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Rev Esp Quimioter 2021;34(Suppl.1):15-17

Bioinformatics approaches to the study of antimicrobial resistance

ALEJANDRO SEOANE, GERMÁN BOU

Published: 30 September 2021

http://www.doi.org/10.37201/req/s01.04.2021

Detection and monitoring of antimicrobial resistance are two pillars on which clinical microbiology will be based in the coming decades. The implementation of certain technologies such as whole genome sequencing (WGS) or mass spectrometry and the creation of national and international databases that include and gather data on antimicrobial resistance from around the world has allowed the application of bioinformatics in the study of antimicrobial resistance in microorganisms involved in human pathology.

Rev Esp Quimioter 2021; 34(Suppl. 1):15-17 [Full-text PDF]


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Rev Esp Quimioter 2021;34(Suppl.1):12-14

RedLabRA; a Spanish Network of Microbiology Laboratories for the Surveillance of Antibiotic Resistant Microorganisms

JAVIER E. CAÑADA-GARCÍA, MARÍA PÉREZ-VÁZQUEZ, JESÚS OTEO-IGLESIAS

Published: 30 September 2021

http://www.doi.org/10.37201/req/s01.03.2021

There is an urgent need to control the clinical and public health impact that antibiotic resistance (AR) causes worldwide. Any measure for its control must be based on an up-to-date and comprehensive knowledge of the situation. However, it is difficult to determine the current dimension of AR because a large part of the available information is based on heterogeneous, insufficiently unified and retrospective data. The integration of genomic information in the surveillance of AR is another important factor for improvement. The Spanish Network of Laboratories for the Surveillance of Resistant Microorganisms (RedLabRA) is a structured network of interconnected microbiology laboratories developed within the Spanish National Plan against Antibiotic Resistance. Its main objective is to support the diagnosis of resistance to antibiotics, integrating molecular characterization in the surveillance.

Rev Esp Quimioter 2021; 34(Suppl. 1):12-14 [Full-text PDF]


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Rev Esp Quimioter 2021;34(Suppl.1):8-11

What happened to infectious diseases and anti-infective therapy in 2020 beyond COVID-19?

SARAY MORMENEO BAYO, JUAN M. GARCÍA-LECHUZ MOYA

Published: 30 September 2021

http://www.doi.org/10.37201/req/s01.02.2021

The year 2020 was the year of infectious diseases with the arrival of SARS-CoV-2, which represented a profound change in the world we knew. However, we present a brief description of some of the top infectious diseases articles from 2020 not related with SARS-CoV-2. We reviewed a selection of the most important and relevant achievements in diagnosis and therapy related to bacteremia, nosocomial pneumonia, skin and soft tissue infections, infections by Clostridioides difficile, mycobacterial infections and invasive fungal infections. This year entailed a significant step forward in the indisputable value of the health care stewardship programs.

Rev Esp Quimioter 2021; 34(Suppl. 1):8-11 [Full-text PDF]


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Rev Esp Quimioter 2021;34(Suppl.1):2-7

What happened to microbiological diagnosis in 2020 beyond COVID-19?

EMILIA CERCENADO

Published: 30 September 2021

http://www.doi.org/10.37201/req/s01.01.2021

The global pandemic of COVID-19 has had negative repercussions on the activities and research in clinical microbiology laboratories other than those related to SARS-CoV-2. Nonetheless, the research activity has also continued in other fields. In this brief review, some of the recent publications related to new diagnostic tests, methods for rapid antimicrobial susceptibility testing and for the detection of resistance genes, new diagnostic technologies, and some aspects related to old and emergent pathogens (Candida auris, Elizabethkingia spp. Streptococcus pyogenes) are summarized.

Rev Esp Quimioter 2021; 34(Suppl. 1):2-7 [Full-text PDF]


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Rev Esp Quimioter 2021;34(6):672-674

Micofenolato como ahorrador de corticoides en paciente con neumonía organizada por COVID-19

MARÍA JOSÉ ESTEVE GIMENO, CELIA ROIG MARTÍ, IGNACIO PÉREZ CATALÁN, NÚRIA TORNADOR GAYA, JORGE USÓ BLASCO

Published: 29 September 2021

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/048.2021

Rev Esp Quimioter 2021;34(6):672-674 [Texto completo PDF]


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Rev Esp Quimioter 2021;34(6):655-659

Skin and soft tissue infection caused by Streptococcus pneumoniae: report of 15 cases

SARA PÉREZ DE MADRID, ALBA MARÍA RODRIGO, DANIEL TENA

Published: 27 September 2021

http://www.doi.org/10.37201/req/060.2021

Background. Streptococcus pneumoniae is a very rare cause of skin and soft tissue infections (SSTI). The aim of this study was to determine the clinical and microbiological characteristics of these infections.
Material and methods. The medical records of patients with SSTIs due to S. pneumoniae diagnosed at the University Hospital of Guadalajara between January 2012 and December 2020 were retrospectively reviewed. Microbiological identification was performed using conventional procedures. Antimicrobial sensitivity was performed using the MicroScan WalkAway-96 plus automatic system and E-test strips following the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST).
Results. Fifteen cases of SSTIs were diagnosed. 73,3% of the cases presented underlying diseases, neoplasias being the most frequent. 60% of the cases presented predisposing factors, immunosuppression being the most common. The clinical presentations were: abscesses in different locations, ulcers, surgical wounds, lactational mastitis and necrotizing fasciitis. Polymicrobial infections were detected in 73.3% and the etiology was nosocomial in 6.6%. The clinical course was favorable in 90.9% of the cases. The antibiotics with the highest percentages of sensitivity against S. pneumoniae were cefotaxime, levofloxacin, vancomycin, linezolid and rifampicin.
Conclusions. S. pneumoniae should be kept in mind as a possible causative agent of SSTIs, especially in patients with neoplasias and immunosuppression. Its involvement in infections such as lactational mastitis and necrotizing fasciitis should be highlighted. The clinical evolution is favorable in most patients, but it is important to pay special attention to cases of necrotizing fasciitis due to the severity of these
infections.

Rev Esp Quimioter 2021;34(6):655-659 [Texto completo PDF]


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Rev Esp Quimioter 2021;34(6):618-622

Evaluation of the validity of Ag PANBIO-COVID19 in the diagnosis of SARS-CoV-2 infection in asymptomatic or mildly infected patients

PAULA GRAS-VALENTI, INMACULADA VIDAL, INÉS MONTIEL-HIGUERO, ISABEL ESCRIBANO, NATIVIDAD ALGADO-SELLES, PABLO CHICO-SÁNCHEZ, MARIA PAZ VENTERO, NATALI JIMÉNEZ-SEPULVEDA, CARMEN MOLINA-PARDINES, ESPERANZA MERINO-LUCAS, JOSÉ SÁNCHEZ- PAYÁ, JUAN CARLOS RODRÍGUEZ

Published: 22 September 2021

http://www.doi.org/10.37201/req/054.2021

Objective. To assess the validity of SARS-CoV-2 Antigen (Ag) detection for the diagnosis of SARS-CoV-2 infection in mildly infected or asymptomatic patients.
Material and methods. Observational study to evaluate diagnostic tests. Non-hospitalized patients with indication for diagnostic testing for SARS-CoV-2 infection were included. The diagnostic test to be evaluated was the determination of Ag and as a reference standard to determine the presence of viral RNA the RT-PCR was used.
Results. A total of 494 patients were included. Of these 71.5% (353/494) had symptoms and 28.5% (141/494) were asymptomatic (presurgery screening (35/494) and confirmed case-contact (106/494). The overall sensitivity of the Ag test was 61.1% and the specificity was 99.7%. The sensitivity and specificity in the asymptomatic group were 40% and 100% respectively, and in the symptomatic group 63.5% and 99.6% respectively. In turn, the sensitivity and specificity in the group of symptomatic patients varied according to the time of symptom evolution: in patients with recent symptoms, they were 71.4% and 99.6% respectively, while in patients with symptoms of more than 5 days of evolution, they were 26.7% and 100% respectively. In all groups studied, the presence of antigen is associated with a high viral load (Ct<30 cycles).
Conclusions. The use of Ag detection test is not indicated for the diagnosis of SARS-CoV-2 infection in asymptomatic patients or with symptoms of more than 5 days of evolution, but it could be useful in patients with symptoms of 1-5 days of evolution.

Rev Esp Quimioter 2021;34(6):618-622[Texto completo PDF]


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Rev Esp Quimioter 2021;34(6):631-638

Choice of influenza vaccine in people over 65 years old. Analysis of reports from international vaccination advisory committees

ALBERTO PÉREZ-RUBIO, JOSÉ JAVIER CASTRODEZA, JOSÉ MARÍA EIROS

Published: 22 September 2021

http://www.doi.org/10.37201/req/076.2021

Introduction. Annual recommendations on influenza vaccine use in different countries are developed by influenza-specific working groups within their Immunization Advisory Committees. Adults aged 65 years and over are included in the groups for which vaccination against influenza is particularly recommended due to the morbidity associated. A variety of influenza vaccines are available, some of which boosted immunity, are licensed for use only in this specific age group, where the immune response to traditional influenza vaccines may be suboptimal. We analyze the main annual recommendations on the use of the influenza vaccine issued by advisory committees on immunization for the population over 65 years of age.
Material and methods. The latest influenza vaccination guidelines have been selected and the recommendations for people over 65 years of age published by the main vaccination advisory committees have been reviewed.
Results. The UK Advisory Committee (JCVI) recommends the use of Quadruvalent Inactivated Influenza Vaccine with Adjuvant (aQIV) or High Dose Quadrivalent Inactivated Influenza Vaccine (QIV-HD). The US committee (ACIP) does not express a preference for any type of vaccine. The Australian committee (ATAGI) preferably recommends adjuvanted influenza vaccine. The advisory committees of Canada and Germany (NACI, STIKO) and the European Center for Disease Control (Ecdc) recommend using any of the age-appropriate flu vaccines available, although they bet on the use of inactivated quadrivalent flu vaccine high dose at the individual level for those over 65 years.
Conclusion. It is necessary further studies and improvement in their quality that analyze the different vaccines available and their comparability, although the use of reinforced immunity vaccines is generally recommended in the population over 65 years of age.

Rev Esp Quimioter 2021;34(6):631-638 [Texto completo PDF]


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Rev Esp Quimioter 2021;34(5):429-440

Oral antibiotic treatment of exacerbation of COPD. Beyond COVID-19

JOSÉ MIGUEL RODRÍGUEZ GONZÁLEZ-MORO, JOSÉ LUIS IZQUIERDO ALONSO

Published: 17 September 2021

http://www.doi.org/10.37201/req/125.2021

COPD (chronic obstructive pulmonary disease) includes patients with chronic bronchitis and / or emphysema who have in common the presence of a chronic and progressive airflow obstruction, with symptoms of dyspnea and whose natural history is modified by acute episodes of exacerbations. Exacerbation (EACOPD) is defined as an acute episode of clinical instability characterized by a sustained worsening of respiratory symptoms. It is necessary to distinguish a new EACOPD from a previous treatment failure or a relapse. EACOPD become more frequent and intense over time, deteriorating lung function and quality of life. The diagnosis of EACOPD consists of 3 essential steps: a) differential diagnosis; b) establish the severity, and c) identify its etiology. The main cause of exacerbations is infection, both bacterial and viral. Antibiotics are especially indicated in severe EACOPD and the presence of purulent sputum. Beta-lactams (amoxicillin-clavulanate and cefditoren) and fluoroquinolones (levofloxacin) are the most widely used antimicrobials. This review updates the problem of acute exacerbation with infectious origin from the perspective of etiology, antimicrobial resistance, microbiological studies, risk stratification, and antimicrobial management. The risk, prognosis and characteristics of COPD patients who develop COVID19 are analyzed.

Rev Esp Quimioter 2021;34(5):429-440 [Texto completo PDF]


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Rev Esp Quimioter 2021;34(6):610-617

Antimicrobial stewardship programs in emergency departments: how do we measure antimicrobial use? A systematic review

JESUS RUIZ-RAMOS, EMILI VALLVÉ ALCÓN, FRANCISCO MORENO RAMOS, ROSARIO SANTOLAYA-PERRÍN, JOSE MARÍA GUARDIOLA TEY

Published: 15 September 2021

http://www.doi.org/10.37201/req/028.2021

Objectives. The implementation of antimicrobial stewardship programs (ASPs) has become a usual practice in hospital settings. However, the method for monitoring antimicrobial use in accident and emergency departments (ED) is not yet adequately defined. Thus, the objective of this review is to describe antimicrobial use indicators used by ASPs implemented in ED.
Material and methods. A systematic review was performed based on studies found in the following academic research databases: MEDLINE, EMBASE, Web of Science, and Scopus (Period: January 2000 to December 2019). Controlled clinical trials, before-and-after studies, interrupted time series, and repeated measures studies assessing the impact of ASPs on antimicrobial use in ED were included; studies published in languages other than English or Spanish were excluded from this review.
Results. Twenty-six studies met the inclusion criteria and were included in this systematic review. In total, 15 (62.5%) studies described the ASP team members who collaborated with the ED staff. Most (21; 80.8%) studies used the percentage of patients with an antibiotic prescription as an indicator. Four (15.4%) studies included defined daily dose data. The antibiotic treatment duration was reported in four (15.4%) studies. Only two studies assessed the impact of the ASP using microbiological indicators, both of which used the incidence of infection with Clostridioides difficile as the indicator.
Conclusions. The reports of experiences in implementing ASPs in ED show heterogeneous antimicrobial use indicators, which makes it difficult to compare results. Therefore, antimicrobial use indicators for ASPs must be standardised between hospital units.

Rev Esp Quimioter 2021;34(6):610-617 [Full-text PDF] [Supplementary material PDF]


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