JOSÉ ORTIZ, FRANCISCO JOVER, VICTORIA ORTIZ DE LA TABLA, ELISABET DELGADO
Published: 27 April 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/132.2022
Rev Esp Quimioter 2023; 36(4): 421-424 [Full-text PDF]
FRANCISCO JAVIER CANDEL, MIGUEL SALAVERT, DAVID LORITE MINGOT, MARTA MANZANO CRESPO, PAULA PÉREZ PORTERO, RAFAEL CUERVO PINTO
Published: 24 April 2023
http://www.doi.org/10.37201/req/023.2023
Recipients of solid organ transplants (SOT) are at higher risk of infection by SARS-CoV-2 virus especially due to chronic immunosuppression therapy and frequent multiple comorbid conditions. COVID-19 is a potentially life-threatening disease in SOT recipients, with an increased likelihood of progressing to severe disease, with the need of hospitalization, admission to the intensive care unit (ICU) and mechanical ventilatory support. This article presents an updated review of different aspects related to the outcome of COVID-19 in SOT recipients. In nvaccinated SOT recipients, COVID-19 is associated with a high mortality rate, in-patient care and ICU admission, and impaired graft function or rejection in severe disease. In vaccinated SOT recipients even after full vaccination, there is a reduction of the risk of mortality, but the course of COVID-19 may continue to be severe, influenced by the time from transplant, the net state of immunosuppression and having suffered graft rejection or dysfunction. SOT recipients develop lower immunity from mRNA vaccines with suboptimal response. Treatment with mAbs provides favorable outcomes in non-hospitalized SOT recipients at high risk for severe disease, with lower rates of hospitalization, emergency department visits, ICU care, progression to severe disease, and death. However, broad vaccination and therapeutic options are required, particularly in light of the tendency of the SARS-CoV-2 virus to adapt and evade both natural and vaccine-induced immunity.
Rev Esp Quimioter 2023; 36(4): 380-391 [Full-text PDF]
GRAPHICAL ABSTRACT
SARAY MORMENEO BAYO, ALBA BELLÉS BELLÉS, IVÁN PRATS SÁNCHEZ, ERIC LÓPEZ GONZÁLEZ, JESÚS ARAMBURU ARNUELOS, ALBERT BERNET SÁNCHEZ, MERCÈ GARCÍA GONZÁLEZ
Published: 20 April 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/133.2022
Rev Esp Quimioter 2023; 36(4): 425-426 [Full-text PDF]
MARÍA PILAR ARRAZOLA MARTÍNEZ, JOSÉ MARÍA EIROS BOUZA, PERE PLANS RUBIÓ, JOAN PUIG-BARBERÀ, JESÚS RUIZ ARAGÓN, ÁLVARO TORRES LANA
Published: 20 April 2023
http://www.doi.org/10.37201/req/145.2022
Most of the complications and deaths related to seasonal flu occur in the elderly population (≥65 years) with comorbidities, and the influenza vaccine is the most effective way to prevent them. Immunization is less effective in older adults due to immunosenescence. MF59-adjuvanted vaccines, designed to improve the magnitude, persistence and amplitude of the immune response in elderly people, have been used in clinical practice since 1997 in their trivalent formulation and, since 2020, in their tetravalent formulation. Data from various studies show that these vaccines are not only safe for all age groups, with a reactogenicity profile similar to that of the conventional vaccine, but also that they are especially effective in boosting the immune response in the population aged 65 or over by increasing antibody titers after vaccination and significantly reducing the risk of hospital admission. Adjuvanted vaccines have been shown to provide cross-protection against heterologous strains and to be as effective as the high-dose vaccine in the population aged 65 or over. In this review, the scientific evidence on the efficacy and effectiveness of the MF59-adjuvanted vaccine in real clinical practice in people ≥65 years of age is analyzed through a narrative and descriptive review of the literature with data from clinical trials, observational studies and systematic reviews or meta-analysis.
Rev Esp Quimioter 2023; 36(4): 334-345 [Texto completo – PDF]
MANUEL MIRÓN-RUBIO, JUAN JOSÉ PARRA JORDÁN, VÍCTOR JOSÉ GONZÁLEZ RAMALLO, ABEL MUJAL MARTÍNEZ, JOSEFINA FERNÁNDEZ MUIXÍ, MARINA IGLESIAS GALLEGO, MARÍA CRUZ LUCAS NÚÑEZ, ELISA RODADO ALABAU, SANDRA VIDAL PEREZ-CAMPOAMOR, ESTEFANY URÍA
Published: 5 April 2023
http://www.doi.org/10.37201/req/134.2022
Objective. To describe and quantify resource use and direct health costs associated with skin and skin structure infections (SSSIs) caused by Gram-positive bacteria in adults receiving outpatient parenteral antimicrobial therapy (OPAT), administered by Hospital at Home units (HaH) in Spain.
Material and methods. Observational, multicenter, retrospective study. We included patients of both sexes included in the HaH-based OPAT Registry during 2011 to 2017 who were hospitalized due to SSSIs caused by Gram-positive bacteria. Resource use included home visits (nurses and physician), emergency room visits, conventional hospitalization stay, HaH stay and antibiotic treatment. Costs were quantified by multiplying the natural units of the resources by the corresponding unit cost. All costs were updated to 2019 euros.
Results. We included 194 episodes in 189 patients from 24 Spanish hospitals. The most frequent main diagnoses were cellulitis (26.8%) and surgical wound infection (24.2%), and 94% of episodes resulted in clinical improvement or cure after treatment. The median HaH stay was 13 days (interquartile range [IR]:8-22.7), and the conventional hospitalization stay was 5 days (IR: 1-10.7). The mean total cost attributable to the complete infectious process was €7,326 (95% confidence interval: €6,316-€8,416).
Conclusions. Our results suggest that OPAT administered by HaH is a safe and efficient alternative for the management of these infections and could lead to lower costs compared with hospital admission.
Rev Esp Quimioter 2023; 36(3): 291-301 [Full-text PDF] [Supplementary material PDF]
JOSÉ RAMÓN AZANZA, JOSÉ MENSA, JOSÉ BARBERÁN, LOURDES VÁZQUEZ, JAIME PÉREZ DE OTEYZA, MI KWON, LUCRECIA YÁÑEZ, JOSÉ MARÍA AGUADO, ANTONIO CUBILLO GRACIAN, CARLOS SOLANO, ISABEL RUIZ CAMPS, JESÚS FORTÚN, MIGUEL SALAVERT LLETÍ, CARLOTA GUDIOL, TERESA OLAVE RUBIO, CAROLINA GARCÍA-VIDAL, MONTSERRAT ROVIRA TARRATS, MARÍA SUÁREZ-LLEDÓ GRANDE, PEDRO GONZÁLEZ-SIERRA, CARLOS DUEÑAS GUTIÉRREZ
Published: 5 April 2023
http://www.doi.org/10.37201/req/013.2023
The administration of antifungals for therapeutic and, especially, prophylactic purposes is virtually a constant in patients requiring hematology-oncology treatment. Any attempt to prevent or treat Aspergillus or Mucor infections requires the administration of some drugs in the azole group, which include voriconazole, posaconazole and isavuconazole, noted for their activity against these pathogens. One very relevant aspect is the potential risk of interaction when associated with one of the antineoplastic drugs used to treat hematologic tumors, with serious complications. In this regard, acalabrutinib, bortezomib, bosutinib, carfilzomib, cyclophosphamide, cyclosporine A, dasatinib, duvelisib, gilteritinib, glasdegib, ibrutinib, imatinib, nilotinib, ponatinib, prednisone, ruxolitinib, tacrolimus, all-transretinoic acid, arsenic trioxide, venetoclax, or any of the vinca alkaloids, are very clear examples of risk, in some cases because their clearance is reduced and in others because of increased risk of QTc prolongation, which is particularly evident when the drug of choice is voriconazole or posaconazole.
Rev Esp Quimioter 2023; 36(3): 226-258 [Full-text PDF]
EMILIO BOUZA, JOSÉ AUGUSTO GARCÍA NAVARRO, SERGIO ALONSO, JUAN CARLOS DURAN ALONSO, CARINA ESCOBAR, BENITO J. FONTECHA GÓMEZ , MARÍA ISABEL GALVÁ BORRÁS, AMÓS JOSÉ GARCÍA ROJAS, FRANCISCO JAVIER GÓMEZ PAVÓN, DIEGO GRACIA, JOSÉ GUTIÉRREZ RODRÍGUEZ, MARTHA KESTLER, FERNANDO MARTÍNEZ CUERVO, FRANCISCO JAVIER MARTÍN SÁNCHEZ, CARLOS MELERO, ROSARIO MENÉNDEZ VILLANUEVA, PATRICIA MUÑOZ, ESTEBAN PALOMO, JUAN MANUEL PÉREZ-CASTEJÓN GARROTE, JOSÉ ANTONIO SERRA REXACH, SEBASTIÁN JOSÉ SANTAEUGENIA, FRANCISCO JOSÉ TARAZONA SANTABALBINA, MARÍA TERESA VIDÁN ASTIZ
Published: 29 March 2023
http://www.doi.org/10.37201/req/002.2023
A progressively increasing percentage of the elderly live during the last years of their lives in nursing homes. Although these institutions are intended to mimic life at home as much as possible, they have characteristics that make them quite similar to a “nosocomiun”, i.e. an establishment for the treatment of the sick. The very coexistence among the elderly, the fact of sharing caregivers and the very significant exposure to third parties, together with the frequent predisposing diseases to infection in this population, make infection frequent among residents and also easily transmissible. This leads us to ask what can be done to prevent infection in this environment and more specifically what is the state of the art of the matter in a Western European nation such as ours. The Board of Trustees of the Health Sciences Foundation has asked itself a series of questions on the subject of infection prevention in Nursing Homes, the structure of procedures, the legislation available, compliance with the measures indicated, the best indicators of the processes and therefore, the need to promote in Spain a document of recommendations to avoid infections in this poplation whose morbidity and mortality need not be highlighted. To this end, a multidisciplinary group of experts in different aspects of this problem has been convened and asked the proposed questions. The questions were discussed by the group as a whole and led to a series of conclusions agreed upon by the participants. The results of the meeting are reported below.
Rev Esp Quimioter 2023; 36(4): 346-379 [Full-text PDF]
IRIS SHARON PÉREZ RAMOS, MIREN JOSEBE UNZAGA BARAÑANO, MARÍA CARMEN ESPALLARGAS RUIZ-OGARRIO, JOSÉ LUIS DIAZ DE TUESTA DEL ARCOO
Published: 27 March 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/139.2022
Rev Esp Quimioter 2023; 36(3): 332-333 [Texto completo PDF]
ANA ISABEL ÁLVARO VARELA, AITZIBER AGUINAGA PÉREZ, ANA NAVASCUÉS ORTEGA, JESÚS CASTILLA CATALÁN, CARMEN EZPELETA BAQUEDANO
Published: 27 March 2023
http://www.doi.org/10.37201/req/118.2022
Mycoplasma pneumoniae is a bacterium that lacks a cell wall. It produces infections all It produces infections world-wide, in epidemic outbreaks every 4-7 years, or endemically. Its clinical manifestations occur mostly in the respiratory tract and it is a common cause of atypical pneumonia. The treatment is with macrolides, tetracyclines or fluoroquinolones. Since 2000, an increase in resistance to macrolides has been detected worldwide, being more frequent in Asia. In Europe the frequency of resistance ranges between 1% and 25%, depending on the country. Molecular techniques and serology techniques provides very high sensitivity in diagnostic confirmation, being very useful for detecting and controlling M. pneumoniae outbreaks. The detection of resistance to macrolides requires a sequencing technique.
Rev Esp Quimioter 2023; 36(3): 259-266 [Texto completo PDF]
SERGIO GARCÍA-FERNÁNDEZ, JORGE CALVO, EMILIA CERCENADO, ANA ISABEL SUÁREZ-BARRENECHEA, MARÍA FERNÁNDEZ-BILLÓN, FRANCISCO JAVIER CASTILLO, LYDIA GÁLVEZ-BENÍTEZ, FE TUBAU, RUTH ESTHER FIGUEROA CERÓN, ALICIA HERNÁNDEZ-CABEZAS, FERNANDO GONZÁLEZ ROMO, MARÍA CARMEN FARIÑAS, MARÍA GÓMEZ, JAZMÍN DÍAZ-REGAÑÓN, RAFAEL CANTÓN
Published: 22 March 2023
http://www.doi.org/10.37201/req/007.2023
Objectives. To determine susceptibility to the novel β-lactam/β-lactamase inhibitor combination imipenem/relebactam in clinical isolates recovered from intra-abdominal (IAI), urinary (UTI), respiratory (RTI) and bloodstream (BSI) infections in the SMART (Study for Monitoring Antimicrobial Resistance Trends) study in SPAIN during 2016 – 2020.
Methods. Broth microdilution MICs for imipenem/relebactam and comparators were determined by a central laboratory against isolates of Enterobacterales and Pseudomonas aeruginosa. MICs were interpreted using EUCAST-2021 breakpoints.
Results. In total, 5,210 Enterobacterales and 1,418 P. aeruginosa clinical isolates were analyzed. Imipenem/relebactam inhibited 98.8% of Enterobacterales. Distinguishing by source of infection susceptibility was 99.1% in BSI, 99.2% in IAI, 97.9% in RTI, and 99.2% in UTI. Of intensive care unit isolates (ICU) 97.4% were susceptible and of non-ICU isolates 99.2% were susceptible. In Enterobacterales, activity against Class A, Class B and Class D carbapenemases was 96.2%, 15.4% and 73.2%, respectively. In P. aeruginosa, imipenem/relebactam was active in 92.2% of isolates. By source of infection it was 94.8% in BSI, 92.9% in IAI, 91.7% in RTI, and 93.1% in UTI. An 88.7% of ICU isolates and 93.6% of non-ICU isolates were susceptible to imipenem/relebactam. Imipenem/relebactam remained active against P. aeruginosa ceftazidime-resistant (76.3%), cefepime-resistant (73.6%), imipenem-resistant (71.5%) and piperacillin-resistant (78.7%) isolates. Of all multidrug-resistant or difficult-to-treat resistance P. aeruginosa isolates, 75.1% and 46.2%, respectively, were susceptible to imipenem/relebactam.
Conclusions. Imipenem/relebactam showed high rates of susceptibility in Enterobacterales and P. aeruginosa isolates from different sources of infection as well as depending on patients’ location (ICU or non-ICU scenarios).
Rev Esp Quimioter 2023; 36(3): 302-309 [Full-text PDF]
