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Rev Esp Quimioter 2024; 37(6): 472-478

A 5-year study of bloodstream infections caused by carbapenemase-producing Gram-negative bacilli in southern Spain

FERNANDO COBO, JUAN ANTONIO REGUERA-MÁRQUEZ, JOSÉ ANTONIO MARÍN-RODRÍGUEZ, FRANCISCO JOSÉ MARTÍN-PÉREZ, PATRICIA PÉREZ-PALACIOS, ESTHER RECACHA, JOSÉ MARÍA NAVARRO-MARÍ

Published: 19 September 2024

http://www.doi.org/10.37201/req/045.2024

Introduction. The aim of this study was to evaluate the microbiological epidemiology of carbapenemase-producing Gram-negative bacilli (CPGNB) isolated from blood during a 5-year period.
Methods. A total of 80 isolates from 78 patients were finally included; fifty-five (70.5%) were men and the mean age was 60 years. Detection of carbapenemase production was
performed by immunocromatography (IC) and polymerase chain reaction (PCR). Genotyping was carried-out by pulsedfield gel electrophoresis (PFGE) and multi-locus sequence typing (MLST), and characterization of carbapenemase-producing isolates was performed by whole genome sequencing (WGS).
Results. The main microorganisms isolated were K. pneumoniae (29.4%), E. cloacae (28.2%), A. baumannii (17.9%) and P. aeruginosa (15.3%). Overall, the most common carbapenemase in Enterobacterales was OXA-48 group (57.7%). The most common carbapenemase in non-fermenting bacilli was OXA-23 (60.8%). The most common ST in K. pneumoniae producing OXA-48 types was ST45 and in E. cloacae ST114, while in E. cloacae producing VIM types was ST78. In OXA-23 types, the most common clone in A. baumannii was ST2, whereas in P. aeruginosa producing IMP types was ST253.
Conclusions. There was an increase in cases recorded in the years of highest incidence and severity of the SARS-CoV-2 pandemic, with a significant number of cases in patients admitted to the ICU. All bacteremias caused by A. baumannii were caused by the same clone, and 12 of the 14 cases caused by A. baumannii were part of outbreaks in the ICU.

Rev Esp Quimioter 2024; 37(6): 472-478 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(6): 498-503

Nirsevimab effectiveness against hospital admission for respiratory syncytial virus bronchiolitis in infants

ROSA RODRÍGUEZ-FERNÁNDEZ, FELIPE GONZÁLEZ-MARTÍNEZ, INÉS OJEDA VELÁZQUEZ, MARTA RODRÍGUEZ DÍAZ, MARÍA VICTORIA CAPOZZI BUCCIOL, MARÍA ISABEL GONZÁLEZ-SÁNCHEZ, JIMENA PÉREZ-MORENO, BLANCA TOLEDO DEL CASTILLO

Published: 23 September 2024

http://www.doi.org/10.37201/req/026.2024

Introduction. Respiratory syncytial virus (RSV) bronchiolitis is the leading cause of hospitalization in infants. This season, a long half-life monoclonal antibody (Nirsevimab) is available to prevent this disease for all infants born from 1 April-30 September to 2023 and all those born during RSV season (October2023- March 2024). The aim of this study was to evaluate the impact of the implementation of this antibody on RSV admissions in a tertiary hospital.
Material and methods. Observational, retrospective and analytical study. All patients <6 months in October admitted for bronchiolitis at 2 time points were included: T1 or Pre-nirsevimab time: 1 September 2015-30 September 2023 and T2 or Nirsevimab time: 1 October-31 December 2023. Total admissions due to any cause of infants <6 months in the same period were used as the reference population. To assess the impact of the implementation of nirsevimab, we calculated the reduction in the percentage of admissions due to RSV with respect to total admissions in both periods, and also in the 2023-2024 season we calculated the double negative test to calculate the effectiveness of the intervention (1-Odds ratio) x 100.
Results. In infants under 6 months of age, we found significant differences in the number of admissions for RSV bronchiolitis between the last season and the previous 7 seasons [574/1195 (48%) vs 6/138 (4.3%); p<0.01, RPI: 91%). In the 2023/2024 season, the effectiveness of nirsevimab in preventing admission for RSV bronchiolitis in children under 6 months of age was 85% (CI 95%: 32-97%).
Conclusions. The implementation of nirsevimab has had an important impact on the number of hospital admissions for RSV bronchiolitis. There were no differences in the severity of bronchiolitis

Rev Esp Quimioter 2024; 37(6): 498-503 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(6): 454-471

Invasive group A Streptococcus infection (Streptococcus pyogenes): Current situation in Spain

MARI CRUZ MARTÍN-DELGADO, PILAR DE LUCAS RAMOS, ALEJANDRA GARCÍA-BOTELLA, RAFAEL CANTÓN, ALBERTO GARCÍA-LLEDÓ, TERESA HERNÁNDEZ-SAMPELAYO, JAVIER GÓMEZ-PAVÓN, JUAN GONZÁLEZ DEL CASTILLO, FRANCISCO JAVIER MARTÍN SÁNCHEZ, MANUEL MARTÍNEZ-SELLÉS, JOSÉ MARÍA MOLERO GARCÍA, SANTIAGO MORENO GUILLÉN, FERNANDO RODRÍGUEZ-ARTALEJO, JULIÁN RUIZ-GALIANA, ALMUDENA BURILLO, PATRICIA MUÑOZ, CRISTINA CALVO REY, MERCEDES CATALÁN-GONZÁLEZ, EMILIO CENDEJAS-BUENO, ANA VERÓNICA HALPERIN-BENITO, RAÚL RECIO, CARMEN VIÑUELA-BENÍTEZ, EMILIO BOUZA

Published: 30 July 2024

http://www.doi.org/10.37201/req/067.2024

Group A ß-hemolytic Streptococcus (S. pyogenes), also known as GAS, is a Gram-positive bacterium. It can be easily identified in the microbiology laboratory by its ability to hemolyse blood in culture media. This bacterium is highly virulent due to its production of enzymes and toxins, and its ability to cause immunologically mediated diseases such as rheumatic fever and post-streptococcal glomerulonephritis.
GAS is the primary cause of bacterial pharyngotonsillitis, although it is typically a benign and non-invasive disease. However, it also has the potential to cause severe skin and soft tissue infections, necrotising fasciitis, bacteraemia and endocarditis, pneumonia and empyema, and streptococcal toxic shock syndrome, without any age or predisposition limits. The term invasive GAS disease (iGAS) is used to refer to this group of conditions.
In more developed countries, iGAS disease has declined thanks to improved hygiene and the availability of antibiotics. For example, rheumatic fever has practically disappeared in countries such as Spain. However, recent data suggests a potential increase in some iGAS diseases, although the accuracy of this data is not consistent.
Because of this, the COVID and Emerging Pathogens Committee of the Illustrious Official College of Physicians of Madrid (ICOMEM) has posed several questions about invasive GAS infection, especially its current situation in Spain. The committee has enlisted the help of several experts in the field to answer these questions. The following lines contain the answers that we have collaboratively produced, aiming to assist not only the members of ICOMEM but also anyone interested in this topic.

Rev Esp Quimioter 2024; 37(6): 454-471 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(6): 512-514

Impacto en la población adulta de la inmunización con nirsevimab en los menores de 6 meses frente al virus respiratorio sincitial

JORDI REINA, JULIA VIANA-RAMIREZ

Published: 16 July 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/049.2024

Rev Esp Quimioter 2024; 37(6): 512-514 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(5): 432-434

Vulvovaginitis por Streptococcus pyogenes en mujeres adultas

CARMEN AMORES-ANTEQUERA, ANA DELGADO-BAENA, PAULA PARRADO-HERNANDO, PURIFICACIÓN CANTUDO-MUÑOZ, LIDIA VELASCO-RODRÍGUEZ

Published: 15 July 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/046.2024

Rev Esp Quimioter 2024; 37(5): 432-434 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(5): 435-437

Refractory Enterobius vermicularis infection in an elderly woman: Mebendazole or albendazole?

CRISTINA CARRANZA-RODRÍGUEZ, TOMÁS TOSCO-NUÑEZ, NIEVES JAÉN-SÁNCHEZ, LAURA SUÁREZ-HORMIGA, JOSÉ-LUIS PÉREZ-ARELLANO

Published: 12 July 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/047.2024

Rev Esp Quimioter 2024; 37(5): 435-437 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(5): 427-428

Resultado falso negativo en diversas PCR multiplex y monoplex en un episodio de bacteriemia por Neisseria meningitidis. Implicaciones diagnósticas, terapéuticas y epidemiológicas

Mª LUISA MONFORTE, ROCÍO CEBOLLADA, Mª JESÚS ESCOBAR, RAQUEL ABAD, CARMEN ASPIROZ

Published: 10 July 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/040.2024

Rev Esp Quimioter 2024; 37(5): 427-428 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(6): 438-453

Human intestinal microbiome: Role in health and disease

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, SANTIAGO MORENO GUILLÉN, FERNANDO RODRÍGUEZ-ARTALEJO, ELENA REIGADAS, ROSA DEL CAMPO, SERGIO SERRANO, JULIÁN RUIZ-GALIANA, EMILIO BOUZA

Published: 9 July 2023

http://www.doi.org/10.37201/req/056.2024

The study of the microbiota and the microbiome, and specifically the intestinal one, has determined great interest due to the possible association of their alterations with numerous diseases. These include entities as diverse as Crohn’s disease, autism, diabetes, cancer or situations as prevalent today as obesity. In view of this situation, different recommendations have been performed regarding the use of probiotics, prebiotics, and postbiotics as modulators of the microbiota and the microbiome, seeking both preventive and therapeutic effects, and faecal material transfer (FMT) is proposed as an alternative. The latter has emerged as the only proven beneficial intervention on the intestinal microbiome, specifically in the treatment of recurrent colitis associated with Clostridioides difficile (R-CDI). In the rest of the entities, the lowering of laboratory costs has favored the study of the microbiome, which is resolved by delivering reports with catalogs of microorganisms, metabolites or supposed biomarkers without consensus on their composition associated with healthy or diseased microbiota and the disease. There is still insufficient evidence in any disease for interventions on the microbiome beyond FMT and R-CDI. Multi- and multi-disciplinary work with extensive research and the application of artificial intelligence in this field may shed light on the questions raised currently. Ethical issues must also be resolved in light of possible interventions within the umbrella of personalized medicine.

Rev Esp Quimioter 2024; 37(6): 438-453 [Full-text PDF]


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Rev Esp Quimioter 2024, 37(5): 409-414

Evolution of Salmonella spp. isolated compared to those of Campylobacter spp. in faecal samples for 12 years

ANA DE MALET PINTOS-FONSECA, SUSANA OROL MASEDA, ISABEL LOPEZ LOPEZ, REBECA RODIL FERREIRO, CARLOS RUIZ DE ALEGRÍA PUIG, PILAR ALONSO GARCIA

Published: 8 July 2023

http://www.doi.org/10.37201/req/038.2024

Introduction. The Autonomous Community of Galicia has adopted DECREE 216/2011 on health standards for poultry production, in addition to the Spanish national programs. However, no program has yet been implemented to eradicate campylobacteriosis, which shares the same reservoir. The aim of this study was to compare the evolution of Salmonella spp. isolates with respect to those of Campylobacter spp. in faecal samples received by the Microbiology Department.
Material and methods. A retrospective descriptive comparative study was conducted through the Laboratory Information System (SIL) of Salmonella spp. isolated against Campylobacter spp. in faeces between 2011 and 2022 at the Lucus Augusti University Hospital (HULA), Lugo, Spain.
Results. A total of 35,704 stool samples were analysed, of which 3,045 were positive. 751 Salmonella spp. were isolated. Statistical differences were observed in the annual distribution (p<0.01), with a clear turning point in 2018. Five hundred and five patients required hospital care, especially in 2014 with 72 patients (69%). On the other hand, 1,587 Campylobacter spp. were isolated. Required hospital care 1,002 patients during the study, with a peak in 2019 with 111 cases (62%).
Conclusion. The reduction of salmonellosis cases and the maintenance of campylobacteriosis cases are directly related to the implementation of DECREE 216/2011. This, in turn, has reduced the pressure on hospitals in the HULA health area. Therefore, we believe that the ONE Health concept is being strengthened in the area studied.

Rev Esp Quimioter 2024; 37(5): 409-414 [Full-text PDF]


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Rev Esp Quimioter 2024, 37(5): 415-421

Change in Klebsiella pneumoniae susceptibility profile after the arrival of ceftazidime-avibactam in an Argentinean intensive care unit: a new ecological landscape

PATRICIO FAVIER, LORENA ABUSAMRA, SANTIAGO MONCALERO, LAURA ERRECALDE, SILVIA MONTIBELLO, OLGA RODRÍGUEZ, SANDRA COGUT, MARIANA ERBIN, MARÍA JOSÉ ROLÓN

Published: 3 July 2023

http://www.doi.org/10.37201/req/042.2024

Introduction. Ceftazidime-avibactam (CZA) is a good option for Gram-negative bacilli infections that produce carbapenemase Classes A (especially blaKPC) and D (blaOXA). However, it is unknown whether it would have an impact on metallo-β-lactamases (blaMBL) selection. The aim of the study was to compare carbapenem and CZA Klebsiella pneumoniae (KPN) susceptibility profiles for a period of two years following the introduction of CZA.
Material and methods. The study was conducted in a 36-bed adult ICU of a tertiary hospital in Buenos Aires, Argentina. Antimicrobial consumption was expressed as days of treatment per 100 patients-day (DOT).
Results. A total of 123 KPN strains in the first year and 172 in the second year were analyzed. An alarming decrease in carbapenem susceptibility was detected in the second year (OR 0.5 [0.3-0.8] p<.001). In parallel, there was a decrease in CZA susceptibility (OR 0.5 [0.3-0.9] p<.05). These findings were linked to a rise in blaMBL-KPN (32.1% vs. 45.1%, OR 1.7 [1.1-2.9], p <.04) during the second year. This new KPN susceptibility profile promoted an increment in CZA (1.0 DOT vs. 6.6 DOT, OR 6.6 [4.9-9.1] p<.001) and aztreonam (0.3 DOT vs. 4.1 DOT, OR 16.3 [9.1-29.3] p<.001) consumption. Thus, there was a decrease in carbapenem prescription (17.8 DOT vs. 15.4 DOT, OR 0.8 [0.8-0.9] p<.001).
Conclusions. There was an escalation of blaMBL-KPN rate two years after CZA introduction, leading to a decrease in CZA and carbapenem susceptibility and an increase in CZA and aztreonam prescriptions.

Rev Esp Quimioter 2024; 37(5): 415-421 [Full-text PDF]


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