Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia最新文献

{"title":"<i>Mycobacterium bovis</i>, a rare causative pathogen of multiple pseudoaneurysms.","authors":"Manuel Callejón-Fernández, Dácil García-Rosado, Zena Ibrahim-Achi, Silvia Campos-Gutiérrez, María Del Mar Alonso-Socas, María Lecuona-Fernández","doi":"10.37201/req/057.2025","DOIUrl":"https://doi.org/10.37201/req/057.2025","url":null,"abstract":"<p><p>We report the case of an 85-year-old male with a history of bladder adenocarcinoma treated with 17 intravesical instillations of Bacillus Calmette-Guérin (BCG), who presented with constitutional symptoms and multiple pseudoaneurysms: in the left subclavian, right external iliac, and right superficial femoral arteries. Despite the absence of initial microbiological findings, blood and urine cultures ultimately grew <i>Mycobacterium bovis</i> BCG strain, resistant to pyrazinamide. The clinical course was marked by progressive deterioration and death prior to microbiological confirmation. This case highlights a rare but serious complication of intravesical BCG therapy and underscores the importance of early suspicion and combined surgical and antimicrobial management in patients presenting with unexplained pseudoaneurysms after BCG exposure.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recommendations from an antimicrobial stewardship program on the duration of antibiotic treatment: effectiveness of short-course regimens in the emergency department].","authors":"Paula Martínez-de La Cruz, Sira Sánz-Márquez, José Francisco Valverde-Cánovas, Rafael Hervás-Gómez, Oriol Martín-Segarra, Ana Vegas-Serrano, María Velasco-Arribas, Juan Emilio Losa-García, Leonor Moreno-Núñez","doi":"10.37201/req/040.2025","DOIUrl":"https://doi.org/10.37201/req/040.2025","url":null,"abstract":"<p><strong>Introduction: </strong>Excessive duration of antibiotic treatment is associated with adverse events without improving clinical outcomes. The Emergency Department (ED) is a strategic location to implement Antibiotic Stewardship Programs (ASP). Our objective was to determine the effect of ASP recommendations on short antibiotic treatment regimens in patients with uncomplicated infections treated in the ED.</p><p><strong>Material and methods: </strong>We conducted a quasi-experimental study comparing patients treated in the ED in September and October 2022 who were discharged with antibiotic treatment (control group) with those treated in November and December of the same year (intervention group). Recommendations regarding the appropriateness of antibiotic therapy were made in both groups, and regarding treatment duration only in the intervention group. A 30-day follow-up was performed to assess healing, readmissions due to infection, and adverse effects.</p><p><strong>Results: </strong>A total of 78 patients were included, 40 in the control group and 38 in the intervention group. The median duration of antibiotic treatment was significantly shorter in the intervention group (7.5 days, IQR: 7-10 vs 6 days, IQR: 5-7, p<0.001). Healing rates were similar in both groups (92.5% vs 97.4%, p = 0.616). Adverse effects were documented in 7 patients from the intervention group (18.4%).</p><p><strong>Conclusions: </strong>An ASP in the ED can shorten the duration of antibiotic treatment in patients with uncomplicated infections who are discharged, without affecting clinical outcomes, and without being associated with severe adverse effects, mortality, or readmissions due to infection.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of increased meeting frequency of the antimicrobial stewardship program team on indicators of the hospital use of antimicrobial agents based on consumption].","authors":"María Inmaculada Zas-García, José Manuel Fernández-Carreira, Daniel González-Fernández, Elsa Castelo-Alvárez, Jesús Rubio-Sanz, Marcos Álvarez-Pérez, Ana Blanco-Suárez, Jorge Rodríguez-Prida, Tania Rubio-Alfonso","doi":"10.37201/req/042.2025","DOIUrl":"https://doi.org/10.37201/req/042.2025","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze how the increased frequency of meetings held by the Antimicrobial Stewardship Program (PROA) groupduring which non-mandatory, supportive prescription audits were conductedimpacted antimicrobial use, using hospital antimicrobial consumption-based indicators. To compare these results with those of other centers of similar complexity.</p><p><strong>Materials and methods: </strong>A retrospective cohort study comparing antimicrobial use through hospital antimicrobial consumption-based indicators in 2023 (the first year the PROA team met twice per week) with 2022 (the last year the PROA team met once per week). The comparison with other centers was carried out using the antimicrobial hospital consumption platform of the Pharmaceutical Care Group for Infectious Diseases of the Spanish Society of Hospital Pharmacy.</p><p><strong>Results: </strong>In 2023 compared to 2022, improvements were observed in 7 out of the 13 indicators: overall consumption of systemic antifungals, carbapenem consumption, metronidazole/piperacillin-tazobactam + carbapenem ratio, fosfomycin consumption, anti-MSSA/anti-MRSA agent ratio, amoxicillin-clavulanate/piperacillin-tazobactam ratio, and fluconazole/echinocandin ratio. In 2023, our hospital ranked above the 50th percentile in 7 out of the 13 indicators.</p><p><strong>Conclusions: </strong>The increased frequency of PROA team meetings may be associated with partial improvements in antimicrobial use, according to hospital antimicrobial consumption-based indicators.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hepatitis D virus infection in a cohort of HIV-infected patients in Guipúzcoa].","authors":"Xabier Camino-Ortiz de Barrón, Claudia Nevado-Pavón, Ignacio Álvarez-Rodríguez, María Jesús Bustinduy-Odriozola, Harkaitz Azkune-Galparsoro","doi":"10.37201/req/055.2025","DOIUrl":"https://doi.org/10.37201/req/055.2025","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pre-exposure prophylaxis and the rise in sexually transmitted infections: Misunderstood safety?]","authors":"Marta Domínguez-Gil Gonzalez, José María Eiros-Bouza, Laura Rita Iotti, Lucía Puente-Fuertes","doi":"10.37201/req/059.2025","DOIUrl":"https://doi.org/10.37201/req/059.2025","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute infectious gastroenteritis in childhood: the role of rapid multiplex molecular syndromic panels in diagnosis and clinical management.","authors":"Ana Belén Jiménez-Jiménez, Fátima Galán-Sánchez, Milagros García-López Hortelano, Victoria Fumadó, Llanos Salar-Vidal, José Tomás Ramos-Amador, Ana Isabel Menasalvas-Ruiz","doi":"10.37201/req/026.2025","DOIUrl":"10.37201/req/026.2025","url":null,"abstract":"<p><p>Acute infectious diarrhea is a major global health issue, especially in children, as gastrointestinal infections are the second most common infectious disease after respiratory infections. The implementation of rapid multiplex molecular syndromic panels (RMMSP) for the comprehensive detection and identification of enteric pathogens in stool samples has enhanced diagnostic precision, supplementing-or, in some cases, replacing-traditional methodologies. This narrative, non-systematic review synthesized the available evidence on the clinical performance of gastrointestinal RMMSP up to December 31, 2024. On May 27, 2024, specialists in Pediatrics and Microbiology met to assess the use of RMMSP in pediatric gastrointestinal infection diagnosis. This review focused on RMMSP applicable to urgent management of infectious acute gastroenteritis (AGE), excluding those panels unsuitable for immediate diagnosis. RMMSP facilitated rapid pathogen detection in pediatric infectious AGE and have shown potential advantages over traditional microbiological methods, including a reduction in time to appropriate treatment. Their use appeared particularly useful in emergency and inpatient settings for inflammatory AGE, prolonged traveler's diarrhea, or cases at risk for complications. They were also considered for outpatient diagnosis in moderate/severe cases, chronic diarrhea, or immunocompromised patients. Within a diagnostic stewardship framework, current evidence suggests that RMMSP can contribute to minimizing unnecessary testing and hospitalizations, improving outbreak control, and optimizing antimicrobial use. However, further research is necessary to refine diagnostic workflows and ensure timely result delivery. This document evaluated key aspects regarding the application of RMMSP in pediatric infectious AGE, aiming to establish standardized protocols, support clinical decision-making, and facilitate optimal patient management.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"258-277"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of dual therapy with co-packaged dolutegravir and lamivudine compared to triple therapy as switching strategy in clinical practice.","authors":"Diego Cecchini, Edgardo Bottaro, Brenda Bacelar, Ángeles Tisné, Claudia Migazzi, Macarena Roel, Maximiliano Bergman, Isabel Cassetti","doi":"10.37201/req/030.2025","DOIUrl":"https://doi.org/10.37201/req/030.2025","url":null,"abstract":"<p><strong>Introduction: </strong>Dolutegravir plus lamivudine (DTG/3TC) dual therapy has demonstrated efficacy in HIV treatment, but access remains challenging in Latin America. Argentina approved a generic co-packaged DTG+3TC presentation to improve accessibility. This study evaluated the effectiveness and safety of co-packed DTG/3TC compared to DTG-based triple therapy in clinical practice.</p><p><strong>Materials and methods: </strong>A retrospective observational cohort study conducted between October 2019 and November 2023 at a reference HIV center in Argentina. Treatment-experienced people living with HIV (PLWH) with viral suppression who switched to either co-packaged DTG/3TC or DTG-based triple therapy were included. Primary outcomes included persistence, virologic suppression rates (VSR), and safety at 6, 12, and 18 months.</p><p><strong>Results: </strong>Of 599 PLWH, 245 (41%) switched to dual therapy and 354 (59%) to triple therapy. Persistence rates for dual therapy at 6, 12, and 18 months were 99%, 100% and 98%; for triple therapy: 99%, 97% and 97%, respectively. VSR for dual therapy were 99%, 98% and 99%; for triple therapy: 99%, 97% and 98% at the same timepoints. Adverse event rates were low in both groups: dual therapy (0.5%, 0%, 0.8% at 6, 12, 18 months) and triple therapy (1.2%, 0.7%, 0.4% at 6, 12, 18 months).</p><p><strong>Conclusion: </strong>Co-packaged DTG/3TC demonstrated high persistence and virologic suppression rates with a favorable safety profile in clinical practice. Its effectiveness and safety were comparable to DTG-based triple therapy, supporting its use as a cost-effective alternative for treatment-experienced PLWH in resource-limited settings.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recommendations on prevention and treatment of respiratory infections in institutionalised older people].","authors":"Rubén Lovatti-González, Javier Gómez-Pavón, Rafael Bielza, Clara Hernando, Javier Martínez-Peromingo, Jesús Mateos-Nozal, Cristina Bermejo-Boixareu","doi":"10.37201/req/054.2025","DOIUrl":"https://doi.org/10.37201/req/054.2025","url":null,"abstract":"<p><p>Acute respiratory infections (ARIs) are one of the main causes of morbidity, functional impairment, and mortality in institutionalised older adults. This group is highly vulnerable due to factors such as advanced age, multimorbidity, frailty, and structural barriers to infection prevention and control. This article reviews, in a question-and-answer format, the most recent evidence on the epidemiology, prevention and treatment of the most relevant respiratory infections in nursing homes: influenza, SARS-CoV-2, respiratory syncytial virus, and <i>Streptococcus pneumoniae</i>. Epidemiological changes after the COVID-19 pandemic, current vaccination strategies, the efficacy and characteristics of newly vaccines available, as well as the updated therapeutic approach according to resistance profiles and the availability of antivirals, are analysed. In addition, the clinical and functional impact that these infections can have on residents is addressed, as well as the need to find a balance between preventive measures and the quality of life of this population group. The importance of effective coordination between health and social care professionals, and the implementation of protocols adapted to the residential context is highlighted. The article provides practical, evidence-based recommendations to improve the prevention and treatment of these infections in a particularly vulnerable environment.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Epidemiological characteristics of patients with carbapenemase-producing NDM Enterobacterales isolates in a high-complexity hospital].","authors":"Cristina María Artiles-León, Sarita Rodríguez-Restrepo, Ivonne Andrea Torres-Jiménez, María de Las Delicias Quintana-Estellés, Esther Viedma-Moreno, Pilar Arrazola-Martínez, Felisa Jaén-Herreros, Inmaculada Sanz-Gallardo, Esther Suárez-García, Ana Craviotto-Vallejo, Sara de Miguel-García","doi":"10.37201/req/015.2025","DOIUrl":"10.37201/req/015.2025","url":null,"abstract":"<p><strong>Introduction: </strong>Carbapenemase-producing Enterobacteriaceae (CPE) of the New Delhi metallo-β-lactamase (NDM) type are a growing public health concern due to their rapid dissemination, widespread antimicrobial resistance and associated increase in morbidity and mortality. The aim of this study was to describe the epidemiological characteristics of patients with NDM-type CPE (NDM-CPE) isolates.</p><p><strong>Methods: </strong>A descriptive study of patients with at least one CPE-NDM isolate between December 1, 2022, and December 31, 2023. Demographic and clinical evolution data were collected from electronic medical records.</p><p><strong>Results: </strong>NDM-CPE were identified in 77 patients, 87% of whom were adults and 75.3% were male. Thirty-two-point five percent were immunosuppressed. A total of 84.4% required hospital admission (60% in ICU) and 66.2% underwent surgery. The median time between admission and the first microbiological isolation of NDM-CPE was 18 days (RIC: 4-32 days). The most frequent microorganism was <i>Klebsiella pneumoniae</i> (92.2%), followed by <i>Escherichia coli</i> (4.2%), and <i>Citrobacter freundii</i> (4.2%). A total of 58.4% carried genes coding for NDM and OXA-48 carbapenemases, 40.3% for only NDM, and 1.3% for NDM and VIM. A total of 45.5% were patients with positive colonization samples for NDM-CPE, of whom 31.4% developed infection. Overall mortality at study end was 24.7 %.</p><p><strong>Conclusions: </strong>Early identification of carriers, strengthening epidemiological and molecular surveillance, and prompt implementation of control measures are essential to interrupt transmission chains and protect the most vulnerable patients.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"287-293"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of perceived versus actual care complexity in HIV-positive patients receiving antiretroviral treatment: The STRATPATIENT study.","authors":"Cristina Galindo García, Enrique Contreras-Macías, Gema Araceli Naranjo-Pérez, Ramón Morillo-Verdugo","doi":"10.37201/req/014.2025","DOIUrl":"10.37201/req/014.2025","url":null,"abstract":"<p><strong>Introduction: </strong>HIV is now considered a chronic disease due to advances in antiretroviral therapy (ART), which have improved survival but have also increased both comorbidities and polypharmacy. This underscores the need for personalized care strategies such as the Capacity-Motivation-Opportunity (CMO) model and patient stratification tools. This study aimed to identify the discrepancy between patient-perceived and actual care complexity in HIV-positive patients on ART, as assessed by a stratification tool.</p><p><strong>Methods: </strong>A retrospective, observational study at Valme Hospital (April-June 2024) included HIV-positive patients aged over 18 years on stable ART, excluding clinical trial participants. Data collected included age, sex, route of HIV acquisition, viral load, CD4 count, AIDS stage, comorbidities, polypharmacy and the Medication Regimen Complexity Index (MRCI). Perceived complexity was assessed using a visual analogue scale, whereas complexity according to the stratification tool was calculated with the variables of the CMO model.</p><p><strong>Results: </strong>A total of 411 participants with a median age of 55 years were included, of whom 72.5 % had comorbidities, primarily cardiovascular. The median MRCI score was 8, with 85.4 % of patients were classified at stratification level 3, while 74.9 % reported low perceived healthcare complexity. Concordance between stratification and perceived complexity was weak. Significant associations were observed between perceived complexity and AIDS stage, extensive polypharmacy, and stratification levels.</p><p><strong>Conclusions: </strong>This study emphasises integrating objective assessments and patient perspectives to improve healthcare evaluation and patient-centered care.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"278-286"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}