Diagnostic and therapeutic approach of intra-abdominal candidiasis                     

ANA MONTERO, FERNANDO GILSANZ, EMILIO MASEDA          

Invasive fungal disease is associated to a high mortality rate on critical ill patients. In the last decades an important epidemiological shift has been described. Early diagnosis and treatment are related with a better prognosis. The key factors lie in a set of predictive scores that allow to identify patients that will benefit of early treatment, as well as using diagnosis techniques that are culture independent. New diagnosis ap-proximations are being developed with promising results: in situ hybridisation using PNA-FISH probes, MALDI-TOF MS and rapid nucleic acids detection assays. The use of echinocandin is recommended as antifungal therapy on critical ill patients with candida peritonitis.

Rev Esp Quimioter 2016; 29(Suppl. 1):52-55 [pdf]

Invasive fungal infections in children: Similarities and differences with adults                     

JOSÉ TOMÁS RAMOS, LAURA FRANCISCO, ZARIFE DAOUD          

Invasive fungal infections (IFI) are a major cause of morbidity and mortality in immunocompromised adults and children. The purpose of this review was to update the epidemiological, clinical and therapeutic options in children, and to compare them with the adult population. Although there are important differences, the epidemiology, clinical features and risk factors for IFI have many similarities. Patient at risk include neutropenic hematology children, in whom Candida spp. y Aspergillus spp. predominate; primary immunodeficiencies, particularly chronic granulomatous disease with high susceptibility for Aspergillus spp.; and extremely premature infants, in whom C. albicans y C. parapsilosis are more prevalent. Premature babies are prone to dissemination, including the cen-tral nervous system. There are peculiarities in radiology and diagnostic biomarkers in children. In pulmonary aspergillosis, clasical signs in CT are usually absent. There is scant information on PCR and beta-D-glucan in children, and more limited on the performance of galactomannan enzyme immunoassay, that does not appear to be much different in neutropenic patients. There is a delay in the development of antifungals, limiting their use in children. Most azoles require therapeutic drug monitoring in children to optimize its safety and effectiveness. Pediatric treatment recommendations are mainly extrapolated from results of clinical trials performed in adults. There is no evidence for the benefit of preemptive therapy in children. It is necessary to foster specific pediatric studies with current and new antifungals to evaluate their pharmacokinetics, safety, and effectiveness at different ages in the pediatric population.

Rev Esp Quimioter 2016; 29(Suppl. 1):59-65 [pdf]

Resistance to the antimalarial drugs                     

EMMANUELE VENANZI, ROGELIO LÓPEZ-VÉLEZ          

Malaria is one of the most widespread infectious diseases around the world with 214 million cases and 438,000 deaths in 2015. In the early twentieth century it was described for the first time the resistance to quinine and, since then, drug resistance to antimalarial drugs has spread up to represent a global challenge in the fight and control of malaria. Understanding the mechanisms, geography and monitoring tools that we can act against resistance to antimalarial drugs is critical to prevent its expansion.

Rev Esp Quimioter 2016; 29(Suppl. 1):72-75 [pdf]

The clinical microbiologist before the taxonomic changes in the genus Clostridium                     

JOSÉ ELÍAS GARCÍA-SÁNCHEZ, ENRIQUE GARCÍA-SÁNCHEZ, MARÍA GARCÍA-MORO          

The various species included in the genus Clostridium are very heterogeneous, both from a phenotypic and a phylogenetic point of view. The advances in polyphasic taxonomy, particularly in phylogeny, are allowing to resolve this dysfunction reclassifying several species in other genres, although there is still work to be done. Changes in generic denominations are quite normal in taxonomy, but can turn into a problem when they affect species with strong clinical impact and that have been recognised for a long time, as in the case of some traditional Clostridium species. After knowing these changes clinical microbiologists, in whose work taxonomy is an essential tool, should evaluate what matters most, if the communication with other health professionals or the phylogeny, and think about the possibility of combining both things. This paper reviews some of the taxonomic changes that have took place in well-known Clostridium species that can be clinically interesting and evaluates, as far as possible, their significance in the scientific and medical communication.

Rev Esp Quimioter 2016; 29(5):239-243 [pdf]

Multilocus Sequence Typing analysis of human Campylobacter coli in Granada (Spain)                     

JOSÉ ANTONIO CARRILLO-ÁVILA, ANTONIO SORLÓZANO-PUERTO, MERCEDES PÉREZ-RUIZ, JOSÉ GUTIÉRREZ-FERNÁNDEZ          

Introduction. Different subtypes of Campylobacter spp. have been associated with diarrhoea and a Multilocus Sequence Typing (MLST) method has been performed for subtyping. In the present work, MLST was used to analyse the genetic diversity of eight strains of Campylobacter coli.
Material and methods. Nineteen genetic markers were amplified for MLST analysis: AnsB, DmsA, ggt, Cj1585c, CJJ81176-1367/1371, Tlp7, cj1321-cj1326, fucP, cj0178, cj0755/cfrA, ceuE, pldA, cstII, cstIII. After comparing the obtained sequences with the Campylobacter MLST database, the allele numbers, sequence types (STs) and clonal complexes (CCs) were assigned.
Results. The 8 C. coli isolates yielded 4 different STs belonging to 2 CCs. Seven isolates belong to ST-828 clonal complex and only one isolate belong to ST-21. Two samples came from the same patient, but were isolated in two different periods of time.
Conclusions. MLST can be useful for taxonomic characterization of C. coli isolates.

Rev Esp Quimioter 2016; 29(6):332-335 [pdf]