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Rev Esp Quimioter 2022;35(Suppl.3):67-73

Diagnostic and therapeutic approach to pulmonary infiltrates in cancer patients receiving immune checkpoint inhibitors

MARIO FERNÁNDEZ-RUIZ

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.15.2022

The advent of immune checkpoint inhibitors (ICIs) targeting cytotoxic T lymphocyte antigen 4 (CTLA-4) and the programmed cell death (PD-1)/PD-1 ligand 1 (PD-L1) axis has transformed the treatment paradigm for multiple cancer types. ICIs are able to restore T-cell-mediated antitumor responses and do not entail an increased risk of infection per se. However, immunotherapy is associated to a unique form of toxicity due to the off-target effects on healthy tissues of the excessively enhanced immune response in form of immune-related adverse events (irAEs). Although ICI-induced pneumonitis ranks the fifth of all irAEs in terms of frequency of occurrence, it is associated with a relevant attributable mortality. This review summarizes the incidence, risk factors, clinical and radiological presentation, and therapeutic approach of ICI-induced pneumonitis. Particular focus is on the differential diagnosis of new or worsening pulmonary infiltrates in cancer patients receiving ICI therapy. Finally, the impact on the risk of opportunistic infection of ICIs and immunosuppressive therapy used to treat associated irAEs is reviewed. The diagnosis and management of suspected ICI-induced pneumonitis remains clinically challenging.

Rev Esp Quimioter 2022; 35(Suppl.3):67-73 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):63-66

Norovirus infection as a model of chronic or recurrent infection in common variable immunodeficiency

PEDRO MORAL MORAL, DAFNE CABAÑERO-NAVALON, VICTOR GARCIA-BUSTOS, MARÍA NÚÑEZ BELTRÁN, MIGUEL SALAVERT LLETÍ

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.14.2022

Common variable immunodeficiency (CVID) is the most frequent symptomatic primary immunodeficiency (PID) in general population. PID are genetic diseases that share a dysfunction in the immune system entailing a greater risk of both chronic and recurrent infections. These patients can also develop chronic gastrointestinal infections caused by norovirus with persistent viral dissemination, which can be detected months after primoinfection. Additionally, a proportion of CVID patients show a typical severe enteropathy presenting with recurrent diarrhoea, intestinal malabsorption, inflammatory lesions, and villous atrophy. Some studies have related this enteropathy with chronic intestinal infection caused by norovirus.

Rev Esp Quimioter 2022; 35(Suppl.3):63-66 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):54-62

COVID-19 in donation and transplant

FRANCISCO JAVIER CANDEL, CÁNDIDO PARDO REY, JUAN IGNACIO TORRES-GONZÁLEZ, PAULA FERNÁNDEZ-VEGA, MARCOS FRAGIEL, DAVID OTEO, ENRIQUE DEL TORO, MÓNICA VEGA-BAYOL, CRISTINA OUTON, MARTA ENCABO, AGUSTÍN GARCÍA-MARUGÁN, SARA RESINO, DOLORES PARRA, MAYRA MATESANZ, FRANCISCO J. DEL RIO GALLEGOS

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.13.2022

SARS-CoV-2 infection has had a major impact on donation and transplantation. Since the cessation of activity two
years ago, the international medical community has rapidly generated evidence capable of sustaining and increasing this neccesary activity. This paper analyses the epidemiology and burden of COVID-19 in donation and transplantation, the pathogenesis of the infection and its relationship with graft-mediated transmission, the impact of vaccination on donation and transplantation, the evolution of donation in Spain throughout the pandemic, some lessons learned in SARS-CoV-2 infected donor recipients with positive PCR and the applicability of the main therapeutic tools recently approved for treatment among transplant recipients.

Rev Esp Quimioter 2022; 35(Suppl.3):54-62 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):51-53

New treatments for multidrug-resistant non-fermenting Gram-negative bacilli Infections

MARIANA CHUMBITA, PATRICIA MONZO-GALLO, CARLOS LOPERA-MÁRMOL, TOMMASO FRANCESCO AIELLO, PEDRO PUERTA-ALCALDE, CAROLINA GARCIA-VIDAL

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.12.2022

Ceftolozane/tazobactam, ceftazidime/avibactam and cefiderocol belong to a novel generation of antibiotics that correspond with the β-lactam family. It is necessary to having new options in treating infections caused by Gram-negative, non-fermenting multidrug-resistant bacilli due to the significant increase in multidrug resistance in the last decades. Knowing the main characteristics of each drug is key for correct use.

Rev Esp Quimioter 2022; 35(Suppl.3):51-53 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):46-50

Treatment of infections caused by carbapenemase-producing Enterobacterales

MELANIA ÍÑIGO, JOSÉ LUIS DEL POZO

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.11.2022

Antibiotic resistance is one of the main menaces to public and individual health worldwide. In the last two decades,
an increase in the detection of carbapenem-resistant Enterobacterales has been reported. The treatment of infections caused by these strains is a therapeutic challenge. The use of carbapenems may be beneficial depending on MIC value and source of infection. New drugs, with different activity against the different classes of carbapenemases, are developed showing significant benefits.

Rev Esp Quimioter 2022; 35(Suppl.3):46-50 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):41-45

Update on antimicrobial pharmacotherapy against multidrug-resistant Gram-negative bacilli

EMILIO MASEDA, ALEJANDRO SUÁREZ DE LA RICA

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.10.2022

Extended-spectrum β-lactamases (ESBL)-producing organisms currently represent a major health problem. Although recently published guidelines still consider carbapenems as the treatment of choice for ESBL-producing infections, it is necessary to find non-carbapenem β-lactams as alternatives to reduce the effects associated with their overutilization. In this review we focus on these alternatives to carbepenem use. It is possible that piperacillin-tazobactam may be an alternative in clinical settings with “low inoculum” infections like urinary tract infections. Newer β-lactam-β-lactamase inhibitors (BLBLIs) are potential options too. The current available data support the efficacy of both ceftazidime-avibactam and ceftolozane-tazobactam against susceptible ESBL-producing Enterobacterales (ESBL-E). We are waiting for the results of MERINO-3 study to confirm whether ceftolozane-tazobactam is a good option versus meropenem for treating bloodstream infections caused by ESBL- or AmpC-producing Enterobacterales.

Rev Esp Quimioter 2022; 35(Suppl.3):41-45 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):37-40

Antimicrobial resistance and One Health

CARLOS SERNA, BRUNO GONZALEZ-ZORN

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.09.2022

Antimicrobial resistance is one of the major health problems we face in the 21st century. Nowadays we cannot understand global health without the interdependence between the human, animal and environmental dimensions. It is therefore logical to adopt a “One Health” approach to address this problem. In this review we show why a collaboration of all sectors and all professions is necessary in order to achieve optimal health for people, animals, plants and our environment.

Rev Esp Quimioter 2022; 35(Suppl.3):37-40 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):34-36

Global strategy in the treatment of HIV infection in 2022

MARTA ROSAS, SANTIAGO MORENO

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.08.2022

The treatment of HIV infection has become a cornerstone for the global control of the pandemic due to its benefits on individual health and for preventing the transmission of HIV. It should be started in all people with HIV infection and as quickly as possible. Ideally, it should be started on the same day of diagnosis or, failing that, within the first 7 days. Antiretroviral regimens with excellent efficacy, no significant toxicity, and convenient administration are currently available for initiation of antiretroviral treatment. They can incorporate two or three drugs and are always based on a second-generation integrase inhibitor.

Rev Esp Quimioter 2022; 35(Suppl.3):34-36 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):30-33

Optimization of antimicrobial treatment in sepsis

JOSÉ RAMÓN AZANZA PEREA

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.07.2022

Sepsis represents a serious risk to the life of any patient, which is why it is crucial to start an effective treatment in all its extremes as soon as possible, that is, the chosen antibiotics must have activity against the pathogen that produces the condition and, in addition, they must be dosed considering the patient’s situation in all its extremes. It should be considered that it will be necessary to adjust the dose when there is edema (drugs with reduced volume of distribution), hypoproteinemia (drugs bound to proteins in a high proportion), obesity, and also when they require the use of external techniques such as ECMO or any of the different types of hemodialysis and hemofiltration.

Rev Esp Quimioter 2022; 35(Suppl.3):30-33 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):25-29

Current treatment of nosocomial pneumonia and ventilator-associated pneumonia

ERIKA P. PLATA-MENCHACA, RICARD FERRER

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.06.2022

Hospital-acquired pneumonia and ventilator-associated pneumonia are severe nosocomial infections leading to high morbidity and mortality. Broad-spectrum antibiotics with coverage against all likely pathogens are recommended by the international guidelines. Inappropriate empirical treatment is one of the most important prognostic factors. Knowledge of local epidemiology and continuous microbiological surveillance is crucial for improving clinical approaches to empirical antimicrobial treatment. The development of protocols and policies for training healthcare professionals on preventive strategies, such as the “Pneumonia Zero” project, and improved implementation of antimicrobial stewardship practices, will aid early de-escalation of antibiotics and prevent resistance

Rev Esp Quimioter 2022; 35(Suppl.3):25-29 [Full-text PDF]


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