DAVID SÁNCHEZ-RAMOS, ESTEBAN VEGA-TORRES, CARLOS IRLES-VIDAL, JAVIER COLOMINA-RODRÍGUEZ
Published: 17 June 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/034.2022
Rev Esp Quimioter 2022; 35(4):418-420 [Full-text PDF]
PABLO VIDAL-CORTÉS, MARÍA CRUZ MARTÍN, EMILI DÍAZ, MARÍA BODÍ, JOSÉ CARLOS IGEÑO, JOSÉ GARNACHO-MONTERO
Published: 9 June 2022
http://www.doi.org/10.37201/req/025.2022
Objective. To measure the impact of the pandemic in Spanish ICUs.
Material and methods. On-line survey, conducted in April 2021, among SEMICYUC members. Participants were asked about number of patients admitted, increase in the number of beds and staff, structures created in the hospital and self-assessment of the work performed.
Results. We received 246 answers from 157 hospitals. 67.7% of the ICUs were expanded during the pandemic, overall increase in beds of 58.6%. The ICU medical staff increased by 6.1% and there has been a nursing shortage in 93.7% of units. Patients exceeded 200% the pre-pandemic ICU capacity. In 88% of the hospitals the collaboration of other specialists was necessary. The predominant collaboration model consisted of the intensive care medicine specialist being responsible for triage and coordinating patient management. Despite that 53.2% centres offered training for critical care, a deterioration in the quality of care was perceived. 84.2% hospitals drew up a Contingency Plan and in 77.8% of the hospitals a multidisciplinary committee was set up to agree on decision-making. Self-evaluation of the work performed was outstanding and 91.9% felt proud of what they had achieved, however, up to 15% considered leaving their job.
Conclusions. The Spanish ICUs assumed an unprecedented increase in the number of patients. They achieved it without hardly increasing their staff and, while intensive care medicine training was carried out for other specialists who collaborated. The degree of job satisfaction was consistent with pre-pandemic levels.
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Rev Esp Quimioter 2022; 35(4):392-400 [Full-text PDF]
DOMINGO FERNÁNDEZ VECILLA, CRISTINA ASPICHUETA VIVANCO, FELICITAS ELENA CALVO MURO, LANDER ANTÓN MÉNDEZ, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO
Published: 9 June 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/024.2022
Rev Esp Quimioter 2022; 35(4):411-414 [Texto completo PDF]
Mª DEL MAR RODRÍGUEZ DEL ÁGUILA, ANTONIO SORLÓZANO-PUERTO, Mª AMELIA FERNÁNDEZ-SIERRA, JOSÉ Mª NAVARRO MARÍ, JOSÉ GUTIÉRREZ FERNÁNDEZ
Published: 6 June 2022
http://www.doi.org/10.37201/req/016.2022
Objective. To determine the epidemiological characteristics of significative bacteriuria (SB) and their relationship with sociodemographic factors and to analyze risk factors in inpatients.
Material and methods. Cross-sectional descriptive study carried out on urine culture samples received between 2016-2020 in the Microbiology laboratory, differentiating between minors and adults. The dependent variable was the presence of SB and the independent variables were age, sex, year, type of sample and source of the sample. In urine cultures of inpatients, risk factors were evaluated from the Minimum Basic Data Set.
Results. A total of 68,587 valid records (96.3% of the total) were analyzed. 40.8% (95% CI: 40.4%-41.2%) of urine cultures in adults and 33.8% (95% CI: 32.9%-34.7%) in children were positive, with an incidence that ranged in adults between 18.2 cases/1,000 inhabitants in 2016 and 14.6 cases/1,000 inhabitants in 2020 and 21.1 and 8.4 cases/1,000 inhabitants respectively in minors. Positive urine cultures were more frequent in children from urban areas compared to rural areas (OR=1.37; p<0.01). In hospitalized adults, for each year of age the risk of SB increased by 2%, it was 36% higher in women, 18% higher in obese patients and 17% more frequent in patients with kidney disease, (p<0.01). No relationship was observed between SB and diagnosis of COVID-19.
Conclusion. The sociodemographic characteristics of the population with SB in our health area are similar to those found in other geographical areas worldwide, observing a decreasing trend in incidence in the years studied. The frequency of SB in children is higher in urban areas.
Rev Esp Quimioter 2022; 35(4):382-391 [Texto completo PDF]
WEN WEN, HONG LI, CHUNYI WANG, CHEN CHEN, JIAKE TANG, MENGYUN ZHOU, XUWEI HONG, YONGRAN CHENG, QI WU, XINGWEI ZHANG, ZHANHUI FENG, MINGWEI WANG
Published: 2 June 2022
http://www.doi.org/10.37201/req/011.2022
Background. To investigate the clinical outcome of patients with infective endocarditis (IE) during and after outpatient parenteral antimicrobial treatment (OPAT), and to further clarify the safety and efficacy of OPAT for IE patients.
Methods. Through December 20, 2021, a total of 331 articles were preliminarily searched in Pubmed, Web of Science, Cochrane Library and Embase, and 9 articles were eventually included in this study.
Results. A total of 9 articles comprising 1,116 patients were included in this study. The overall mortality rate of patients treated with OPAT was 0.04 (95% CI, 0.02-0.07), that means 4 deaths per 100 patients treated with OPAT. Separately, mortality was low during the follow-up period after OPAT treatment, with an effect size (ES) of 0.03 (95%CI, 0.02-0.07) and the mortality of patients during OPAT treatment was 0.04 (95% CI, 0.01-0.12). In addition, the readmission rate was found to be 0.14 (95% CI, 0.09-0.22) during the follow-up and 0.18 (95% CI, 0.08-0.39) during treatment, and 0.16 (95% CI, 0.10-0.24) for patients treated with OPAT in general. Regarding the relapse of IE in patients, our results showed a low overall relapse rate, with an ES of 0.03 (95% CI, 0.01-0.05). In addition, we found that the incidence of adverse events was low, with an ES of 0.26 (95% CI, 0.19-0.33).
Conclusion. In general, the incidence of adverse events and mortality, readmission, and relapse rates in IE patients treated with OPAT are low both during treatment and follow-up period after discharge, indicating that OPAT is safe and effective for IE patients. However, our study did not compare routine hospitalization as a control group, so conclusions should be drawn with caution. In order to obtain more scientific and rigorous conclusions and reduce clinical risks, it is still necessary to conduct more research in this field and improve the patient selection criteria for OPAT treatment, especially for IE patients. Finally, clinical monitoring and follow-up of OPAT-treated patients should be strengthened.
Rev Esp Quimioter 2022; 35(4):370-377 [Full-text PDF]
MARÍA FERNÁNDEZ MIAJA, ANA VIVANCO ALLENDE, SARA DELGADO-NICOLÁS, MA EUGENIA LLANEZA-VELASCO, JAVIER FERNÁNDEZ DOMÍNGUEZ
Published: 31 May 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/170.2021
Rev Esp Quimioter 2022; 35(4):406-407 [Full-text PDF]
MARTA DE ANTONIO-CUSCÓ, FRANCISCO JOSÉ PARRILLA, HERNANDO KNOBEL FREUD, DANIEL ECHEVERRÍA-ESNAL, ANDREA CASTELLVÍ FONT, ANTONIA VÁZQUEZ, JOAN RAMON MASCLANS, OLIVIA FERRÁNDEZ, SANTIAGO GRAU
Published: 30 May 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/004.2022
Rev Esp Quimioter 2022; 35(4):408-410 [Full-text PDF]
ALEJANDRO DE GEA GRELA, LUZ MARTÍN CARBONERO, RAFAEL MICÁN, JOSÉ IGNACIO BERNARDINO, LUIS RAMOS, Mª EULALIA VALENCIA
Published: 24 May 2022
http://www.doi.org/10.37201/req/013.2022
Objective. To analyze the efficacy and tolerability of the strategy to change from rilpivirine (RPV) based regimens to bictegravir / emtricitabine / tenofovir alafenamide (B/F/TAF).
Methods. Single-center, observational and retrospective study. Patients who made the change to B/F/TAF before February 2020 were selected, analyzing the results after 24 and 48 weeks. The percentage that remained with an undetectable viral load was determined, as well as the changes in CD4 + lymphocytes, metabolic parameters and renal function.
Results. A total of 42 patients were included. Thirty-two of the 35 patients (91.4%) who completed the 48 weeks of follow-up had an undetectable viral load. The CD4 + lymphocyte count remained stable at 24 and 48 weeks. The response to B/F/TAF was not influenced by the two analogs previously received.
Conclusion. Switching from triple therapy with RPV to B/F/TAF is a safe and effective strategy in real life.
Rev Esp Quimioter 2022; 35(4):378-381 [Texto completo PDF]
PALOMA GARCÍA CLEMENTE, MARÍA PILAR ROMERO-GÓMEZ, JULIO GARCÍA-RODRÍGUEZ, EMILIO CENDEJAS-BUENO
Published: 23 May 2022
http://www.doi.org/10.37201/req/135.2021
Introduction. Bacteriemia is a major cause of morbidity and mortality among hospitalized patients worldwide. Early identification of microorganisms from blood culture can lead to improvement of treatment and outcomes.
Methods. The study was divided into two phases. The first phase when a comparison of the methods was made to check the concordance between them, using as a reference the standard method implemented in the laboratory. In a second phase, both methods are combined. We used the rapid identification method and when it could not identify we used the standard method. The microorganisms that were not identified by either of the two methods were identified from colony at 24 hours
Results. A total of 589 microbial positive blood cultures have been included in the present study. With the rapid method we obtained 96% and 88% identification results for Gram-negative bacilli (GNB) and Gram-positive cocci (GPC) respectively. In this study we observed that the combination of the rapid and standard method achieved identifications of 98% and 97% for GNB and GPC respectively.
Conclusions. The data analysed shows that both methods combined perform better than individually. We achieved an optimization of the identification of microorganisms directly from positive blood cultures by MALDI-TOF. This combination identified 98% of the microorganisms in between ten minutes to one hour and a half since the blood culture flagged positive.
Rev Esp Quimioter 2022; 35(4):362-369 [Full-text PDF]
MIGUEL FERNÁNDEZ-HUERTA, OSCAR Q. PICH, MATEU ESPASA
Published: 29 April 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/005.2022
Rev Esp Quimioter 2022; 35(3): 301-303 [Texto completo PDF]
