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Rev Esp Quimioter 2023;36(Suppl.1):64-67

What are the most relevant publications in Clinical Microbiology in the last two years?

EMILIA CERCENADO

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.15.2023

ABSTRACT
This minireview describes some of the articles published in the last two years related to innovative technologies including CRISPR-Cas, surface-enhanced Raman spectroscopy, microfluidics, flow cytometry, Fourier transform infrared spectroscopy, and artificial intelligence and their application to microbiological diagnosis, molecular typing and antimicrobial susceptibility testing. In addition, some articles related to resistance to new antimicrobials (ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, and cefiderocol) are also described.

Rev Esp Quimioter 2023; 36(Suppl.1):64-67 [Full-text PDF]


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Rev Esp Quimioter 2023;36(Suppl.1):59-63

New trends in antifungal treatment: What is coming up?

JESÚS GUINEA

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.14.2023

ABSTRACT
New antifungal agents are needed to overcome limitations of available ones such as poor pharmacokinetic traits, toxicity, drug-drug interactions, limited clinical efficacy, and emerging antifungal resistance. New antifungal drugs belong to well-known families (azoles, polyenes, or beta-d-glucan synthase inhibitors) or to drug families showing completely new mechanisms of action. Some drugs have a head start in terms of potential to reach the clinical setting and are here reviewed.

Rev Esp Quimioter 2023; 36(Suppl.1):59-63 [Full-text PDF]


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Rev Esp Quimioter 2023;36(Suppl.1):54-58

Present and future of resistance in Pseudomonas aeruginosa: implications for treatment

MANUEL PINA-SÁNCHEZ, MARTA RUA, JOSÉ LUIS DEL POZO

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.13.2023

ABSTRACT
Pseudomonas aeruginosa is a pathogen that has a high propensity to develop antibiotic resistance, and the emergence of multidrug-resistant strains is a major concern for global health. The mortality rate associated with infections caused by this microorganism is significant, especially those caused by multidrug-resistant strains. The antibiotics used to treat these infections include quinolones, aminoglycosides, colistin, and β-lactams. However, novel combinations of β-lactams-β-lactamase inhibitors and cefiderocol offer advantages over other members of their family due to their better activity against certain resistance mechanisms.
Selecting the appropriate empiric antibiotic treatment requires consideration of the patient’s clinical entity, comorbidities, and risk factors for multidrug-resistant pathogen infections, and local epidemiological data. Optimizing antibiotic pharmacokinetics, controlling the source of infection, and appropriate collection of samples are crucial for successful treatment.
In the future, the development of alternative treatments and strategies, such as antimicrobial peptides, new antibiotics, phage therapy, vaccines, and colonization control, holds great promise for the management of P. aeruginosa infections.

Rev Esp Quimioter 2023; 36(Suppl.1):54-58 [Full-text PDF]


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Rev Esp Quimioter 2023;36(Suppl.1):52-53

Post-CART-T Cell Infection: Etiology, pathogenesis, and therapeutic approaches

NICOL GARCÍA-POUTÓN, OLIVER PEYRONY, MARIANA CHUMBITA, FRANCESCO AIELLO, PATRICIA MONZO, ANTONIO GALLARDO-PIZARRO, CAROLINA GARCIA-VIDAL

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.12.2023

ABSTRACT
Chimeric antigen receptor (CAR) T cell therapy targeting CD-19 has revolutionized the treatment of refractory B-cell malignancies. However, patients undergoing this therapy face an increased risk of infections due to compromised immune function, lymphodepleting chemotherapy, hospitalization, and therapy-related complications such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome. Patients with systemic corticosteroid use, low immunoglobulin levels, and severe CRS, are at higher risk of infection. This review article highlights the spectrum of infections encountered in CAR T cell therapy, including bacterial, viral, and fungal infections. Following consensus guidelines for vaccination and immunoglobulin replacement is recommended. Clear criteria for antibiotic usage and vaccinating household members against respiratory viruses are crucial. Understanding the risk factors, spectrum of infections, and implementing appropriate prophylactic measures are essential to optimize outcomes in patients undergoing CAR T cell therapy. By prioritizing infection prevention strategies, healthcare professionals can effectively improve patient care.

Rev Esp Quimioter 2023; 36(Suppl.1):52-53 [Full-text PDF]


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Rev Esp Quimioter 2023;36(Suppl.1):46-51

Treatment guidelines for multidrug-resistant Gram-negative microorganisms

RAFAEL CANTÓN, PATRICIA RUIZ-GARBAJOSA

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.11.2023

ABSTRACT
In recent years, new antimicrobials have been introduced in therapeutics, including new beta-lactam-beta-lactamase inhibitor combinations and cefiderocol in response to therapeutic needs in the face of increasing resistance. There are also different treatment guidelines for infections caused by these microorganisms that have been approved by different professional societies, including those of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), the Infectious Disease Society of America (IDSA) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC). All of them are based on scientific evidence, but with differences in the weight of expert opinion in their recommendations. Both ESCMID and IDSA include recommendations for the treatment of extended-spectrum beta-lactamase-producing microorganisms. The IDSA is the only one including AmpC producers, all address the treatment of infections caused by carbapenem-resistant Enterobacterales and Acinetobacter baumannii and multidrug-resistant or difficult-to-treat Pseudomonas aeruginosa, and the IDSA and SEIMC include recommendations on the treatment of Stenotrophomonas maltophilia. Future guidelines should integrate new antimicrobials and new innovative management options not covered by current guidelines.

Rev Esp Quimioter 2023; 36(Suppl.1):46-51 [Full-text PDF]


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Rev Esp Quimioter 2023;36(Suppl.1):37-45

Current approach to skin and soft tissue infections. Thinking about continuity of care

ROSA BLANES HERNÁNDEZ, MARTÍN RODRÍGUEZ PÉREZ, JUAN FERNÁNDEZ NAVARRO, MIGUEL SALAVERT LLETÍ

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.10.2023

ABSTRACT
Skin and soft tissue infections are a common reason for patients seeking inpatient and outpatient medical care. Surgery is an essential part of managing in many episodes. Careful evaluation of antibiotic therapy could help clinicians in early identification to patients with treatment failure and to consider an alternative approach or a new surgical revision in “focus control”. With the arrival of new drugs, there is a need to refine the appropriate drug’s decision-making. Drugs with a long half-life (long-acting lipoglycopeptides such as dalbavancin or oritavancin), which allows weekly administration (or even greater), can reduce hospital admission and length of stay with fewer healthcare resources through outpatient management (home hospitalization or day hospitals). New anionic fluoroquinolones (e.g. delafloxacin), highly active in an acidic medium and with the possibility of switch from the intravenous to the oral route, will also make it possible to achieve these new healthcare goals and promote continuity of care. Therefore, management should rely on a collaborative multidisciplinary group with experience in this infectious syndrome.

Rev Esp Quimioter 2023; 36(Suppl.1):37-45 [Full-text PDF]


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Rev Esp Quimioter 2023;36(Suppl.1):33-36

Group A Streptococcus invasive infection in children: Epidemiologic changes and implications

JOSÉ TOMÁS RAMOS AMADOR, ARANTXA BERZOSA SÁNCHEZ, MARTA ILLÁN RAMOS

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.09.2023

ABSTRACT
Group A Streptococcus (GAS) can cause a broad array of clinical manifestations and complications. Recently, in post COVID-19 postpandemic months, there has been an increased incidence and severity of invasive infections in the pediatric age group in Spain and other European countries with high morbidity, affecting mostly to young children, associated with seasonal peaks in incidence of viral respiratory pathogens. The increased in incidence and severity has not been associated with predominant GAS strains, but rather to the lack of immunity to both GAS and common viral respiratory infections due to isolation measures to prevent COVID-19. Due to the nonspecific initial clinical manifestations a high index of suspicion is necessary in order to initiate a prompt medical and surgical treatment when necessary to improve the outcome. Prevention strategies are needed as well as continuous microbiological surveillance of iGAS strains.

Rev Esp Quimioter 2023; 36(Suppl.1):33-36 [Full-text PDF]


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Rev Esp Quimioter 2023;36(Suppl.1):29-32

Mpox global outbreak: update in epidemiology, clinical spectrum and considerations in prevention and treatment

SANTIAGO FERNÁNDEZ-CASTELAO, EVA ORVIZ

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.08.2023

ABSTRACT
Mpox is the most prevalent Orthopoxvirus infection in humans. Several clinical characteristics of mpox distinguish this disease from other rash illnesses. Complications are not uncommon. New therapeutics and vaccines are likely to change the course of the disease, especially in immunocompromised individuals. Clinicians must ensure that access to treatment and prevention measures are guaranteed especially in this particular population. This review exposes the epidemiology, clinical spectrum and updated considerations in treatment and prevention within the mpox global outbreak.

Rev Esp Quimioter 2023; 36(Suppl.1):29-32 [Full-text PDF]


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Rev Esp Quimioter 2023;36(Suppl.1):25-28

Clinical experience in the treatment of COVID-19 with monoclonal antibodies in solid organ transplant recipients

ELENA MÚÑEZ-RUBIO, JORGE CALDERÓN-PARRA, ANDREA GUTIÉRREZ-VILLANUEVA, ANA FERNÁNDEZ-CRUZ, ANTONIO RAMOS-MARTÍNEZ

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.07.2023

ABSTRACT
Solid organ transplant (SOT) recipients are at high risk for complications from coronavirus disease 2019 (COVID-19). SOT recipients mount lower immunological responses to vaccines than general population and are at high risk for breakthrough COVID-19 infections. Passive immunotherapy in the form of anti-Spike monoclonal antibodies (MoAbs) may be an alternative for the prophylaxis and treatment of COVID-19 in these patients. SARS-CoV-2 has evolved by accumulating resistance mutations that have escaped the neutralizing action of most MoAbs. However, MoAbs directed at more conserved epitopes and that maintain effector functions could maintain efficacy in the treatment of these patients. According to published data, SOT recipients with low anti-spike antibody responses to vaccination could benefit from the use of MoAbs in pre-exposure prophylaxis, in the treatment of COVID-19 mild to moderate and severe COVID-19 with less than 15 days of symptom duration and low oxygen requirements. Combination therapy could be more effective than monotherapy for the treatment of mild-to-moderate SARS-CoV-2 infection.

Rev Esp Quimioter 2023; 36(Suppl.1):25-28 [Full-text PDF]


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Rev Esp Quimioter 2023;36(Suppl.1):22-24

SARS-CoV-2 infection in solid organ transplant recipients: Experience with molnupiravir

MIGUEL VILLAMARÍN, OSCAR LEN

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.06.2023

ABSTRACT
Solid organ transplant recipients (SOTR) constitute one of the groups at highest risk for the development of severe COVID-19. However, evidence on the effectiveness of treatments for SARS-CoV-2 infection in this group of patients is scarce. Molnupiravir is an orally administered antiviral drug that has demonstrated effectiveness in reducing the risk of progression to severe COVID-19 in high-risk outpatients, mainly in the unvaccinated population. Although its effectiveness is lower than that of other antivirals, on many occasions it is the only therapeutic option in transplant recipients given the absence of pharmacological interactions with immunosuppressive treatment, the oral route of administration and the good safety profile.

Rev Esp Quimioter 2023; 36(Suppl.1):22-24 [Full-text PDF]


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