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Rev Esp Quimioter 2024, 37(4): 285-298

Meningococcal meningitis in Spain in the Horizon 2030: A position paper

FERNANDO MORAGA-LLOP, ELENA ANDRADAS, LUIS CARLOS BLESA-BAVIERA, RAFAEL CANTÓN, JUAN GONZÁLEZ DEL CASTILLO, FEDERICO MARTINÓN-TORRES, ELENA MOYA, ANTONI TRILLA, JULIO VAZQUEZ, RODOLFO JAVIER VILLENA, JULIÁN RUIZ-GALIANA, PILAR DE LUCAS RAMOS, ALEJANDRA GARCÍA-BOTELLA, ALBERTO GARCÍA-LLEDÓ, TERESA HERNÁNDEZ-SAMPELAYO, JAVIER GÓMEZ-PAVÓN, MARI CRUZ MARTÍN-DELGADO, FRANCISCO JAVIER MARTÍN SÁNCHEZ, MANUEL MARTÍNEZ-SELLÉS, JOSÉ MARÍA MOLERO GARCÍA, SANTIAGO MORENO GUILLÉN, FERNANDO RODRÍGUEZ-ARTALEJO, EMILIO BOUZA

Published: 22 March 2024

http://www.doi.org/10.37201/req/023.2024

Meningococcal meningitis (MM) and invasive meningococcal disease remain a major public health problem that generates enormous public alarm. It is caused by Neisseria meningitidis, a Gram-negative diplococcus with an enormous capacity for acute and rapidly progressive disease, both episodic and epidemic in nature, with early diagnosis and treatment playing a major role. It occurs at any age, but is most common in children under 5 years of age followed by adolescents. Although most cases occur in healthy people, the incidence is higher in certain risk groups. Despite advances in reducing the incidence, it is estimated that in 2017 there were around 5 million new cases of MM worldwide, causing approximately 290,000 deaths and a cumulative loss of about 20,000,000 years of healthy life. In Spain, in the 2021/22 season, 108 microbiologically confirmed cases of MM were reported, corresponding to an incidence rate of 0.23 cases per 100,000 inhabitants. This is a curable and, above all, vaccine-preventable disease, for which the World Health Organisation has drawn up a roadmap with the aim of reducing mortality and sequelae by 2030. For all these reasons, the Illustrious Official College of Physicians of Madrid (ICOMEM) and the Medical Associations of 8 other provinces of Spain, have prepared this opinion document on the situation of MM in Spain and the resources and preparation for the fight against it in our country. The COVID-19 and Emerging Pathogens Committee of ICOMEM has invited experts in the field to participate in the elaboration of this document.

Rev Esp Quimioter 2024; 37(4): 285-298 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(3): 209-220

Microbiological and epidemiological features of respiratory syncytial virus

IVÁN SANZ-MUÑOZ, LAURA SÁNCHEZ-DE PRADA, JAVIER CASTRODEZA-SANZ, JOSÉ M EIROS

Published: 21 Mach 2024

http://www.doi.org/10.37201/req/006.2024

The properties of the main surface proteins and the viral cycle of the respiratory syncytial virus (RSV) make it an attractive pathogen from the perspective of microbiology. The virus gets its name from the manner it infects cells, which enables it to produce syncytia, which allow the virus’ genetic material to move across cells without having to release viral offspring to the cellular exterior, reducing immune system identification. This causes a disease with a high impact in both children and adults over 60, which has sparked the development of several preventive interventions based on vaccines and monoclonal antibodies for both age groups. The epidemiological characteristics of this virus, which circulates in epidemics throughout the coldest months of the year and exhibits a marked genetic and antigenic drift due to its high mutation capability, must be taken into consideration while using these preventive methods. The most important microbiological and epidemiological elements of RSV are covered in this study, along with how they have affected the creation of preventive medications and their use in the future.

Rev Esp Quimioter 2024; 37(3): 209-220 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(3): 221-251

Candent issues in pneumonia. Reflections from the Fifth Annual Meeting of Spanish Experts 2023

CRISTÓBAL M RODRÍGUEZ-LEAL, CARLOS GONZÁLEZ-CORRALEJO, FRANCISCO JAVIER CANDEL, MIGUEL SALAVERT, ON BEHALF OF COLLABORATIVE AUTHORS AND MEDICAL SOCIETIES FOR THE 5TH EDITION OF PNEUMONIA DAY

Published: 4 Mach 2024

http://www.doi.org/10.37201/req/018.2024

Pneumonia is a multifaceted illness with a wide range of clinical manifestations, degree of severity and multiple potential causing microorganisms. Despite the intensive research of recent decades, community-acquired pneumonia remains the third-highest cause of mortality in developed countries and the first due to infections; and hospital-acquired pneumonia is the main cause of death from nosocomial infection in critically ill patients. Guidelines for management of this disease are available world wide, but there are questions which generate controversy, and the latest advances make it difficult to stay them up to date. A multidisciplinary approach can overcome these limitations and can also aid to improve clinical results. Spanish medical societies involved in diagnosis and treatment of pneumonia have made a collaborative effort to actualize and integrate last expertise about this infection. The aim of this paper is to reflect this knowledge, communicated in Fifth Pneumonia Day in Spain. It reviews the most important questions about this disorder, such as microbiological diagnosis, advances in antibiotic and sequential therapy, management of beta-lactam allergic patient, preventive measures, management of unusual or multi-resistant microorganisms and adjuvant or advanced therapies in Intensive Care Unit.

Rev Esp Quimioter 2024; 37(3): 221-251 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(3): 203-208

Clinical study types and guidance for their correct post-pandemic interpretation

MANUEL MARTÍNEZ-SELLÉS, LUIS PRIETO-VALIENTE

Published: 26 February 2024

http://www.doi.org/10.37201/req/003.2024

Randomized clinical trials (RCTs) are key to the advancement of medicine and microbiology, but they are not the only option. Observational studies provide information on long-term efficacy and safety, are less expensive, allow the study of rare events, and obtain information more quickly than RCTs. On the other hand, they are more vulnerable to confounding factors.
Prospective exploratory pilot studies share many aspects with RCTs but are not subject to supervision by external commissions or mandatory registration. Multitesting can pervert the balance of publications in favor of the desired effect. Bonferroni’s reasoning shows that if 10 studies are performed with an ineffective antibiotic, the probability that at least one will show P <0.05 might be 40%. Scenarios in which there is intensive pressure to perform research, such as the recent pandemic, might result in many research teams trying to study the effect of an antimicrobial. Even if the drug has no efficacy, if 100 research teams conduct a study to assess its usefulness, it might be virtually certain that at least one will get a P value <0.05. If the other studies (with P >0.05) are not published, the scientific commu nity would consider that there is strong evidence in favor of its usefulness.
In conclusion, RCTs are a very good source of clinical information, but are not the only one. The systematic registration of all research can and should be applied to all types of clinical studies.

Rev Esp Quimioter 2024; 37(3): 203-208 [Full-text PDF] [Supplementary material PDF]


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Rev Esp Quimioter 2024; 37(2): 196-198

Paciente con alergia a medicamentos antituberculosos de primera línea

XABIER LARREA URTARAN, ANNA DORDÀ BENITO, LAURA GRATACÓS SANTANACH, ELISABET NOGUÉ PUJADAS, RAQUEL AGUILAR SALMERON, XAVIER SALGADO SERRANO

Published: 23 February 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/140.2023

Rev Esp Quimioter 2024; 37(2): 196-198 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(2): 199-202

Secondary lumbosacral echinococcosis as presumptive sequelae of other primary locations

DOMINGO FERNÁNDEZ VECILLA, MARY PAZ ROCHE MATHEUS, MARÍA CARMEN NIETO TOBOSO, ROBERTO MONGIL ESCUDERO, VICTOR MIGUEL MARTÍNEZ, ITXASO LOMBIDE AGUIRRE, JOSU MIRENA BARAIA-ETXABURU ARTETXE, FERNANDO DÍEZ RENOVALES, JAUME ROSSELLÓ SORIA, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO

Published: 23 February 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/148.2023

Rev Esp Quimioter 2024; 37(2): 199-202 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(2): 193-195

Absceso en psoas secundario a infección de endoprótesis aortica abdominal por Listeria monocytogenes

BELÉN GONZÁLEZ FERNÁNDEZ, SONSOLES GARCINUÑO PÉREZ, LAURA SÁNCHEZ-DE PRADA, IGNACIO EIROS-BACHILLER, JOSÉ ANTONIO BRIZUELA SANZ, JOSÉ M. EIROS

Published: 20 February 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/135.2023

Rev Esp Quimioter 2024; 37(2): 193-195 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(2): 163-169

Antibiotic stewardship programs in the Spanish emergency services: PROA-URG Study

JESÚS RUIZ RAMOS, ANA SUÁREZ-LLEDÓ GRANDE, MARÍA ROSARIO SANTOLAYA PERRÍN, CARMEN CABALLERO REQUEJO, MARIAM HIJAZI VEGA, LAIA LÓPEZ VINARDELL, ÁNGELES GARCÍA MARTÍN, YLENIA CAMPOS BAETA, ANA JOSEFA MARCOS GONZÁLEZ, MONTSERRAT ALONSO DÍEZ, SILVIA CONDE GINER, SAÚL HERRERA CARRANZA, ANA SUCH DIÁZ, MARGARITA PRATS RIERA, LARA MENENDEZ LIENDO, CRISTINA TORO BLANCH, ANA REVUELTA AMALLO, CRISTINA CALZÓN BLANCO, EN REPRESENTACIÓN DEL GRUPO PROA-URGENCIAS

Published: 19 February 2024

http://www.doi.org/10.37201/req/138.2023

Introduction. Antimicrobial stewardship programs (ASP) have become a key tool in the adaptation of these drugs to the health system. The information available on the application and indicators used in these programs in emergency departments is scarce. The objective of this study is to know the extent of ASP implementation in the emergency departments, as well as the use of antimicrobials in these units.
Material and methods. Multicenter retrospective study. An invitation was sent to all participants of the REDFASTER-SEFH emergency pharmacist working group. A questionnaire was used consisting of 21 items, answered by a team made up of a pharmacist, emergency room specialist, infectious disease specialist and microbiologist.
Results. Eighteen hospitals completed the survey. Fourteen (77.8%) had an ASP manager. The DDD value per 1000 admissions ranged between 36.5 and 400.5 (median: 100.4 [IQR:57.2-157.3]). Both carbapenem and macrolide group presented wide variability in use. Six (33.3%) hospitals had an annual report on the specific resistance profile for urine and blood cultures. The percentage of multi-drug resistant strains in urine cultures was 12.5% and in blood cultures 12.2%. The percentage of adequacy in the bacteremia treatment was 81.0% (IQR:74.6-85.0%), while in urinary tract infections was 78.0% (IQR:71.5-88.0).
Conclusions. Despite the existence of ASP members in emergency services, as well as the training activity and local guidelines is common. knowledge of the use of antimicrobials and resistances is limited. Future activities must be aimed at improving information about the ASP results in these units.

Rev Esp Quimioter 2024; 37(2): 163-169 [Texto completo PDF]


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Rev Esp Quimioter 2024;37(1): 88-92

Rapid AST: Possibility of inferring resistance mechanisms with complex phenotypes

JORGE LIGERO-LÓPEZ, IKER FALCES-ROMERO, ALFONSO ARANDA-DÍAZ, DIANA GARCÍA-BALLESTEROS, JULIO GARCÍA-RODRÍGUEZ, EMILIO CENDEJAS-BUENO

Published: 8 November 2023

http://www.doi.org/10.37201/req/043.2023

The new automated systems designed for rapid performance of AST have significantly reduced the response time for susceptibility testing of microorganisms causing bacteremia and sepsis. The Accelerate Pheno® system (AAC) is one such system. Our objective for this study was to determine whether the AAC system is capable of providing an accurate susceptibility profile to infer resistance mechanisms in different carbapenemase-producing isolates when compared to the MicroScan WalkAway System (MWS). Disk diffusion method was also performed on all isolates as a reference method. Additionally, we compared the results obtained with the routine AST production system. We selected 19 isolates from the cryobank of the Microbiology department, all of which were carbapenemase-producing gram-negative bacilli. AAC was able to identify and infer the resistance of a total of 10 isolates, with an EA and CA of 84.2% for meropenem and 88.2% and 64.7% for ertapenem EA and CA, respectively. If we consider the disk diffusion technique, the CA was 57.9% and 76.5% for meropenem and ertapenem. However, in the presence of carbapenemases, AAC was not able to provide adequate MICs or infer the resistance mechanisms of the isolates accurately. Further studies with a larger number of isolates, including the new antibiotics ceftolozane/tazobactam and ceftazidime/avibactam, are needed for a more comprehensive comparison.

Rev Esp Quimioter 2024;37(1): 88-92 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(2): 176-179

Is it in their eyes? Correlation between microorganisms isolated from bronchial aspirates and conjunctival swabs in a Pediatric Intensive Care Unit

JORGE LIGERO-LÓPEZ, LUIS ESCOSA-GARCÍA, CRISTINA SCHÜFFELMANN-GUTIÉRREZ, MARÍA LAPLAZA-GONZÁLEZ, MARÍA INMACULADA QUILES-MELERO, FRANCISCO MORENO-RAMOS, FERNANDO BAQUERO-ARTIGAO, JUANA CACHO-CALVO, EMILIO CENDEJAS-BUENO

Published: 23 January 2024

http://www.doi.org/10.37201/req/116.2023

Objectives. Our observational, retrospective study aimed to determine the correlation between bacteria isolated from bronchial aspirates of pediatric ICU patients (PICU) with respiratory infections and those obtained from conjunctival swabs of the same patients exhibiting clinical conjunctivitis.
Material and methods. Throughout the period from 2015 to 2022, we reviewed all clinically significant bronchial aspirates (≥105 CFU/mL) and positive conjunctival swabs obtained from PICU patients. These records were retrieved from the microbiology database, cross-referencing the data to identify patients who tested positive for both during the same clinical episode.
Results. The median age of the patients was 5 months (interquartile range: 1-7). Among the cohort, twenty-one patients exhibited positivity in both bronchial aspirate and conjunctival swab samples, showcasing a microbial match in 85.71% of cases (18 out of 21). The most frequently isolated microorganisms were Haemophilus influenzae (55.6%), followed by Pseudomonas aeruginosa (14.3%), Klebsiella aerogenes (9.5%), and Escherichia coli, Stenotrophomonas maltophilia, and Enterobacter cloacae, each accounting for 4.8% of the isolates.
Conclusions. Our study demonstrates a strong concordance between the isolated microorganisms from both samples in patients presenting clear symptoms of clinical conjunctivitis. These findings provide a basis for future prospective studies that may leverage conjunctival swabs as a predictive tool for identifying microorganisms involved in respiratory infections.

Rev Esp Quimioter 2024; 37(2): 176-179 [Full-text PDF]


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