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Rev Esp Quimioter 2023; 36(5): 440-465

Sexually transmitted infections in Spain: Current status

JORGE DEL ROMERO, 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, MARI CRUZ MARTÍN-DELGADO, FRANCISCO JAVIER MARTÍN SÁNCHEZ, MANUEL MARTÍNEZ-SELLÉS, JOSÉ MARÍA MOLERO GARCÍA, JAVIER GÓMEZ CASTELLÁ, MARÍA PALOMO, ROCÍO GARCÍA BERRIO, ALDINA COUSO GONZÁLEZ, CÉSAR SOTOMAYOR, EMILIO BOUZA

Published: 19 June 2023

http://www.doi.org/10.37201/req/038.2023

Sexually Transmitted Infections (STI) are a major public health problem. The problems inherent to their diagnosis, treatment and prevention have to do not only with their nature, but also with organizational issues and overlapping competencies of the different health authorities in Spain.
The real situation of STI in Spain, at present, is poorly known. For this reason, the Scientific Committee on COVID and Emerging Pathogens of the Illustrious Official College of Physicians of Madrid (ICOMEM) has formulated a series of questions on this subject which were distributed, not only among the members of the Committee, but also among experts outside it. The central health authorities provide very high and increasing figures for gonococcal infection, syphilis, Chlamydia trachomatis infection and lymphogranuloma venereum (LGV). Both HIV infection and Monkeypox are two important STI caused by viruses in our environment, to which it should be added, mainly, Herpes simplex virus (HSV) and Human papillomavirus (HPV) infections. Emerging microorganisms such as Mycoplasma genitalium pose not only pathogenic challenges but also therapeutic problems, as in the case of N. gonohrroeae.
The pathways that patients with suspected STI follow until they are adequately diagnosed and treated are not well known in Spain. Experts understand that this problem is fundamentally managed in public health institutions, and that Primary Care and Hospital Emergency Services, together with some institutions that deal monographically with this problem, are the recipients of most of these patients. One of the most serious difficulties of STI lies in the availability of the microbiological tests necessary for their diagnosis, particularly in this era of outsourcing of microbiology services. Added to this is the increased cost of implementing the latest generation of molecular techniques and the difficulties of transporting samples.
It is clear that STI are not diseases to which the entire population is equally exposed and it is necessary to have a better knowledge of the risk groups where to focus the necessary interventions adapted to their characteristics. It should not be forgotten that STI are also a problem in the pediatric age group and that their presence can be a marker of sexual abuse with all that this implies in terms of health care and medicolegal activity.
Finally, STI are infections that are associated with a high cost of care for which we have very little information. The possibility of expanding the automatic performance of laboratory tests for STI surveillance through laboratory routines is encountering ethical and legal problems that are not always easy to solve.
Spain has created a ministerial area of specific attention to STI and there are plans to improve the diagnosis, treatment and prevention of these problems, but we still lack the necessary evidence on their impact. We cannot forget that these are diseases that transcend the individual and constitute a Public Health problem.

Rev Esp Quimioter 2023; 36(5): 440-465 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(5): 507-515

The PHH-1V HIPRA vaccine: a new tool in the vaccination strategy against COVID-19

CRISTINA BORRALLERAS, JAVIER CASTRODEZA SANZ, PILAR ARRAZOLA, CARMEN CÁMARA HIJÓN, JOSÉ Mª EIROS, MARÍA FERNÁNDEZ-PRADA, ÁNGEL GIL DE MIGUEL, GLORIA MIRADA MASIP, FERNANDO MORAGA-LLOP, DANIEL OCAÑA RODRÍGUEZ, JOAN PUIG-BARBERÀ, JORGE VÁZQUEZ, JÚLIA VERGARA-ALERT, SALOMÉ DE CAMBRA

Published: 12 June 2023

http://www.doi.org/10.37201/req/046.2023

Objectives. Vaccination against SARS-CoV-2 is essential to mitigate the personal, social and global impact of the coronavirus disease (COVID-19) as we move from a pandemic to an endemic phase. Vaccines are now required that offer broad, long-lasting immunological protection from infection in addition to protection from severe illness and hospitalisation. Here we present a review of the evidence base for a new COVID-19 vaccine, PHH-1V (Bimervax®; HIPRA HUMAN HEALTH S.L.U), and the results of an expert consensus.
Materials and methods. The expert committee consisted of Spanish experts in medicine, family medicine, paediatrics, immunology, microbiology, nursing, and veterinary medicine. Consensus was achieved using a 4-phase process consisting of a face-to-face meeting during which the scientific evidence base was reviewed, an online questionnaire to elicit opinions on the value of PHH-1V, a second face-to-face update meeting to discuss the evolution of the epidemiological situation, vaccine programmes and the scientific evidence for PHH-1V and a final face-to-face meeting at which consensus was achieved.
Results. The experts agreed that PHH-1V constitutes a valuable novel vaccine for the development of vaccination programmes aimed towards protecting the population from SARS-CoV-2 infection and disease. Consensus was based on evidence of broad-spectrum efficacy against established and emerging SARS-CoV-2 variants, a potent immunological response, and a good safety profile. The physicochemical properties of the PHH-1V formulation facilitate handling and storage appropriate for global uptake.
Conclusions. The physicochemical properties, formulation, immunogenicity and low reactogenic profile of PHH-1V confirm the appropriateness of this new COVID-19 vaccine.

Rev Esp Quimioter 2023; 36(5): 507-515 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(5): 470-476

Adequacy of the consumption of antipseudomonal antibiotics after changes in the 2019 EUCAST criteria

ELENA HERRANZ-BAYO, RAFAEL HUARTE-LACUNZA, ANDREA PINILLA-RELLO, IRENE AGUILÓ-LAFARGA, ANA ISABEL LÓPEZ-CALLEJA

Published: 7 June 2023

http://www.doi.org/10.37201/req/137.2022

Introduction. In 2019, the European Committee for the Study of Antibiotic Susceptibility modified the categories of antibiotic susceptibility tests to include the term “susceptible with increased exposure”. Following the dissemination of local protocols reflecting these modifications, the aim of our study was to analyse whether prescribers have adapted to them and the clinical impact in cases of inadequacy.
Material and methods. Observational and retrospective study of patients with infection who received antipseudomonal antibiotics from January to October 2021 in a tertiary hospital.
Results. Non-adherence to the guideline recommendations was 57.6% in the ward and 40.4% in the ICU (p<0.05). In both the ward and ICU, the group with the most prescriptions not by the guideline recommendations were aminoglycosides (92.9% and 64.9% respectively) for using suboptimal doses, followed by carbapenems (89.1% and 53.7% respectively) for not administering an extended infusion. On the ward, the mortality rate during admission or at 30 days in the inadequate therapy group was 23.3% vs 11.5% in those who received adequate treatment (OR: 2.34; 95% CI 1.14-4.82); in ICU there were no statistically significant differences.
Conclusions. The results show the need to implement measures to ensure better dissemination and knowledge of key concepts in antibiotic management, to ensure increased exposures, and to be able to provide better infection coverage, as well as to avoid amplifying resistant strains.

Rev Esp Quimioter 2023; 36(5): 470-476 [Texto completo PDF] [Material suplementario – PDF]


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Rev Esp Quimioter 2023; 36(5): 516-518

Role of Hologic® Panther AptimaTM SARS-CoV-2 assay in the detection of SARS-CoV-2: screening or diagnostic technique?

CRISTINA GARCÍA-SALGUERO, LUIS VALLEJO, MERCERDES MARTÍNEZ-RODRÍGUEZ, ALBERTO DELGADO-IRIBARREN, ESTHER CULEBRAS

Published: 2 June 2023

http://www.doi.org/10.37201/req/135.2022

During the multiple waves of COVID-19 suffered all over the world, having a rapid and sensitive diagnostic test has become a priority for microbiology laboratories. The AptimaTM SARS-CoV-2 transcription-mediated amplification (TMA) assay running on the Panther system (Hologic) was presented as a very good option to cover this need. To evaluate this system, 570 respiratory samples were included in the study and were processed both by the Panther (Hologic) system and by qRT-PCR (Thermo Fisher Science, Waltham, USA), current assay for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A high number of false positives (n=76) was obtained with Panther system (Hologic), but the number of false positives decreases as the relative light units (RLU) value increases. These results show that this technique can be a good option for sample screening but checking for positive results should be mandatory, especially those with low RLU values.

Rev Esp Quimioter 2023; 36(5): 516-518 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(5): 519-525

Tuberculous otitis media: A case presentation and review of european literature

MARÍA AGUILERA-FRANCO, ANA FRANCO-ACOSTA, ANA F YÉPEZ-NARANJO, JAVIER RODRÍGUEZ-GRANGER, ANTONIO SAMPEDRO, JOSÉ MARÍA NAVARRO-MARI

Published: 2 June 2023

http://www.doi.org/10.37201/req/011.2023

Tuberculous otitis media (TOM) is a rare affectation in our environment that represents a challenge in its diagnosis due to the non-specific symptoms that it usually presents. This paper presents our experience in the diagnosis of a case of TOM in a 66-year-old woman with hearing loss and chronic otorrhea of more than 6 months of evolution that did not respond to conventional treatments. In addition, a review of the cases published in the last 20 years (2000-2022) in countries of the European Union (EU) is carried out. The most common symptoms were otorrhea (n=43; 100%), hearing loss (n=37; 86.05%), eardrum perforation (n=19; 44.18%), facial paralysis (n=12, 27,91%) and ear pain (n=13; 30,23%). The most used sample for diagnosis was the biopsy obtained by mastoidectomy (n=34; 79.06%). All patients were given antituberculous therapy for a mean duration of 8.11 months (range, 6-12 months). The most frequent aftereffect was hearing loss (n=28; 65.12%). TOM should be included in the differential diagnosis of chronic suppurative otitis, since early diagnosis and treatment reduce the probability of suffering irreversible sequelae.

Rev Esp Quimioter 2023; 36(5): 519-525 [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(5): 539-540

Neisseria meningitidis, más allá de la afectación del sistema nervioso central

HANSANEE FERNÁNDEZ MANANDU, ESTÍBALIZ MOLINA ITURRITZA, IRENE SAN JOSÉ MUÑIZ, MIREN URRESTARAZU LARRAÑAGA

Published: 1 June 2023

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/015.2023

Rev Esp Quimioter 2023; 36(5): 539-540 [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(5): 533-535

Neumonía asociada a derrame parapneumónico en paciente inmunocompetente causado por Bordetella bronchiseptica

DOMINGO FERNÁNDEZ VECILLA, MARY PAZ ROCHE MATHEUS, GOTZON IGLESIAS HIDALGO, MIREN JOSEBE UNZAGA BARAÑANO, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO

Published: 1 June 2023

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/006.2023

Rev Esp Quimioter 2023; 36(5): 533-535 [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(4): 434-435

Use of ceftaroline in complex central nervous system infections

ALICIA ALONSO ÁLVAREZ, EFRÉN SÁNCHEZ VIDAL, LUCÍA RAMOS MERINO, DOLORES SOUSA REGUEIRO, JOAQUÍN SERRANO AREBA, ENRIQUE MÍGUEZ REY, PEDRO LLINARES MODÉJAR

Published: 17 May 2023

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/143.2022

Rev Esp Quimioter 2023; 36(4): 434-435  [Full-text PDF]

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Rev Esp Quimioter 2023; 36(5): 477-485

Antimicrobial stewardship program in an Intensive Care Unit: A retrospective observational analysis of the results 15 months after its implementation

DAVID PÉREZ-TORRES, LUIS MARIANO TAMAYO-LOMAS, MARTA DOMÍNGUEZ-GIL GONZÁLEZ, ROSENDO ALMENDROS-MUÑOZ, MARÍA AURORA SACRISTÁN-SALGADO, ESTHER GONZÁLEZ-GONZÁLEZ, JOSÉ ÁNGEL BEREZO-GARCÍA, CRISTINA DÍAZ-RODRÍGUEZ, ISABEL CANAS-PÉREZ, BELÉN LORENZO-VIDAL, JOSÉ MARÍA EIROS-BOUZA

Published: 31 May 2023

http://www.doi.org/10.37201/req/142.2022

Objective. We aim to evaluate the adherence rate to an Antimicrobial Stewardship Program (ASP) in an Intensive Care Unit (ICU), and to assess its effect on the use of antibiotics, quality indicators and clinical outcomes.
Patients and methods. Retrospective description of the interventions proposed by the ASP. We compared antimicrobial use, quality and safety indicators in an ASP versus a non-ASP period. The study was performed in a polyvalent ICU of a medium-size University Hospital (600 beds). We studied patients admitted to the ICU for any cause during the ASP period, provided that a microbiological sample aiming to diagnose a potential infection has been drawn, or antibiotics have been started. We elaborated and registered of non-mandatory recommendations to improve antimicrobial prescription (audit and feedback structure) and its registry during the ASP period (15 months, October 2018-December 2019). We compared indicators in a period with ASP (April-June 2019) and without ASP (April-June 2018).
Results. We issued 241 recommendations on 117 patients, 67% of them classified as de-escalation type. The rate of adherence to the recommendations was high (96.3%). In the ASP period, the mean number of antibiotics per patient (3.3±4.1 vs 2.4±1.7, p=0.04) and the days of treatment (155 DOT/100 PD vs 94 DOT/100 PD, p <0.01) were reduced. The implementation of the ASP did not compromise patient safety or produce changes in clinical outcomes.
Conclusion. The implementation of an ASP is widely accepted in the ICU, reducing the consumption of antimicrobials, without compromising patient safety.

Rev Esp Quimioter 2023; 36(5): 477-485 [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(4): 432-433

Bacteriemia por Solobacterium moorei en paciente con sinusitis       

IZASKUN ALEJO-CANCHO, ANA GUAL-DE-TORRELLA, RAQUEL VIELBA POSTIGO, IÑIGO PEREZ ABRAGUIN, LAURA REDONDO FARIAS, MARÍA JOSÉ LOPEZ DE GOIKOETXEA

Published: 17 May 2023

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/141.2022

Rev Esp Quimioter 2023; 36(4): 432-433  [Full-text PDF]


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