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Rev Esp Quimioter 2023; 36(2):169-179

Emergency detection of HIV infection in patients consulting for conditions potentially related to occult infection: Initial results of the “Urgències VIHgila” program

ÒSCAR MIRÓ, EMÍLIA MIRÓ, MÍRIAM CARBÓ, MIREIA SAURA, ALEXIS REBOLLO, ROCÍO DE PAZ, JOSEP MARIA GUARDIOLA, ALEJANDRO SMITHSON, DANIEL ITURRIZA, CRISTINA RAMIÓ LLUCH, CONNIE LEEY, JOSÉ IGNACIO FERRO, ALBERTO VILLAMOR, EMILI GENÉ EN REPRESENTACIÓN DEL GRUPO DE TRABAJO “URGÈNCIES VIHGILA”

Published: 16 January 2023

http://www.doi.org/10.37201/req/085.2022

Objective. To estimate the prevalence of unknown HIV infection in patients who consulted in hospital emergency services (ED) for conditions defined in the SEMES-GESIDA Consensus Document (DC), evaluate the efficiency of its im-plementation and investigate the efficiency of HIV serology determination in other conditions.
Methods. Results were reviewed in 10 Catalan EDs for 12 months (July-21-June-22) after implementing CD recommendations: request HIV serology in case of suspected sexually transmitted infection, chemsex, post-exposure prophylaxis (PEP), mononucleosis syndrome, community pneumonia (18-65 y-o) or herpes zoster (18-65 y-o). Other reasons for request were included. Prevalence (%) of global seropositivity and for each circumstance was calculated, with a 95% confidence interval (95%CI). The efficient strategy was considered if the lower limit of the CI95%>0.1%.
Results. A total of5,107 HIV serologies were performed: 2,847(56%) in situations specified in CD, and 2,266 (44%) in other 138 circumstances. Forty-eight unknown HIV infections were detected (prevalence=0.94%;95%CI=0.69-1.24). The prevalence was somewhat higher in DC requests (30 cas-es 1.12%) than the rest (18 cases 0.71%; p=0.16). The individualized prevalence of CD reasons ranged between 7.41% (95%CI=0.91-24.3) in chemsex and 0.42% 95%CI=0.14-0.98) in PPE, always efficient except herpes zoster (0.76%; CI95%=0.02-4.18). In other reasons, cases were detected in 12 circumstances, and in four the determination could be efficient: lymphopenia (10%;CI95%=0.25-44.5), fever with polyarthralgia-polyarthritis (7.41%;CI95% =0.91-24.3), behavioral alteration-confusion-encephalopathy (3.45%;95%CI=0.42-11.9) and fever of unknown origin (2.50%;95%CI=0.82-5.74).
Conclusion. The determination of HIV serology in HES in the processes defined by DC SEMES-GESIDA is efficient. Some circumstances are identified that could be added to those previously contemplated to increase efficiency.

Rev Esp Quimioter 2023; 36(2):169-179 [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(2):144-151

Microbial etiology of bacterial chronic prostatitis: systematic review

RAÚL MENDOZA-RODRÍGUEZ, ITAHISA HERNÁNDEZ-CHICO, BLANCA GUTIÉRREZ-SOTO, JOSÉ MARÍA NAVARRO-MARÍ, JOSÉ GUTIÉRREZ-FERNÁNDEZ

Published: 9 January 2023

http://www.doi.org/10.37201/req/099.2022

Objectives. The importance of Gram-positive microorganisms and atypical bacteria in chronic bacterial prostatitis (CBP) has recently been described. For this reason, this study analyzes the etiology of CBP, as well as the evolution of antibiotic resistance through a systematic review.
Material and methods. A systematic review of studies obtained through the MEDLINE (PubMed) database, related to the etiology and antibiotic resistance profile of CBP, published up July 1, 2021.
Results. The most frequent isolated microorganisms that we have found in publications are Enterococcus faecalis (46.90%), Staphylococcus spp. (22.30%), Escherichia coli (15.09%) and atypical bacteria (6.04%).
Conclusions. CBP is undergoing and unprecedented change of paradigm. Gram-positive bacteria and atypical bacteria are the main pathogens involved in the aetiology of this entity. This forces us to rethink the therapeutic strategy used, since it is necessary to use antibiotics that assume the etiological change and the profile of antibiotic resistance described.

Rev Esp Quimioter 2023; 36(2):144-151[Texto completo – PDF] [Material suplementario – PDF]


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Rev Esp Quimioter 2023; 36(2):203-207

Enfermedad de Whipple con presentación múltiple en paciente reumatológico. Caso y revisión de la literatura

DOMINGO FERNÁNDEZ VECILLA, ESTÍBALIZ UGALDE ZÁRRAGA, ALEXANDRE TARÍN NIETO, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO

Published: 2 January 2023

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/077.2022

Rev Esp Quimioter 2023; 36(2):203-207  [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(2):201-202

Tuberculosis extremadamente resistente tratada con bedaquilina

ANA LÓPEZ PÉREZ, HERMINIA NAVARRO AZNAREZ, ANDREA PINILLA RELLO, JUDIT PERALES PASCUAL, PIEDAD ARAZO GARCÉS

Published: 2 January 2023

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/073.2022

Rev Esp Quimioter 2023; 36(2):201-202  [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(1):65-81

Antimicrobial resistance in Gram-negative bacilli in Spain: an experts’ view

PILAR RETAMAR-GENTIL, RAFAEL CANTÓN, VICENTE ABRIL LÓPEZ DE MEDRANO, JOSÉ BARBERÁN, ANDRÉS CANUT BLASCO, CARLOS DUEÑAS GUTIÉRREZ, CAROLINA GARCÍA-VIDAL, NIEVES LARROSA ESCARTÍN, JAIME LORA-TAMAYO, FRANCISCO JAVIER MARTÍNEZ MARCOS, CARLOS MARTÍN RUÍZ, JUAN PASQUAU LIAÑO, PEDRO RASCADO, ÓSCAR SANZ PELÁEZ, GENOVEVA YAGÜE GIRAO, JUAN P. HORCAJADA

Published: 13 December 2022

http://www.doi.org/10.37201/req/119.2022

Background. Antibiotic resistance in Gram-negative bacilli poses a serious problem for public health. In hospitals, in addition to high mortality rates, the emergence and spread of resistance to practically all antibiotics restricts therapeutic options against serious and frequent infections.
Objectives. The aim of this work is to present the views of a group of experts on the following aspects regarding resistance to antimicrobial agents in Gram-negative bacilli: 1) the current epidemiology in Spain, 2) how it is related to local clinical practice and 3) new therapies in this area, based on currently available evidence.
Methodology. After reviewing the most noteworthy evidence, the most relevant data on these three aspects were presented at a national meeting to 99 experts in infectious diseases, clinical microbiology, internal medicine, intensive care medicine, anaesthesiology and hospital pharmacy.
Results and conclusions. Subsequent local debates among these experts led to conclusions in this matter, including the opinion that the approval of new antibiotics makes it necessary to train the specialists involved in order to optimise how they use them and improve health outcomes; microbiology laboratories in hospitals must be available throughout a continuous timetable; all antibiotics must be available when needed and it is necessary to learn to use them correctly; and the Antimicrobial Stewardship Programs (ASP) play a key role in quickly allocating the new antibiotics within the guidelines and ensure appropriate use of them.

Rev Esp Quimioter 2023; 36(1):65-81 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(2):114-124

Insights for COVID-19 in 2023

FRANCISCO JAVIER MARTÍN-SÁNCHEZ, MANUEL MARTÍNEZ-SELLÉS, JOSÉ MARÍA MOLERO GARCÍA, 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, EMILIO BOUZA

Published: 13 December 2022

http://www.doi.org/10.37201/req/122.2022

Predictions for a near end of the pandemic by the World Health Organization should be interpreted with caution. Current evidence indicates that the efficacy of a fourth dose of classical mRNA vaccines (BT162b2 or mRNA-1273) is low and short-lived in preventing SARS-CoV-2 infection in its predominant variant (Omicron). However, its efficacy is high against severe symptomatic infection, hospitalization and death. The new vaccines being introduced are bivalent and active against the Omicron variants. Potential new vaccines to be introduced in the coming year include a vaccine based on a recombinant protein that emulates the receptor binding domain of the Spike protein under development by the Spanish company Hipra, as well as vaccines for nasal or oral administration. Available information suggests that vaccines against COVID-19 can be administered in association with influenza vaccination without particular complications. New drugs against COVID-19, both antiviral and anti-inflammatory, are under investigation, but this does not seem to be the case with monoclonal antibodies. The indication to use masks in some circumstances will be maintained next year in view of the accumulation of scientific data on their efficacy. Finally, the long COVID or Post-COVID syndrome may continue to affect a very high proportion of patients who have had the disease, requiring combined diagnostic and therapeutic resources.

Rev Esp Quimioter 2023; 36(2):114-124 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):30-44

A systematic review on extensively drug-resistant tuberculosis from 2009 to 2020: special emphases on treatment outcomes

SHRUTI SUBHASH SHIROMWAR, AMER HAYAT KHAN, VIJAY CHIDRAWAR

Published: 9 December 2022

http://www.doi.org/10.37201/req/029.2022

Objectives. Extensively drug-resistant tuberculosis (XDR-TB) has raised a great threat to human health globally, especially in developing countries. The objective of the present study is to collate and contrast the proportions of treatment outcome in the previously published XDR-TB articles.
Material and methods. By considering inclusion criteria and search engines, a total of 22 articles were enrolled.
Results. Our findings revealed that the overall favorable treatment outcome was 24.04%. From the cohort of enrolled studies 19.76% (397) and 43.35% (871) patients were cured and died respectively. In 90.9% of enrolled articles, the investigators performed drug-susceptibility testing at the baseline. The overall treatment outcome was improved by the use of new drugs (linezolid, bedaquiline, ciprofloxacin, clofazimine) in the treatment regimen of XDR-TB showing linezolid and bedaquiline better results i.e. 59.44 and 78.88%, respectively. Moreover, use of antiretroviral treatment in XDR-TB patients with HIV infection have not shown any significant difference in the treatment outcome.
Conclusions. XDR-TB treatment success can be achieved by implying standardized definitions, upgraded diagnostic procedures, and novel drugs.

Rev Esp Quimioter 2023; 36(1):30-44 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):97-100

Mejora en la rentabilidad e indicaciones de la extracción de hemocultivos en los servicios de urgencias: otro paso adelante

ISABEL NIETO ROJAS, WILLIAN ESNAIDER LÓPEZ FORERO

Published: 9 December 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/075.2022

Rev Esp Quimioter 2023; 36(1):97-100  [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(1):101-102

The role of hospital emergency departments in identifying patients with unknown HIV infection: an opportunity for diagnosis

ANA GARCÍA-MARTÍNEZ, MIRIAM CARBÓ

Published: 5 December 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/079.2022

Rev Esp Quimioter 2023; 36(1):101-102  [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):110-113

Streptococcus cristatus, an infrequent cause of bacteremia and infective endocarditis. Case report and literature review

DOMINGO FERNÁNDEZ VECILLA, MIKEL JOSEBA URRUTIKOETXEA GUTIÉRREZ, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO

Published: 2 December 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/090.2022

Rev Esp Quimioter 2023; 36(1):110-113  [Full-text PDF]


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