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Rev Esp Quimioter 2024; 37(1): 78-87

Utility of the medial region of pro-adrenomodulin for the detection of true bacteremia in elderly patients treated in the emergency department for suspected infection

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]


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Rev Esp Quimioter 2024; 37(1): 110-111

Tinción de Gram de los hemocultivos de un paciente oncológico

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]


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Rev Esp Quimioter 2024; 37(1): 112-115

Corneal abscess caused by Filobasidium uniguttulatum. Case report and literature review on cryptococcal keratitis

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]


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Rev Esp Quimioter 2024; 37(1): 116-117

Artritis séptica aguda de cadera por Salmonella enterica subesp. enterica serotipo Coeln en una niña de 3 años

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]


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Rev Esp Quimioter 2024; 37(1): 52-57

Evaluation of Sysmex UF-5000 flow cytometer flag BACT-info for Gram discrimination in urinary tract infection

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]


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Rev Esp Quimioter 2024; 37(1): 29-42

Diagnostic accuracy of procalcitonin for bacteremia in the emergency department: a systematic review

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]


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Rev Esp Quimioter 2024; 37(1): 106-109

A case report of multiple abscess co-infected with Eggerthella lenta and Desulfovibrio desulfuricans identificated with MALDI-TOF mass spectrometer

DOMINGO FERNÁNDEZ VECILLA, MARY PAZ ROCHE MATHEUS, MIKEL JOSEBA URRUTIKOETXEA GUTIÉRREZ, CRISTINA ASPICHUETA VIVANCO, GOTZON IGLESIAS HIDALGO, IRIS SHARON PÉREZ RAMOS, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO

Published: 5 December 2023

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/081.2023

Rev Esp Quimioter 2024; 37(1): 106-109 [Full-text PDF]


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Rev Esp Quimioter 2024;37(1): 43-51

Efficacy and safety of pediatric flu vaccination: a systematic review

FRANCISCO MIGUEL ESCANDELL RICO, LUCIA PÉREZ FERNÁNDEZ

Published: 5 December 2023

http://www.doi.org/10.37201/req/101.2023

Introduction. Children are at a higher risk of influenza infection compared to the general population. The World Organization Health and recommendations of the Vaccine Advisory Committee of the Spanish Association of Pediatrics contemplate annual vaccination as the most effective way to prevent the disease. Therefore, the purpose of this review was to update information on efficacy and safety in the anti -shed vaccine in children and adolescents.
Material and methods. A search in four electronic databases (Scopus, Cumulative Index to Nursing and Allied Health Literature, Medline / Pubmed, Google Scholar and Cochrane), as well as a manual search to identify original research published between 2012 and 2022. The guidelines of ANALYSIS (PRISMACR) as a preferred report element for systematic reviews.
Results. Seven original research articles were included where two issues of antigripal vaccination were identified in healthy children/adolescents and with pathologies. The efficacy (between approximately 30% and 80%) varied depending on the vaccine used and circulating subtypes. Most adverse reactions were mild intensity, and the most common local adverse event was pain in the injection site.
Conclusions. We positively highlight the safety of pediatric flu vaccination in analyzed studies, on the contrary, with respect to the efficacy of flu vaccination, we observe a wide variability of results. There is a clear need to continue conducting efficacy and safety studies in the child.

Rev Esp Quimioter 2024;37(1): 43-51 [Texto completo PDF]


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Rev Esp Quimioter 2024; 37(1): 17-28

COVID -19: On the threshold of the fifth year. The situation in Spain

FERNANDO RODRÍGUEZ-ARTALEJO, JULIÁN RUIZ-GALIANA, RAFAEL CANTÓN, PILAR DE LUCAS RAMOS, ALEJANDRA GARCÍA-BOTELLA, ALBERTO GARCÍA-LLEDÓ, TERESA HERNÁNDEZ-SAMPELAYO, JAVIER GÓMEZ-PAVÓN, JUAN GONZÁLEZ DEL CASTILLO, MARI CRUZ MARTÍN-DELGADO, FRANCISCO JAVIER MARTÍN SÁNCHEZ, MANUEL MARTÍNEZ-SELLÉS, JOSÉ MARÍA MOLERO GARCÍA, SANTIAGO MORENO GUILLÉN, DARÍO GARCÍA DE VIEDMA, EMILIO BOUZA

Published: 27 November 2023

http://www.doi.org/10.37201/req/123.2023

Despite having emerged from pandemic status, the incidence of COVID-19 episodes has recently increased in Spain, including pediatric cases and admissions to Intensive Care Units. Several recombinant variants are circulating among us, particularly XBB arising from two Omicron BA.2 sublineages with mutations in the genes encoding the spicule proteins that could increase binding to the ACE2 receptor and be more prone to immune escape. Faced with these, 3 pharmaceutical companies have developed vaccines adapted to the XBB.1.5 sublineage that are already available for administration in our setting with risks that should not be different from those of previous mRNA vaccines and with clearly favorable benefit/risk ratios. They should be applied to patients with potential for poor COVID-19 evolution and to collectives that have a particular relationship of proximity with them. Their application should be understood not only from a perspective of individual convenience but also from that of collective responsibility. The most convenient seems to be a simultaneous immunization of COVID-19 and influenza in our environment. In the therapeutic aspect, there is little to expect right now from antisera, but the already known antiviral drugs are still available and indicated, although their efficacy will have to be reevaluated due to their impact on populations that are mostly immunized and with a better prognosis than in the past. In our opinion, it is necessary to continue to make a reasonable and timely use of masks and other non-pharmacological means of protection.

Rev Esp Quimioter 2024; 37(1): 17-28 [Full-text PDF]


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Rev Esp Quimioter 2023;36(Suppl.1):68-70

The Magnificent Seven: Seven good publications in infectious diseases

OLGA ALGARA, LAURA EVA FRANCO, JUAN MANUEL GARCÍA-LECHUZ

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.16.2023

ABSTRACT
The world of infectious diseases, for various reasons, before and after the COVID-19 pandemic, capture the attention of the scientific community, either due to the epidemiological data of various microbial agents that are emerging, due to the implementation with successful results of new diagnostic strategies or due to the appearance of new therapeutic options, which encourage healthcare workers to continue on the front line.
Topics such as antimicrobial resistance, S. aureus bacteremia, clostridioides difficile, short treatments for tuberculosis, prosthetic joint infection or invasive fungal infections are included. In this article, we want to highlight, among many others, seven recently published articles that deserve our attention, full of useful information to keep us updated.

Rev Esp Quimioter 2023; 36(Suppl.1):68-70 [Full-text PDF]


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