission.
Conclusions. ICG-PDR in our setting is a useful clinical prognostic tool and could optimise the decision tree in patients with septic shock.

Rev Esp Quimioter 2024; 37(5): 401-408 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(5): 429-431

Adenopatías generalizadas e infección diseminada por Mycobacterium lentiflavum en un paciente inmunodeprimido

BELÉN CUADRADO GARCÍA, INÉS OLAYA GARCÍA RODRÍGUEZ, BEATRIZ CASTRO HERNÁNDEZ, RICARDO PELAZAS GONZÁLEZ, MARÍA LECUONA FERNÁNDEZ

Published: 27 June 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/041.2024

Rev Esp Quimioter 2024; 37(5): 429-431 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(5): 422-424

Mycobacterium abscessus subsp. massilliense causing bartholinitis infection: A case report

ALFREDO MALDONADO-BARRUECO, DAVID GRANDIOSO-VAS, MARIO RUIZ-BASTIÁN, JUANA CACHO-CALVO, CARLOS TORO, INMACULADA QUILES-MELERO

Published: 27 June 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/011.2024

Rev Esp Quimioter 2024; 37(5): 422-424 [Full-text PDF]


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Rev Esp Quimioter 2024, 37(5): 387-400

Vascular catheter-related infections: an endemic disease in healthcare institutions. An opinion paper of the Spanish Society of Cardiovascular Infections (SEICAV)

PATRICIA MUÑOZ, MARÍA GUEMBE, MARÍA JESÚS PÉREZ-GRANDA, JOSÉ LUÍS DEL POZO, LUIS EDUARDO LÓPEZ-CORTÉS, MAURO PITTIRUTI, MARÍA CRUZ MARTÍN-DELGADO, EMILIO BOUZA

Published: 26 June 2024

http://www.doi.org/10.37201/req/051.2024

Catheter-related infections (CRI) are a serious healthcare problem due to their potential to cause serious complications, including bacteraemia or infective endocarditis, and to increase patient morbidity and mortality. In addition, these in fections significantly prolong hospital stay and cost. Preventing CRI is crucial and is considered a criterion for quality and safety in healthcare.
For these reasons, the Spanish Society of Cardiovascular Infections (SEICAV) has considered it pertinent to review this topic, with experts in different areas including clinical microbiologists, infectious disease specialists, surgeons and nurses. The data were presented at a session held at the Ramón Areces Foundation, which was organised in the form of specific questions grouped into three round tables. The first panel analysed the scale of the problem including epidemiological, clinical and diagnostic aspects; the second panel addressed advances in the treatment of CRI; and the third panel reviewed developments in the prevention of CRI. The recorded session is available on the Areces Foundation website and we believe it maybe of interest not only to health professionals, but also to any non-expert citizen interested in the subject.

Rev Esp Quimioter 2024; 37(5): 387-400 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(4): 360-361

Meningitis bacteriana por Streptococcus gallolyticus subespecie pasteurianus en paciente adulto: revisión de la literatura

AMPARO BUFORN PASCUAL, ADRIANA HERNÁNDEZ BELMONTE

Published: 20 June 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/139.2023

Rev Esp Quimioter 2024; 37(4): 360-361 [Texto completo PDF]


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Rev Esp Quimioter 2024, 37(4): 334-340

Dalbavancin as consolidation therapy for infective endocarditis in patients with comorbidity. A real world experience

DAVID BRANDARIZ-NÚÑEZ, ANDREA LUANCES-RODRÍGUEZ, PABLO FEIJOO-VILANOVA, JOSÉ MARÍA GUTIÉRREZ-URBÓN, LUIS RAMUDO-CELA, MARÍA ISABEL MARTÍN-HERRANZ, LUIS MARGUSINO-FRAMIÑÁN

Published: 17 June 2024

http://www.doi.org/10.37201/req/012.2024

Introduction. Infective endocarditis (IE) is a potentially life-threatening infection, the incidence of which has in creased in recent decades, particularly among elderly patients with comorbidity. The primary objective of this study was to evaluate the effectiveness of dalbavancin in the consolidation therapy of IE in patients with comorbidity six months after the end of treatment (EOT).
Material and methods. An observational and retrospective study was conducted on patients with a Charlson Comorbidity Index (CCI) ≥ 3 who were diagnosed with IE and received consolidation therapy with dalbavancin.
Results. Forty-eight patients were included, 58.3% were male, mean age of 76.2 years (IQR: 66-88), and a mean age adjusted CCI of 6.5 (IQR: 5-7.5). Definite IE was diagnosed in 77% of cases. The most frequently isolated microorganisms were Staphylococcus aureus (45.8%) followed by Enterococcus spp. (31.3%). Complications of IE were observed in 67.7% of cases, and cardiac surgery was performed in 27% of patients. The primary reason for using dalbavancin was outpatient parenteral antibiotic therapy in 85.4% of cases. The effectiveness at EOT was 93.8%. At six months, six IE-related deaths, four unrelated deaths, and two IE relapses were observed. The effectiveness was 77%. Adverse effects related to DBV were reported in 4.2% of cases, of which 2% were considered serious.
Conclusion. Dalbavancin has proven to be an effective alternative as consolidation antibiotherapy for IE in elderly patients with comorbidity. Moreover, a very favorable safety profile with few associated adverse effects has been observed in this population.

Rev Esp Quimioter 2024; 37(4): 334-340 [Full-text PDF] [Supplementary material PDF]


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Rev Esp Quimioter 2024, 37(4): 356-359

Exploring therapeutic options for mild diabetic-related foot infections: a comparative in vitro study of cefditoren versus amoxicillin/clavulanic acid

LUIS ALOU, ELENA GÓMEZ-RUBIO, MARÍA-JOSÉ GIMÉNEZ MESTRE, FRANCISCO-JAVIER ALVARO-AFONSO, PILAR CORONEL, DAVID SEVILLANO

Published: 13 June 2024

http://www.doi.org/10.37201/req/028.2024

Skin and soft tissue infections (SSTIs), and particularly diabetic-related foot infections (DFI), present diagnostic and therapeutic complexities, often leading to severe complications. This study aims to evaluate the in vitro efficacy of cefditoren and amoxicillin/clavulanic acid against typical DFI pathogens. Clinical samples from 40 patients with mild SSTIs were analyzed, revealing a predominance of Staphylococcus spp. and Streptococcus spp. species. Cefditoren exhibited activity against 90% of isolates, with superior potency over amoxicillin/clavulanic acid. These findings underscore the utility of cefditoren in empirical treatment of DFI, although a larger sample size would be desirable for further validation.

Rev Esp Quimioter 2024; 37(4): 356-359 [Full-text PDF]


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Rev Esp Quimioter 2024, 37(4): 299-322

Clinically important pharmacokinetic drug-drug interactions with antibacterial agents

ARNAU TORRENT RODRÍGUEZ, AINA FONT I BARCELÓ, MELISSA BARRANTES GONZÁLEZ, DANIEL ECHEVERRIA ESNAL, DOLORS SOY MUNER, JOSÉ ANTONIO MARTÍNEZ, MONTSERRAT TUSET CREUS

Published: 5 June 2024

http://www.doi.org/10.37201/req/037.2024

Antimicrobial agents are widely used, and drug interactions are challenging due to increased risk of adverse effects or reduced efficacy. Among the interactions, the most important are those affecting metabolism, although those involving drug transporters are becoming increasingly known. To make clinical decisions, it is key to know the intensity of the interaction, as well as its duration and time-dependent recovery after discontinuation of the causative agents. It is not only important to be aware of all patient treatments, but also of supplements and natural medications that may also interact. Although they can have serious consequences, most interactions can be adequately managed with a good understanding of them. Especially in patients with polipharmacy it is compulsory to check them with an electronic clinical decision support database. This article aims to conduct a narrative review focusing on the major clinically significant pharmacokinetic drug-drug interactions that can be seen in patients receiving treatment for bacterial infections.

Rev Esp Quimioter 2024; 37(4): 299-322 [Full-text PDF]


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Rev Esp Quimioter 2024, 37(4): 351-355

A descriptive overview of cases of congenital cytomegalovirus at a tertiary hospital between 2017 and 2023

ELENA MEDINA GARCÍA, ARANTXA BERZOSA, MARTA ILLÁN RAMOS, VICTORIA CURSACH PEDROSA, CRISTINA ARANDA CAZÓN, GLORIA HERRANZ CARRILLO, ENRIQUE CRIADO VEGA, JOSÉ TOMÁS RAMOS AMADOR

Published: 23 May 2024

http://www.doi.org/10.37201/req/117.2023

Introduction. Cytomegalovirus infection (CMV) is the most common congenital infection in developed countries. The aim of our study was to describe the features of the children that have congenital CMV infection at our hospital for the last 6 years.
Material and methods. A retrospective descriptive study was designed that included all the children with CMV congenital infection that were diagnosed at tertiary hospital of Madrid Community between 2017 and 2023.
Results. Twenty-two children were included. 54.5% have a prenatal diagnosis, 50% of them were in the third trimester, 25% at first trimester and 25% at the second. 22.7% were preterm. CMV was isolated in all the samples with CV more than 1000 copies/ml. When CMV was made in blood, 11/22 (50%) had a high CV. Only one newborn had a high CV at CRL. 44% have affectation at transfontanellar ultrasound evidenced by vasculopathy (62%), intraventricular hemorrhage (IVH) or periventricular calcifications (20%). 68% were asymptomatic, al though 20% had a retarded intrauterine growth (RIG) at birth or clinical features or analytical were objectified (neutropenia, thrombocytopenia, cholestasis). 33% got treatment with val ganciclovir and 33% had sequelae (hearing loss).
Conclusions. CMV congenital infection is still a severe public health issue in developed countries. Most of the cases are mild or asymptomatic even though we should have high clinical suspicion with compatible symptoms and consistent maternal history in order to make an early diagnosis and treatment to prevent or reduce sequelae.

Rev Esp Quimioter 2024; 37(4): 351-355 [Texto completo PDF]


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Rev Esp Quimioter 2024, 37(5): 369-386

New materials and complications of prostheses in humans: situation in Spain

MARÍA VALLET-REGÍ, ARÍSTIDES DE ALARCÓN, ENRIQUE GÓMEZ BARRENA, JOSEP A. PLANELL, JACOBO SILVA, EMILIO BOUZA

Published: 23 May 2024

http://www.doi.org/10.37201/req/039.2024

Prostheses or implantable medical devices (IMDs) are parts made of natural or artificial materials intended to replace a body structure and therefore must be well tolerated by living tissues. The types of IMDs currently available and usable are very varied and capable of replacing almost any human organ. A high but imprecise percentage of Spaniards are carriers of one or more IMDs to which they often owe their quality of life or survival. IMDs are constructed with different types of materials that are often combined in the same prosthesis. These materials must combine harmlessness to human tissues with high wear resistance. Their durability depends on many factors both on the host and the type of prosthesis, but the vast majority last for more than 10-15 years or remain in function for the lifetime of the patient. The most frequently implanted IMDs are placed in the heart or great vessels, joints, dental arches or breast and their most frequent complications are classified as non-infectious, particularly loosening or intolerance, and infectious. Complications, when they occur, lead to a significant increase in morbidity, their repair or replacement multiplies the health care cost and, on occasions, can cause the death of the patient. The fight against IMD complications is currently focused on the design of new materials that are more resistant to wear and infection and the use of antimicrobial substances that are released from these materials. Their production requires multidisciplinary technical teams, but also a willingness on the part of industry and health authorities that is not often found in Spain or in most European nations. Scientific production on prostheses and IMD in Spain is estimated to be less than 2% of the world total, and probably below what corresponds to our level of socio-economic development. The future of IMDs involves, among other factors, examining the potential role of Artificial Intelligence in their design, knowledge of tissue regeneration, greater efficiency in preventing infections and taking alternative treatments beyond antimicrobials, such as phage therapy. For these and other reasons, the Ramón Areces Foundation convened a series of experts in different fields related to prostheses and IMDs who answered and discussed a series of questions previously formulated by the Scientific Council. The following lines are the written testimony of these questions and the answers to them.

Rev Esp Quimioter 2024;  37(5): 369-386 [Full-text PDF]


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