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Rev Esp Quimioter 2021; 34(4): 280-288

Temporary hospitals in times of the COVID pandemic. An example and a practical view

FRANCISCO JAVIER CANDEL, JESÚS CANORA, ANTONIO ZAPATERO, RAQUEL BARBA, JUAN GONZÁLEZ DEL CASTILLO, GONZALO GARCÍA-CASASOLA, JESÚS SAN-ROMÁN, RUTH GIL-PRIETO, PABLO BARREIRO, MARCOS FRAGIEL, FERNANDO PRADOS, PABLO BUSCA, JESÚS VÁZQUEZ-CASTRO, JAVIER MARCO

Published: 22 March 2021

http://www.doi.org/10.37201/req/041.2021

We describe the most widely used temporary hospital in Europe during the first pandemic wave, its structure, function, and achievements. Other models of care developed during the pandemic around the world were reviewed including their capacity, total bed/ICU bed ratio and time of use. We particularly analyzed the common and differential characteristics of this type of facilities. IFEMA Exhibition Center was transformed into a temporary 1,300-bed hospital, which was in continuous operation for 42 days. A total of 3,817 people were treated, generally patients with mild to moderate COVID-19, 91% of whom had pneumonia. The average length of stay was 5 to 36 days. The most frequent comorbidities were hypertension (16.5%), diabetes mellitus (9.1%), COPD (6%), asthma (4.6%), obesity (2.9%) and dementia (1.6%). A total of 113 patients (3%) were transferred to another centers for aggravation, 19 (0.5%) were admitted to ICU and 16 patients (0.4%) died. An element of great help to reducing the overload of care in large hospitals during peaks of health emergencies could be these flexible structures capable of absorbing the excess of patients. These must be safe, breaking domestic transmission and guarantee social and emotional needs of patients. The success of these structures depends on delimitation in admission criteria taking into account the proportion of patients who may require, during admission, assistance in the critical care area.

Rev Esp Quimioter 2021; 34(4): 280-288 [Full-text PDF]


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Rev Esp Quimioter 2021; 34(2): 81-92

Current microbiological aspects of community respiratory infection beyond COVID-19

RAFAEL CANTÓN

Published: 22 March 2021

http://www.doi.org/10.37201/req/049.2021

From a microbiological point of view, both empirical and targeted antimicrobial treatment in respiratory infection is based on the sensitivity profile of isolated microorganisms and the possible resistance mechanisms that they may present. The latter may vary in different geographic areas according to prescription profiles and vaccination programs. Beta-lactam antibiotics, fluoroquinolones, and macrolides are the most commonly used antimicrobials during the exacerbations of chronic obstructive pulmonary disease and community-acquired pneumonia. In their prescription, different aspects such as intrinsic activity, bactericidal effect or their ability to prevent the development of resistance must be taken into account. The latter is related to the PK/PD parameters, the mutant prevention concentration and the so-called selection window. More recently, the potential ecological impact has grown in importance, not only on the intestinal microbiota, but also on the respiratory one. Maintaining the state of eubiosis requires the use of antimicrobials with a low profile of action on anaerobic bacteria. With their use, the resilience of the bacterial populations belonging to the microbiota, the state of resistance of colonization and the collateral damage related to the emergence of resistance to the antimicrobials in pathogens causing the infections and in the bacterial populations integrating the microbiota.

Rev Esp Quimioter 2021; 34(2): 81-92 [Texto completo PDF]


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Rev Esp Quimioter 2021; 34(3):169-184

Clinical implications of the genus Mycoplasma

DAVID GÓMEZ RUFO, ENRIQUE GARCÍA SÁNCHEZ, JOSÉ ELÍAS GARCÍA SÁNCHEZ, MARÍA GARCÍA MORO

Published: 18 March 2021

http://www.doi.org/10.37201/req/014.2021

Within Mycoplasma genus, M. pneumoniae, M. genitalium, M. hominis or U. urealyticum are the main species that have been traditionally linked to infectious processes. However, there are many other species involved in these conditions and that are, frequently, unfamiliar to healthcare professionals. The aim of this review is to identify all Mycoplasma genus species that have been isolated in human beings and to determine their involvement in infectious pathology.

Rev Esp Quimioter 2021; 34(3):169-184 [Texto completo PDF]


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Rev Esp Quimioter 2021; 34(3):256-258

Sospecha de artritis bacteriana en paciente VIH

INÉS OLAYA GARCÍA RODRÍGUEZ, LAURA SANTE FERNÁNDEZ, ANA MADUEÑO ALONSO, MARÍA DEL MAR ALONSO SOCAS, MARÍA LECUONA FERNÁNDEZ

Published: 16 March 2021

http://www.doi.org/10.37201/req/122.2020

LETTER TO THE EDITOR

Rev Esp Quimioter 2021; 34(3):256-258 [Texto completo PDF]


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Rev Esp Quimioter 2021; 34(3):200-206

Continuous infusion of antibiotics using elastomeric pumps in the hospital at home setting

MARTA GARCÍA-QUEIRUGA, BEGOÑA FEAL CORTIZAS, FERNANDO LAMELO ALFONSÍN, SONIA PERTEGA DIAZ, ISABEL MARTÍN-HERRANZ

Published: 16 March 2021

http://www.doi.org/10.37201/req/122.2020

Introduction. To describe the avoided costs and to analyze the effectiveness of intravenous antibiotic treatment in continuous perfusion in patients at Hospital at Home Units (HHU) administered using elastomeric infusion pumps (EIP) prepared in a Hospital Pharmacy Service (HPS).
Materials and methods. Retrospective observational study of the number and type of EIP prepared in the HPS and of the treated patients. Study period: January 2017-December2018. Analyzed data: demographic data of patients, location of infection, responsible microorganism, medication and type of EIP, dose and duration of treatment and its effectiveness in terms of cure or non-cure or patient’s death. Economic valuation considering: costs of EIP, nursing time needed for preparation and cost of HHU care.
Results. A total of 1,688 EIP to treat 102 patients resulted in 106 episodes of outpatient treatment of parenteral antibiotic therapy (OPAT) for 1,409 days, thereby avoiding 1,409 days of hospital admission. A total of 59.8% of the patients were men and the mean age was 70.5 ± 17 years. A 31.1% and 68.9% of the cases were empirical and pathogen-directed treatments, respectively. The most used antimicrobials were piperacillin/tazobactam (42.7%), ceftazidime (24.5%), meropenem (19.8%), ceftolozane/tazobactam (2.8%), and cloxacillin (1.9%). Mean duration of treatment was 13.29 ± 8.60 days. Location of infection: respiratory (42.5%), urinary (17.9%), skin and soft tissue (12.3%), bacteraemia (11.3%), osteomyelitis (7.5%), abdominal (3.8%) and 4.7% in other locations. The cure rate was 84%. Total avoided cost: 580,788.28€ in the 24 months studied.
Conclusion. This program represents very important economic savings for the health system, and the effectiveness of the antibiotic treatment has not been compromised.

Rev Esp Quimioter 2021; 34(3):200-206 [Full-text PDF]


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Rev Esp Quimioter 2021; 34(3):264-266

Aislamiento de Turicella otitidis en el contexto de la infección ótica

JOSÉ MANUEL MENDEZ-LEGAZA, IRENE LÓPEZ-RAMOS, MOISÉS GARCÍA BRAVO, ALMUDENA TINAJAS PUERTAS, MARÍA ANTONIA GARCÍA CASTRO

Published: 15 March 2021

http://www.doi.org/10.37201/req/144.2020

LETTER TO THE EDITOR

Rev Esp Quimioter 2021; 34(3):264-266 [Texto completo PDF]

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Rev Esp Quimioter 2021; 34(3):261-263

Nefritis focal aguda bilateral por Enterococcus faecalis asociada a enfermedad de Kawasaki en un paciente pediátrico

ANA CASTELLANO-MARTÍNEZ, MOISÉS RODRÍGUEZ-GONZÁLEZ

Published: 12 March 2021

http://www.doi.org/10.37201/req/138.2020

LETTER TO THE EDITOR

Rev Esp Quimioter 2021; 34(3):261-263 [Texto completo PDF]


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Rev Esp Quimioter 2021; 34(2): 136-140

Real-life use of remdesivir in hospitalized patients with COVID-19

CAROLINA GARCIA-VIDAL, FERNANDA MEIRA, ALBERTO CÓZAR-LLISTÓ, GERARD DUEÑAS, PEDRO PUERTA-ALCALDE, NICOLE GARCIA-POUTON, MARIANA CHUMBITA, CELIA CARDOZO, MARTA HERNANDEZ-MENESES, RODRIGO ALONSO-NAVARRO, VERÓNICA RICO, DAIANA AGÜERO, MARTA BODRO, LAURA MORATA, CARLOTA JORDAN, CARLOS LOPERA, JUAN AMBROSIONI, FERRAN SEGUI, NACHO GRAFIA, PEDRO CASTRO, FELIPE GARCÍA, JOSEP MENSA, JOSÉ ANTONIO MARTÍNEZ, GEMMA SANJUAN, ALEX SORIANO, AND COVID19-RESEARCHER GROUP

Published: 6 March 2021

http://www.doi.org/10.37201/req/018.2021

Objective. Controversial results on remdesivir efficacy have been reported. We aimed to report our real-life experience with the use of remdesivir from its availability in Spain.
Methods. We performed a descriptive study of all patients admitted for ≥48 hours with confirmed COVID-19 who received remdesivir between the 1st of July and the 30th of September 2020.
Results. A total of 123 patients out of 242 admitted with COVID-19 at our hospital (50.8%) received remdesivir. Median age was 58 years, 61% were males and 56.9 % received at least one anti-inflammatory treatment. No adverse events requiring remdesivir discontinuation were reported. The need of intensive care unit admission, mechanical ventilation and 30-days mortality were 19.5%, 7.3% and 4.1%, respectively.
Conclusion. In our real-life experience, the use of remdesivir in hospitalized patients with COVID-19 was associated with a low mortality rate and good safety profile.

Rev Esp Quimioter 2021; 34(2): 136-140 [Full-text PDF]

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Rev Esp Quimioter 2021; 34(2): 167-168

Fiebre paratifoidea dos meses después de un viaje a la India

MARÍA DOLORES ORTEGA RECIO, GUILLERMO GONZALO OJEDA BURGOS, ROSARIO PALACIOS MUÑOZ, CRISTINA GÓMEZ AYERBE

Published: 4 March 2021

http://www.doi.org/10.37201/req/139.2020

LETTER TO THE EDITOR

Rev Esp Quimioter 2021; 34(2): 167-168 [Texto completo PDF]


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Rev Esp Quimioter 2021; 34(3):228-237

Antimicrobial activity of ceftolozane-tazobactam against Enterobacterales and Pseudomonas aeruginosa recovered during the Study for Monitoring Antimicrobial Resistance Trends (SMART) program in Spain (2016-2018)

RAFAEL CANTÓN, ELENA LOZA, RICARDO M. ARCAY, EMILIA CERCENADO, FRANCISCO JAVIER CASTILLO, RAMÓN CISTERNA, LIDIA GÁLVEZ-BENÍTEZ, FERNANDO GONZÁLEZ ROMO, ALICIA HERNÁNDEZ-CABEZAS, JESÚS RODRÍGUEZ-LOZANO, ANA ISABEL SUÁREZ-BARRENECHEA, FE TUBAU, JAZMÍN DÍAZ-REGAÑÓN, DIEGO LÓPEZ-MENDOZA, AND THE SMART-SPAIN WORKING GROUP

Published: 1 March 2021

http://www.doi.org/10.37201/req/019.2021

Objective. To analyse the susceptibility to ceftolozane-tazobactam and comparators in Enterobacterales and Pseudomonas aeruginosa isolates recovered from intraabdominal (IAI), urinary (UTI), respiratory (RTI) and bloodstream infection (BSI) in the SMART (Study for Monitoring Antimicrobial Resistance Trends) study.
Methods. The susceptibility of 5,351 isolates collected in 11 Spanish hospitals (2016-2018) were analysed (EUCAST-2020 criteria) by broth microdilution and were phenotypically studied for the presence of extended-spectrum beta-lactamases (ESBL). Ceftolozane-tazobactam and/or carbapenem resistant isolates were genetically characterized for ESBL and carbapenemases.
Results. Escherichia coli was the most frequent pathogen (49.3% IAI, 54.9% UTI, 16.7% RTI and 50% BSI), followed by Klebsiella pneumoniae (11.9%, 19.1%, 13.1% and 15.4%, respectively). P. aeruginosa was isolated in 9.3%, 5.6%, 32% and 9%, respectively. The frequency of isolates with ESBLs (2016-2017) was: 30.5% K. pneumoniae, 8.6% E. coli, 2.3% Klebsiella oxytoca and 0.7% Proteus mirabilis. Ceftolozane-tazobactam was very active against non-ESBL-(99.3% susceptible) and ESBL-(95.2%) producing E. coli being less active against K. pneumoniae (98% and 43.1%, respectively) isolates. CTX-M-15 was the most prevalent ESBL in E. coli (27.5%) and K. pneumoniae (51.9%) frequently associated with OXA-48-like carbapenemase. Overall, 93% of P. aeruginosa isolates were susceptible to ceftolozane-tazobactam, preserving this activity (>75%) in isolates resistant to other beta-lactams except in those resistant to meropenen or ceftazidime-avibactam. GES-5, PER-1, VIM-1/2 were the most prevalent enzymes in isolates resistant to ceftolozane-tazobactam.
Conclusions. Ceftolozane-tazobactam showed high activity rates against isolates recovered in the SMART study although it was affected in K. pneumoniae and P. aeruginosa isolates with ESBL and/or carbapenemases.

Rev Esp Quimioter 2021; 34(3):228-237 [Full-text PDF] [Supplentary material PDF]


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