DOMINGO FERNÁNDEZ VECILLA, ITZIAR ANGULO LÓPEZ, MARÍA LUISA GURRUCHAGA YANES, MARÍA CARMEN NIETO TOBOSO, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO
Published: 2 December 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/086.2022
Rev Esp Quimioter 2023; 36(1): 107-109 [Full-text PDF]
DOMINGO FERNÁNDEZ VECILLA, JULIA ARAGÓN DÍEZ, MARÍA CARMEN NIETO TOBOSO, JAUME ROSSELLÓ SORIA, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO
Published: 2 December 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/082.2022
Rev Esp Quimioter 2023; 36(1):103-106 [Full-text PDF]
LAURA SANTE FERNÁNDEZ, PATRICIA CAPÓN GONZÁLEZ, ANTONIO MORENO FLORES, PATRICIA COIRA MARÍN, PILAR ALONSO GARCÍA
Published: 1 December 2022
http://www.doi.org/10.37201/req/088.2022
Introduction. Microscopic examination of the intestinal parasites, from the patient’s concentrated feces, has a lower sensitivity when compared to molecular diagnostic techniques. Therefore, the objective of this study has been to compare both techniques, as well as to evaluate whether there is a correlation between the microscopic examination and the threshold cycles (Ct) obtained for Blastocystis hominis.
Material and methods. Retrospective study of the samples received in the Microbiology laboratory during September 2021. The MiniParasep SF® concentration test was performed for microscopic visualization and then PCR was performed with the Seegene AllplexTM Parasite Assay panel.
Results. A 27% (n=74) of the samples were positive by molecular diagnosis, with a total of 87 parasites detected. 53% (n=39) were women with a mean age of 47 ± 24 years. In 76% (n=56) of the cases the service of origin was Primary Care. The most frequently found parasite was B. hominis, 85% (n=64), followed by Dientamoeba fragilis 20% (n=15) and Giardia lamblia 11% (n=8). Co-infection by two parasites was detected in 13 cases (B. hominis + D. fragilis in 6 cases, and B. hominis + G. lamblia in 7 cases). In the microscopic diagnosis, 9.5% (n=26) positivity was obtained. The most frequently found parasite was B. hominis, 84% (n=23), followed by G. lamblia, which was seen in three cases by microscopy. D. fragilis was not seen in any case. Coinfection of B. hominis + G. lamblia was observed in one sample.
Conclusions. Techniques for molecular diagnosis of intestinal parasites are fast, reliable and more sensitive than microscopic techniques, improving microbiological diagnosis and quality of care.
Rev Esp Quimioter 2023; 36(1):88-91 [Texto completo PDF]
ALEJANDRO SUÁREZ-DE-LA-RICA, BRYANT CROES, LAURA CIUDAD, IRENE VALLEJO, JAIME MÚJICA, MARIANA DÍAZ-ALMIRÓN, EMILIO MASEDA
Published: 28 November 2022
http://www.doi.org/10.37201/req/107.2022
Introduction. This study aimed to evaluate whether early vitamin C and thiamine administration was associated with a lower 28-day and in-hospital mortality in surgical critically ill patients with refractory septic shock.
Patients and methods. We performed a retrospective before-and-after study on patients with refractory septic shock. According to local protocol, hydrocortisone is initiated in case of refractory septic shock. In January 2017, the protocol was changed and vitamin C and thiamine were included. Patients who were admitted in 2015-2016 and 2017-2018 were included in the control and treatment groups, respectively. The primary end point was 28-day and in-hospital mortality. Secondary end points were ICU mortality, ICU and hospital length of stay, duration of vasopressors and mechanical ventilation, use of renal replacement therapy (RRT), and the modification in serum procalcitonin and SOFA score during the first 72 h.
Results. A total of 120 patients were included (58 in the treatment group and 62 in the control group). Log-rank test in Kaplan-Meier curves showed lower 28-day and in-hospital mortality over time in the treatment group (p=0.021 and p=0.035, respectively) but it not reached statistical significance in ICU mortality over time (p=0.100). The need of RRT was less frequent in treatment group (17.2% vs. 37.1%, p=0.024). There were no differences in other secondary outcomes.
Conclusions. Intravenous vitamin C and thiamine administration in surgical patients with refractory septic shock may be associated with a lower 28-day and in-hospital mortality. Further prospective studies are needed in refractory septic shock.
Rev Esp Quimioter 2023; 36(2):187-193 [Full-text PDF]
DOMINGO FERNÁNDEZ VECILLA, ITZIAR ANGULO LÓPEZ, FELICITAS ELENA CALVO MURO, CRISTINA ASPICHUETA VIVANCO, FRANCESCO RENZI, MARÍA ESTHER PEREDA MARTÍNEZ, JAUME ROSSELLÓ SORIA, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO
Published: 25 November 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/060.2022
Rev Esp Quimioter 2023; 36(1): 92-96 [Full-text PDF]
PATRICIA GARCÍA-LLORET, YOLANDA BORREGO-IZQUIERDO, MERCEDES MANZANO-GARCÍA, MARÍA G. CANTILLANA-SUÁREZ, ANTONIO GUTIÉRREZ-PIZARRAYA, RAMÓN MORILLO-VERDUGO
Published: 23 November 2022
http://www.doi.org/10.37201/req/070.2022
Introduction. The objective is to determine the prevalence of potentially inappropriate drugs according to the Marc, STOPP, and PRISCUS lists in elderly HIV patients.
Patients and methods. It was an observational, retrospective, and multicenter study. People living with HIV 65 years or older who underwent chronic concomitant treatment were included. Descriptive and multivariate analyzes were performed to study the association between polypharmacy and potentially inappropriate medication compliance.
Results. A total of 55 patients were included, 81.8% men and a median age of 69 years (IQR: 67-73). The median number of comorbidities was 3 (IQR: 2-5) and the most frequent pattern of multimorbidity was cardiometabolic (62.9%). The predominant antiretroviral treatment was triple therapy (65.5%). Polypharmacy was present in 70.9% of the patients and 25.5% had major polypharmacy. The most frequent polypharmacy pattern was cardiovascular (69.2%). The percentage of potentially inappropriate medications according to the Marc, STOPP and PRISCUS lists was 65.5%, 30.9% and 14.5%, respectively (p<0.001). Adjusted for age and sex, polypharmacy was not independently associated with potentially inappropriate medication compliance in any of the lists.
Conclusion. Polypharmacy and potentially inappropriate medications have a high prevalence. There is great variability in the percentage according to the list applied. Age, sex, and presence of polypharmacy are not predisposing factors to the presence of potentially inappropriate medications.
Rev Esp Quimioter 2023; 36(1): 52-58 [Full-text PDF]
MARÍA JESÚS PÉREZ-GRANDA, PILAR CATALÁN, PATRICIA MUÑOZ, TERESA ALDÁMIZ, JUAN CAMILO BARRIOS, CARLOS RAMÍREZ, RITA GARCÍA-MARTÍNEZ, MARÍA VICTORIA VILLALBA, LUIS PUENTE, EMILIO BOUZA
Published: 22 November 2022
http://www.doi.org/10.37201/req/068.2022
Purpose. To determine the prevalence of CMV reactivation in a population admitted for severe COVID-19 to a general hospital.
Methods. Point prevalence study in all hospitalized patients with severe COVID-19 (admitted either to general wards or ICU). Determination of the presence of CMV DNA in circulating blood. COVID-19 was confirmed in patients with compatible clinical manifestations, usually with pneumonia and a positive nasopharyngeal PCR test.
Results. We included 140 hospitalized patients with COVID-19 who consented to participate. A total of 16 patients (11.42%), had circulating CMV-DNA in peripheral blood at the time of the study. Patients with positive CMV viral load were mainly ICU patients (11/37 -29,7%) and only 5/103 cases (4,85%) were hospitalized into general wards. The accumulated doses of corticosteroids (prednisone equivalents) in the study day were (median and IQR) 987.50 mg (396.87-2,454.68) and 187.50 mg (75.00-818.12) respectively in CMV positive and negative patients (p < 0.001). A significant proportion of CMV positive patients were discovered because of the study and were clinically unsuspected by their physicians. The coinfected COVID-CMV positive population had a higher risk of accumulated secondary nosocomially-acquired infections and a worse prognosis.
Conclusion. CMV reactivation should be systematically searched in patients in COVID-19 cases admitted to the ICU.
Rev Esp Quimioter 2023; 36(1):45-51 [Full-text PDF]
JORDI REINA, CARLA IGLESIAS
Published: 21 November 2022
http://www.doi.org/10.37201/req/096.2022
The absence of an effective vaccine against respiratory syncytial virus (RSV) has led to the development of various drugs with the ability to inhibit or block its replicative activity. The first generation, called fusion inhibitors, bind to the protein on the viral surface and prevent the virus from binding and entering the cell. However, its low efficacy has determined the start of studies with second-generation compounds capable of binding or blocking the nucleoprotein (N); most of these compounds are analogs of 1,4-benzodiazepines. EDP-938 has shown high efficacy against RSV. The first trials in humans have shown that this antiviral is rapidly absorbed after oral administration and has a half-life of between 11-18 hours Administration for seven days of multiple oral doses of up to 600 mg/day or 300 mg/day/twice a day, there were hardly any significant adverse effects and the viral load in the lower respiratory tract decreased significantly.
Rev Esp Quimioter 2023; 36(1):26-29 [Texto completo PDF]
NIKO MIHIC, JAIME ABASCAL, JOSÉ LÓPEZ CHICHARRO, FELIPE SEGURA, SUZANNE HUURMAN, BORJA NÚÑEZ DE AYSA, EMILIO BOUZAA
Published: 7 November 2022
http://www.doi.org/10.37201/req/072.2022
The incidence and risk factors for poor outcome in patients with COVID are well known, as are the protective measures in high-risk populations. In contrast, the epidemiological and clinical behavior of this disease in the population of elite athletes who are the paradigm of good health is poorly understood. Data on COVID in athletes are scarce and have focused preferentially on the consequences on sports performance of confinement measures and on the pathophysiological risks of infected athletes.
Real Madrid is a large elite sports institution with facilities in the City of Madrid where 600 athletes train daily. The incidence of COVID during a study period of 671 days of observation in athletes, professional or amateur, working in the institution has been 0,74 per 1,000 days of exposure. The disease has been asymptomatic or oligosymptomatic in all athletes and did not require any hospital admissions.
The different teams did not have to suspend any of its sportive commitments for COVID during the study period and there was no evidence of outbreaks of internal transmission between members of the different teams.
Rev Esp Quimioter 2023; 36(1):59-64 [Full-text PDF]
RICARD FERRER, JUAN GONZÁLEZ DEL CASTILLO, MARÍA MARTÍNEZ-MARTÍNEZ, ERIKA P. PLATA-MENCHACA, M. NIEVES LARROSA
Published: 4 November 2022
http://www.doi.org/10.37201/req/083.2022
Introduction. This study aimed to identify the common barriers leading to delayed initial management, microbiological diagnosis, and appropriate empirical antimicrobial treatment in sepsis.
Patients and methods. A cross-sectional study was performed by the application of a population-based survey. Four different surveys were designed, targeting the healthcare personnel located in main hospital areas [emergency department (SEMES); infectious diseases and clinical microbiology-microbiological diagnosis (SEIMC-M); intensive care and infectious diseases, (SEMICYUC-GTEIS); and infectious diseases and clinical microbiology-clinical diagnosis, (SEIMC-C)].
Results. A total of 700 valid surveys were collected from June to November 2019: 380 (54.3%) of SEMES, 127 (18.1%) of SEIMC-M, 97 (13.9%) de SEMICYUC-GTEIS and 96 (13.7%) of SEIMC-C, in 270 hospitals of all levels of care. The qSOFA score was used as a screening tool. The most used biomarker was procalcitonin (n=92, 39.8%). The sepsis code was implemented in 157 of 235
participating centers (66.2%), particularly in tertiary level hospitals. The mean frequency of contaminated blood cultures was 8.9% (8.7). In 85 (78.7%) centers, positive results of blood cultures were available within the first 72 hours and were communicated to the treating physician effectively by phone or e-mail in 76 (81.7%) cases. The main reason for escalating treatment was clinical deterioration, and the reason for de-escalating antimicrobials was significantly different between the specialties. Quality indicators were not frequently monitored among the different participating centers.
Conclusion. There are significant barriers that hinder adequate management processes in sepsis in Spanish hospitals.
Rev Esp Quimioter 2023; 36(1):82-87 [Full-text PDF] [Supplementary-material PDF]
