MARÍA JOSÉ RUÍZ MÁRQUEZ, ROCÍO CABRA RODRÍGUEZ, DIEGO RUÍZ MÁRQUEZ
Published: 22 February 2021
http://www.doi.org/10.37201/req/128.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(2): 162-163 [Texto completo PDF]
JERÓNIMO JAQUETI AROCA, LAURA M. MOLINA ESTEBAN, ISABEL GARCÍA-ARATA, JESÚS GARCÍA-MARTÍNEZ, ISABEL CANO DE TORRES, SANTIAGO PRIETO MENCHERO
Published: 19 February 2021
http://www.doi.org/10.37201/req/010.2020
Objectives. Clostridioides difficile (CD) is the most common cause of nosocomial diarrhea. Detection of CD toxin in patients’ faecal samples is the traditional rapid method for the diagnosis of CD infection. Various testing algorithms have been proposed: an initial screening test using a rapid test, and a confirmatory test (cytotoxicity neutralization assay, toxigenic culture, nucleic acid amplification test) for discordant results. The aim of this study was to evaluate the effectiveness of a two-step algorithm using an immunochromatographic test followed of a polymerase chain reaction (PCR).
Material and methods. The specimens have been tested according to the following schedule: 1) Step one: All samples were tested for detection of glutamate dehydrogenase antigen (GDH) and toxin A/B using the C. diff QUIK CHEK Complete test. All GDH and toxins positive results were considered CD positives; 2) Step two: When the results were discrepant (only GDH+ or toxins+), the samples were confirmed using the PCR test BD MAX Cdiff. All PCR positive results were considered CD positives.
Results. A total of 2,138 specimens were initially tested. 139 were positive for GDH and toxins. 160 discrepant results (148 GDH+ and 12 toxins+) were tested by PCR, 117 were positive (107/148 GDH+ and 10/12 toxins+).
Conclusions. The implementation of a PCR method showed an increase de 117 positive results (73.1% of discrepant). Considering the sensitivity of C.diff QUIK CHEK (instructions of manufacturer), the GDH discrepant results may be false negatives, y the samples PCR and toxins positives may be real positives results.
Rev Esp Quimioter 2021; 34(2): 141-144 [Texto completo PDF]
ALICIA ALONSO ÁLVAREZ, LUCÍA RAMOS MERINO, LAURA MARÍA CASTELO CORRAL, ANA PADÍN TRIGO, DOLORES SOUSA REGUEIRO, ENRIQUE MÍGUEZ REY, EFRÉN SÁNCHEZ VIDAL
Published: 15 February 2021
http://www.doi.org/10.37201/req/119.2020
Objective. To determine the indications, success rate and adverse effects of ceftaroline fosamil treatment in a tertiary hospital.
Material and methods. In total, 84 cases from February 2018 to December 2019 were retrospectively analysed. No exclusion criteria were applied.
Results. Eighty-four patients, with a median age of 70 years, of which, 6.7% (56) were male, were treated with ceftaroline fosamil for a median of 14 days. Most indications were off-label, including 29 endocarditis (34.5%), 14 bacteraemia (16.6%), 5 Central nervous system (CNS) infections (6%) and 19 osteoarticular infections (22.6%). Staphylococcus aureus was the most frequently isolated microorganism, including 28 methicillin-sensitive S. aureus (MSSA; 33.3%) and 14 methicillin-resistant S. aureus (MRSA; 16.7%), followed by coagulase-negative Staphylococcus (23, 27.4%). The main reason for ceftaroline fosamil prescription was the failure of previous treatment (41.7% of cases). Treatment was successful in 60/84 patients (71.4%) and failed clinically or microbiologically in 14 (16.7%). Eight patients died for a reason not related to the infection and two were found to have a non-infectious condition. Twenty-two of thirty-five (62.8%) patients prescribed ceftaroline because of failure of previous treatment improved, including eight endocarditis and seven bacteraemia. Adverse
effects were reported in five patients (5.9%) including neutropenia, thrombocytopenia, transaminases elevation and creatinine elevation; all except one were mild and all resolved after discontinuation of treatment.
Conclusions. Ceftaroline fosamil is a well-tolerated cephalosporine, effective against multi- resistant gram-positive and many gram-negative microorganisms. Our experience suggests that it is effective as a rescue or first-line therapy in other indications than those currently approved.
Rev Esp Quimioter 2021; 34(2): 115-119 [Full-text PDF]
SARA ORTONOBES ROIG, NURIA SOLER-BLANCO, ISABEL TORRENTE JIMÉNEZ, EVA VAN DEN EYNDE OTERO, MARC MORENO-ARIÑO, MÒNICA GÓMEZ-VALENT
Published: 1 February 2021
http://www.doi.org/10.37201/req/130.2020
Introduction. Despite the impact of SARS-CoV-2 infection in geriatrics, data on nonagenarian patients is scarce. The aim of this study is to describe the clinical features of COVID19-diagnosed nonagenarians, as well as its clinical evolution and therapeutic response.
Material and methods. Retrospective observational study of nonagenarians, admitted for COVID-19. Sociodemographic and clinical variables were registered, including previous polypharmacy. Blood analysis data and COVID-19-specific treatment were registered.
Results. A total of 79 patients were included, with 50.6% (40 patients) of mortality. None of the comorbidities registered correlated with mortality, which was significantly higher among patients with moderate/complete functional dependence, compared to those mild-dependents/independents (59.5% vs 40.5%; p=0.015). Most prescribed drugs were hydroxychloroquine/chloroquine and azithromycin. Non-survivors presented higher counts of leukocytes and neutrophils, and higher lymphopenia.
Conclusions. Nonagenarians with functional dependence presented higher mortality, irrespective of comorbidities or treatment received. Implementing an integral geriatric evaluation would enhance the implementation of personalized therapeutic strategies for nonagenarians.
Rev Esp Quimioter 2021; 34(2): 145-150 [Texto completo PDF]
CRISTINA MATESANZ LÓPEZ, CRISTINA LORAS GALLEGO, JUANA CACHO CALVO, ISRAEL JOHN THUISSARD VASALLO, MARÍA TERESA RÍO RAMÍREZ
Published: 1 February 2021
http://www.doi.org/10.37201/req/121.2020
Background. This study describes the characteristics of patients with positive cultures of non-tuberculous mycobacteria (NTM) in respiratory samples and determines the risk factors that predispose for a reinfection with different NTM species.
Methods. Patients with NTM isolates in respiratory samples between 2013 and 2017 were studied. Additionally, risk factors and comorbidities of reinfected patients were analyzed.
Results. The study was focused on the 280 patients with NTM isolation (28 were reinfected with at least another species). Mycobacterium avium was the main isolated species. 68% were men. Median age was 73.2. Most remarkable risk factors were: tobacco, COPD and bronchiectasis. Bronchiectasis turned out to be a statistically significant risk factor for reinfection. Only 12 patients (12.4%) were treated.
Conclusion. NTM were mainly identified in elderly patients. The most frequent comorbidities were COPD and smoking, whereas the most frequent species was M. avium. Previous bronchiectasis was a predisposing factor for reinfection.
Rev Esp Quimioter 2021; 34(2): 120-125 [Full-text PDF]
MARÍA NIEVES CARMONA TELLO, MICHELE HERNÁNDEZ CABRERA, EDUARDO JEREZ OLIVERA, MARGARITA BOLAÑOS RIVERO
Published: 28 Janurary 2021
http://www.doi.org/10.37201/req/116.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(2): 156-157 [Texto completo PDF]
NOEMI GÜEMES-VILLAHOZ, CINTHIA CHOCRÓN BENBUNAN, ANA ROCÍO ROMERO PATERNINA, DAVID DIAZ-VALLE, JUAN DONATE-LÓPEZ, MARÍA JOSÉ NÚÑEZ-ORANTOS
Published: 28 Janurary 2021
http://www.doi.org/10.37201/req/113.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(2): 154-155 [Texto completo PDF]
ENRIQUE CONTRERAS-MACÍAS, ANTONIO GUTIÉRREZ- PIZARRAYA, MARÍA AGUAS ROBUSTILLO-CORTÉS, RAMÓN MORILLO-VERDUGO
Published: 27 January 2021
http://www.doi.org/10.37201/req/097.2020
Objectives. People living with HIV (PLWHIV) have now a near-normal life expectancy and thus, a higher risk of polypharmacy. The main objective was to assess the correlation between medication regimen complexity index (MRCI) and quality of life (EQ-5D) and health utilities among PLWHIV patients on ART.
Patients and methods. Observational prospective single-center study including adult PLWHIV on ART from January to March-2020 attended at hospital pharmacy outpatient service according to a Capacity-Motivation-Opportunity (CMO) pharmaceutical care model.
Results. A total of 428 patients were included, mean age of 50 ± 10.9 years, 82.2% males. Negative correlation (r2=−0.147; p= 0.0002) between MRCI and EQ-5D was found. Relationship between the comorbidity pattern and quality of life, was also observed. Regarding MRCI, Anxiety/Depression, Pain/discomfort and Self-Care were the dimensions with the worst assessment.
Conclusions. A new multidimensional revised care plan for PLWHIV focussed on optimising overall patient care, not limited to viral load goal achievement alone but also in their pharmacotherapeutic complexity and quality of life is needed.
Rev Esp Quimioter 2021; 34(2): 93-99 [Full-text PDF]
LAURA CALLE-MIGUEL, GRACIA MODROÑO RIAÑO, ANA ISABEL IGLESIAS CARBAJO, MARÍA AGUSTINA ALONSO ÁLVAREZ, CELIA VICENTE MARTÍNEZ, GONZALO SOLÍS SÁNCHEZ
Published: 26 January 2021
http://www.doi.org/10.37201/req/108.2020
Background. Antibiotics in Spain are mainly prescribed in the community sector, remarking a high variability between areas. The aim of this study is to describe the variability between health areas in the antibiotic consumption in the pediatric population of Asturias during 2005-2018 period.
Methods. Retrospective and comparative study using data about consumption of antibacterial agents for systemic use (J01C group in ATC, Anatomical Therapeutic Chemical, classification) in the pediatric outpatients of the eight health areas of Principado de Asturias between 2005 and 2018, based on defined daily dose (DDD) per 1000 inhabitants and day (DID).
Results. Mean antibiotic consumption in pediatric outpatients in Principado de Asturias (2005-2018) was 14 DID (CI95% 13.4 – 14.6). Consumption increased until 2009 (15.2 DID) and decreased from 2015 onwards (11.9 DID in 2018). β-lactam penicillins was the most consumed therapeutic group (10.7 DID). There were statistically significant differences among the areas with the highest and the lowest consumption rates (Avilés, 19 DID; Oviedo, 11.5 DID). A high variability between health areas was observed when analysing data temporally (difference of 11.8 DID in 2011) and therapeutic groups. The consumption of macrolides in Langreo health area and quinolones in Jarrio health area were 2.3 and 4.1 times higher, respectively, comparing to Gijón health area.
Conclusions. There is a wide quantitative and qualitative variability of antibiotic consumption in the pediatric outpatients among the different health areas of Asturias.
Rev Esp Quimioter 2021; 34(2): 107-114 [Texto completo PDF]
JOSÉ MARÍA BARBERO ALLENDE, MARTA GARCÍA SÁNCHEZ, ANA MARÍA CULEBRAS LÓPEZ, ROSA AGUDO ALONSO
Published: 25 Janurary 2021
http://www.doi.org/10.37201/req/105.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(2): 151-153 [Texto completo PDF]
