MARIA DOLORES ROJO-MARTIN, INMACULADA DE TORO PEINADO, JUAN DIEGO RUIZ MESA, BEGOÑA PALOP BORRÁS
Published: 28 February 2021
http://www.doi.org/10.37201/req/123.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(2): 158-161 [Full-text PDF]
IRATI ARREGUI GARCIA, MATILDE ELÍA LOPEZ, AITZIBER AGUINAGA PÉREZ, JOAQUÍN MANRIQUE ESCOLA, CARMEN EZPELETA BAQUEDANO
Published: 26 February 2021
http://www.doi.org/10.37201/req/136.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(2): 164-166 [Texto completo PDF]
EMILIO BOUZA, JAVIER COBO, Mª JESÚS RODRÍGUEZ-HERNÁNDEZ, MIGUEL SALAVERT, JUAN P HORCAJADA, JOSÉ ANTONIO IRIBARREN, ENGELS OBI, VIRGINIA LOZANO, STEFANO MARATIA, MARIBEL CUESTA, ESTEFANY URÍA, ENRIC LIMÓN
Published: 23 February 2021
http://www.doi.org/10.37201/req/135.2020
Introduction. Clostridioides difficile infection (CDI) is associated with increased hospital stays and mortality and a high likelihood of rehospitalization, leading to increased health resource use and costs. The objective was to estimate the economic burden of recurrent CDI (rCDI).
Material and methods. Observational, retrospective study carried out in six hospitals. Adults aged ≥18 years with ≥1 confirmed diagnosis (primary or secondary) of rCDI between January 2010 and May 2018 were included. rCDI-related resource use included days of hospital stay (emergency room, ward, isolation and ICU), tests and treatments. For patients with primary diagnosis of rCDI, the complete hospital stay was attributed to rCDI. When diagnosis of rCDI was secondary, hospital stay attributed to rCDI was estimated using 1:1 propensity score matching as the difference in hospital stay compared to controls. Controls were hospitalizations without CDI recorded in the Spanish National Hospital Discharge Database. The cost was calculated by multiplying the natural resource units by the unit cost. Costs (euros) were updated to 2019.
Results. We included 282 rCDI episodes (188 as primary diagnosis): 66.31% of patients were aged ≥65 years and 57.80% were female. The mean hospital stay (SD) was 17.18 (23.27) days: 86.17% of rCDI episodes were isolated for a mean (SD) of 10.30 (9.97) days. The total mean cost (95%-CI) per episode was €10,877 (9,499-12,777), of which the hospital stay accounted for 92.56%.
Conclusions. There is high cost and resource use associated with rCDI, highlighting the importance of preventing rCDI to the Spanish National Health System.
Rev Esp Quimioter 2021; 34(2): 126-135 [Full-text PDF]
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]
