CELIA GARCÍA-RIVERA, MARTA NAVARRO, MÓNICA PARRA, ANTONIA SÁNCHEZ BAUTISTA, INMACULADA GÓMEZ, MARÍA-PAZ VENTERO. JUAN CARLOS RODRÍGUEZ
Published: 22 December 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/080.2023
Rev Esp Quimioter 2024; 37(1): 104-105 [Texto completo PDF]
HÉCTOR TOLEDO, ADELINA GIMENO, JOSÉ CARLOS ALARCÓN, RAFAEL LUQUE-MÁRQUEZ
Published: 21 December 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/051.2023
Rev Esp Quimioter 2024; 37(1): 100-101 [Full-text PDF]
ÁLVARO VÁZQUEZ-PÉREZ, ESPERANZA ORTI-MORENTE, FERNANDO COBO, JUAN LUIS SANTOS-PÉREZ
Published: 20 December 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/076.2023
Rev Esp Quimioter 2024; 37(1): 102-103 [Texto completo PDF]
SILVIA GARCÍA-BUJALANCE, EDUARDO RUBIO-MORA, ALFREDO MALDONADO-BARRUECO, ROCÍO MONTEJANO, JULIO GARCÍA RODRIGUEZ
Published: 18 December 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/106.2023
Rev Esp Quimioter 2024; 37(1): 118-120 [Texto completo PDF]
M. CECILIA YAÑEZ PALMA, FRANCISCO ROMAN, FERRÁN LLOPIS-ROCA, MARCOS FRAGIEL, AGUSTÍN JULIÁN JIMÉNEZ, FRANCISCO JAVIER MARTÍN-SÁNCHEZ, JUAN GONZÁLEZ DEL CASTILLO
Published: 18 December 2023
http://www.doi.org/10.37201/req/110.2023
Background. The prediction of bacteremia in the emergency department (ER) is important for initial decision-making. The elderly population is a diagnosis challenge. The objective was to evaluate the accuracy of mid regional pro-adrenomedullin (MR-proADM) to identify true bacteremia (BV) in elderly patients attended in 3 hospital emergency departments.
Methods. Observational study including patients ≥75 years of age or older attended in the ER for suspected infection in whom a blood culture (BC) was extracted. Sociodemographic, comorbidity, hemodynamic and analytical variables, biomarkers [MR-proADM, procalcitonin (PCT), C-reactive protein (CRP) and lactate] and final diagnosis were collected. The primary outcome was a true positive on a blood culture.
Results. A total of 109 patients with a mean age of 83 (SD: 5.5) years were included. A final diagnosis of BV was obtained in 22 patients (20.2%). The independent variables to predict it were PCT (OR: 13.9; CI95%: 2.702-71.703; p=0.002), MR-proADM (OR: 4.081; CI95%: 1.026-16.225; p=0.046) and temperature (OR: 2.171; CI95%: 1.109-4.248; p=0.024). Considering the cut-off point for MR-proADM (2.13 mg/dl), a sensitivity (Se) of 73%, specificity (E) of 71%, a positive predictive value (PPV) of 39%, a negative predictive value (NPV) of 91%, a positive likelihood ratio (LHR+) of 2.53 and a negative likelihood ratio (LHR-) of 0.38; for PCT (0.76 mg/dl) a Se of 90%, E of 65%, PPV of 40%, NPV of 96%, LHR+ 2,64 and a LHR- of 0.14 were obtained. When combining both, a Se of 69%, E of 84%, PPV of 52%, NPV of 91%, LHR+ of 4.24 and LHR- of 0.38 were observed.
Conclusions. Elevated levels of PCT and MR-proADM were independently associated with an increased risk of BV and the combination of both improves the accuracy to identify these patients.
Rev Esp Quimioter 2024; 37(1): 78-87 [Texto completo PDF]
CARMEN PIÑA-DELGADO, MARGARITA BOLAÑOS-RIVERO, MARÍA ALEJANDRA CORDERO-ÁLVAREZ, ISABEL DE MIGUEL-MARTÍNEZ
Published: 15 December 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/083.2023
Rev Esp Quimioter 2024; 37(1): 110-111 [Texto completo PDF]
DOMINGO FERNÁNDEZ VECILLA, SILVIA LÓPEZ-PLANDOLIT ANTOLÍN, PAULA BELÉN BLASCO PALACIO, MIREN JOSEBE UNZAGA BARAÑANO, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO
Published: 12 December 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/097.2023
Rev Esp Quimioter 2024; 37(1): 112-115 [Full-text PDF]
IOSU RAZQUIN OLAZARÁN, AITZIBER AGUINAGA PÉREZ, MATILDE ELÍA LÓPEZ, CARMEN EZPELETA BAQUEDANO
Published: 11 December 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/103.2023
Rev Esp Quimioter 2024; 37(1): 116-117 [Texto completo PDF]
ITZIAR ANGULO-LÓPEZ, DARÍO MARTÍN-CORUJO, JOSÉ LUIS DÍAZ-DE-TUESTA DEL ARCO, MIREN BASARAS-IBARZABAL
Published: 11 December 2023
http://www.doi.org/10.37201/req/063.2023
Introduction. Urine culture as a gold standard for the diagnosis of urinary tract infection (UTI) involves a considerable workload in Clinical Microbiology Departments, due to the high number of samples received that will ultimately be negative. Therefore, it is necessary to use screening systems that also reduce the turnaround time for UTI diagnosis. The new flow cytometer UF-5000 (Sysmex Corporation) is able to differentiate between Gram-negative and Gram-positive bacteria using the BACT-info parameter according to manufacturer. The aim of our study was to evaluate the gram discrimination ability of the UF-5000 cytometer.
Methods. A prospective study with 449 urine samples collected consecutively was conducted, in the period 7/3/2022-27/5/2022, in which the BACT-info flag was compared with urine culture as the reference method.
Results. The sensitivity obtained for both Gram-negative and Gram-positive bacteria was above 95%. However, for Gram-positive bacteria, the moderate Kappa index (0.49) and the low positive predictive value (37.1%) indicated that the correlation between BACT-info flag and urine culture was not acceptable and should not be reported to the requesting clinician.
Conclusion. Implementation of the third generation UF-5000 cytometer represents a significant advance in the aetiological orientation of UTIs caused by Gram-negative bacteria. Reporting the Gram morphology in the urine samples reduces the response time in the microbiological diagnosis of UTI, which would have an impact on the reduction and optimisation of empirical treatment, and thus on the generation of antimicrobial resistance.
Rev Esp Quimioter 2024; 37(1): 52-57 [Texto completo PDF]
AGUSTÍN JULIÁN-JIMÉNEZ, DARÍO EDUARDO GARCÍA, GRACIELA MERINOS-SÁNCHEZ, LUIS GARCÍA DE GUADIANA-ROMUALDO, JUAN GONZÁLEZ DEL CASTILLO
Published: 7 December 2023
http://www.doi.org/10.37201/req/099.2023
Introduction. Obtaining blood cultures (HC) is performed in 15% of the patients treated with suspicion of infection in the Hospital Emergency Services (ED) with a variable diagnostic yield (2-20%). The 30-day mortality of patients with bacteremia is two or three times higher than the rest with the same process. Procalcitonin (PCT) is a biomarker that has been used as a tool to help predict bacteremia in HEDs. The main objective of this systematic review is to investigate the diagnostic accuracy of PCT in predicting true bacteraemia in adult patients treated with clinical suspicion of infection in the ED, as well as to identify a specific PCT value as the most relevant from the clinical decision diagnostic point of view that can be recommended for decision making
Method. A systematic review was performed following the PRISMA guidelines in the PubMed, Web of Science, EMBASE, Lilacs, Cochrane, Epistemonikos, Tripdatabase and ClinicalTrials.gov databases from January 2010 to May 31, 2023 without language restrictions and using a combination of MESH terms: “Bacteremia/ Bacteraemia/ Blood Stream Infection”, “Procalcitonin”, “Emergencies/ Emergency/ Emergency Department” and “Adults”. Observational cohort studies and partially an systematic review were included. No meta-analysis techniques were performed, but the results were compared narratively.
Results. A total of 1,372 articles were identified, of which 20 that met the inclusion criteria were finally analyzed. The included studies represent a total of 18,120 processed HC with 2,877 bacteraemias (15.88%). Ten studies were rated as high, 9 moderate and 1 low quality. The AUC-COR of all the studies ranges from 0.68 (95% CI: 0.59-0.77) to 0.98 (95% CI: 0.97-0.99). The PCT value >0.5 ng/ml is the most widely used and proposed in up to ten of the works included in this systematic review, whose estimated mean yield is an AUC-COR of 0.833. If only the results of the 6 high-quality studies using a cut-off point (PC) >0.5 ng/mL PCT are taken into account, the estimated mean AUC-COR result is 0.89 with Se of 77.6% and It is 78%.
Conclusions. PCT has a considerable diagnostic accuracy of bacteraemia in patients treated in EDs for different infectious processes. The CP>0.5 ng/ml has been positioned as the most suitable for predicting the existence of bacteraemia and can be used to reasonably rule it out.
Rev Esp Quimioter 2024; 37(1): 29-42 [Texto completo PDF]
