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

{"title":"[Gonococcal arthritis: neither so common nor so straightforward. Clinical description of cases diagnosed in northern Spain between 2013 and 2023].","authors":"Laura Guio Carrión, María José Blanco Vidal, Leire Toscano Ruiz, Juan Carlos Gainzarain Arana, Marta Fernández-Sampedro, Miguel Ángel Goenaga Sánchez, Víctor Polo Sanricardo, Begoña Vilar Achabal, Marina Fernández Torres, Daniel Pablo Marcos, Malen Aguirregabiria Padilla, José Luis Díaz de Tuesta Del Arco","doi":"10.37201/req/158.2026","DOIUrl":"10.37201/req/158.2026","url":null,"abstract":"<p><strong>Introduction: </strong>Given the current increase in the incidence of <i>Neisseria gonorrhoeae</i> infection, a rise in disseminated forms of the disease may also be expected. Within disseminated gonococcal disease, gonococcal arthritis has specific clinical, diagnostic and therapeutic characteristics.</p><p><strong>Methods: </strong>A retrospective search was conducted for synovial fluid samples that tested positive for <i>N. gonorrhoeae</i> by culture or molecular biology techniques between 2013 and 2023 at several hospitals in northern Spain. A descriptive analysis was subsequently performed.</p><p><strong>Results: </strong>Fifteen patients were analysed. Monoarthritis was the most frequent presentation (60%), followed by polyarthritis, predominantly affecting the wrist or knee. Arthralgia or tenosynovitis at other sites, particularly the wrist, was common. Microbiological identification was performed by conventional culture (12/14) or PCR (7/7). Repeated ultrasound-guided drainage or surgical washout was required in 30% of cases. The mean duration of intravenous antibiotic therapy was 12 days, while the mean total duration of antibiotic therapy was 22 days. The clinical response was favourable in all cases.</p><p><strong>Conclusions: </strong>In the current context of increasing gonococcal infection incidence, gonococcal arthritis should be considered in patients with septic monoarthritis or polyarthritis and concomitant tenosynovitis, particularly when the radiocarpal joint is involved. Molecular biology techniques may be useful for identifying <i>N. gonorrhoeae</i> in suspected cases. The clinical course may vary and may require surgical washout and prolonged treatment.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"409-416"},"PeriodicalIF":2.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709110","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":"The ICU pharmacist's contribution to antimicrobial optimization through routine pharmacist interventions.","authors":"Natalia Sánchez-Ocaña, Luis Pérez-de-Amezaga-Tomás, Andres Giglio, Marcio Borges","doi":"10.37201/req/166.2026","DOIUrl":"10.37201/req/166.2026","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobials are among the medication groups most frequently involved in medication errors and adverse drug events in the Intensive Care Unit (ICU). Despite growing evidence supporting the role of Critical Care Pharmacists (CCPs) in antimicrobial stewardship, their integration into ICU teams remains inconsistent across European healthcare systems.</p><p><strong>Methods: </strong>A prospective observational study was conducted over five months in an 18-bed medical-surgical ICU at a tertiary-level hospital in Spain. All admitted patients were included. A specialist pharmacist reviewed daily antimicrobial prescriptions through the electronic prescribing system. Pharmaceutical interventions (PIs) were classified as proactive or reactive and categorised by intervention type according to a predefined taxonomy. A descriptive analysis was performed.</p><p><strong>Results: </strong>A total of 331 PIs were recorded, of which 150 (45.31%) corresponded to antimicrobial therapy, representing the most frequently involved medication group. This figure corresponds to a mean of 1.50 antimicrobial-related PIs per working day. Of these, 115 (76.67%) were proactive. The most frequent intervention type was dose adjustment for overdosing or excessive duration (47.33%), followed by dose adjustment for underdosing or insufficient duration (18.00%), therapeutic drug monitoring recommendations (10.67%), and drug information to clinical staff (6.66%).</p><p><strong>Conclusions: </strong>CCPs identify a substantial number of antimicrobial-related drug problems in the ICU through routine prospective review. The coexistence of overdosing and underdosing interventions reflects the pharmacokinetic complexity of this population. These findings support the formal integration of CCPs into ICU antimicrobial stewardship activities.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"369-374"},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407670","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":"[Missed opportunities in HIV detection: experience in a referral hospital].","authors":"Sara Gómez-García, Elena Tapia-Moral, Javier Gamazo-Herrero, Laura Rodríguez-Delgado, Cristina Novoa-Fernández, Marina García de Vicuña-Oyaga, Laura Rodríguez-Fernández, Pablo Tellería-Gómez, Sara Miranda-Riaño, Carlos Dueñas-Gutiérrez","doi":"10.37201/req/162.2026","DOIUrl":"10.37201/req/162.2026","url":null,"abstract":"<p><strong>Introduction: </strong>Late diagnosis of HIV infection continues to be a significant public health challenge. The objective of the study was to analyze the frequency of late diagnosis and missed diagnostic opportunities among newly diagnosed cases of HIV infection.</p><p><strong>Materials and methods: </strong>A retrospective observational study including newly diagnosed HIV cases between 2017 and 2024 was conducted, evaluating demographic and clinical variables and routes of transmission, as well as previous contact with the healthcare system.</p><p><strong>Results: </strong>103 patients were analyzed, most of whom were men (86.5%). The main route of transmission was sexual among men who have sex with men (61.2%). 44.7% of cases were diagnosed late, and 25.2% had advanced disease. 87.4% had previous healthcare contact, and in 49.5% of cases, diagnostic opportunities had been missed.</p><p><strong>Conclusions: </strong>Strengthening early detection is essential to reduce morbidity and mortality and curb HIV transmission.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"365-368"},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407648","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":"Cutaneous eruption by <i>Streptococcus dysgalactiae</i> in an immunocompromised patient.","authors":"Beatriz Aldea-Manrique, Marcial Álvarez-Salafranca, Mar García-García, Antonio Beltrán-Rosel, Jorge Ligero-López, Mariano Ara-Martín","doi":"10.37201/req/186.2026","DOIUrl":"10.37201/req/186.2026","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"384-386"},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407605","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":"Nasal swab-guided deescalation of empirical linezolid in respiratory infections at a secondary-level hospital: quantification of quality gaps and antimicrobial stewardship opportunities.","authors":"Javier Martínez de Victoria-Carazo, Carlos Guerrero-Herrera, Lucía Guillén-Zafra, Waldo Sánchez-Yebra-Fernández, Andrés Ruíz-Sancho, María Núñez-Núñez","doi":"10.37201/req/183.2026","DOIUrl":"10.37201/req/183.2026","url":null,"abstract":"<p><strong>Background: </strong>Empirical linezolid for respiratory infections risks overtreatment and therapeutic inertia. Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) nasal swabs have high negative predictive value for ruling out MRSA pneumonia, yet their systematic integration into clinical practice remains poorly documented in Spain. The aim of the study was to quantify three sequential quality gaps in the empirical linezolid prescribing process and estimate the potential for improvement through an antimicrobial stewardship programme (ASP).</p><p><strong>Methods: </strong>A retrospective observational study of 83 patients receiving empirical linezolid for respiratory infections at a secondary-level hospital during five non-consecutive months of 2025. Three quality gaps were defined: Gap 0 (initiation without MRSA risk criteria); Gap 1 (failure to request a nasal swab in eligible patients); and Gap 2 (therapeutic inertia following a negative result).</p><p><strong>Results: </strong>Gap 0 affected 30.1% of patients, predominantly CAP (72%), discontinuation was more frequent in Gap 0 patients than in eligible candidates. Gap 1 affected 32.5%, with marked inter-unit variability: swabs were requested in 78% of Internal Medicine patients versus 41.7% in Respiratory Medicine. Among 56 patients with results, 85.7% were negative; Gap 2 affected 20.8%, generating 56 days of linezolid administered after a negative result was available. Patients with positive swabs had significantly higher cumulative risk scores than negative patients. Overall, 62.7% of patients presented ≥1 gap, accounting for 69.5% of 377 total linezolid-days.</p><p><strong>Conclusions: </strong>Quality gaps in empirical linezolid use affect two-thirds of patients and are associated with nearly 70% of treatment days. Targeted two-level ASP interventions, explicit indication criteria, and systematic de-escalation prompts after negative swabs are warranted.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"347-356"},"PeriodicalIF":2.2,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335341","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":"Associations between high-risk human papillomavirus genotypes: evidence of HPV16 predominance as a monoinfection and its no stronger link with high-grade lesions.","authors":"Julia González Cantó, María Amparo Burgos-Isern, Antonio Burgos-Teruel","doi":"10.37201/req/178.2026","DOIUrl":"10.37201/req/178.2026","url":null,"abstract":"<p><strong>Background: </strong>High-risk human papillomaviruses (HR-HPVs) are the main etiological agents of cervical cancer. Although coinfections with multiple HPV types are common, it remains unclear whether certain genotypes tend to associate preferentially or whether these associations occur randomly. In particular, HPV16 is considered the most oncogenic type, but its behavior in the context of mono- versus coinfection is less well defined.</p><p><strong>Methods: </strong>We retrospectively analyzed cervical cytology and HPV genotyping results from 1,140 women aged 25-65 years. We calculated absolute and relative frequencies of individual HR-HPV types, examined between associations of two-type coinfections, and compared observed versus expected frequencies to assess whether genotype combinations occurred beyond chance. Special attention was given to HPV16, analyzing cytological outcomes in monoinfections versus coinfections.</p><p><strong>Results: </strong>Most HR-HPV coinfections occurred at frequencies consistent with chance, suggesting no preferential interactions between genotypes. HPV16, however, was disproportionately present as a monoinfection. Importantly, no HPV16 monoinfections were significantly more associated with high-grade squamous intraepithelial lesions (HSIL) than HPV16 coinfections (p=0,365).</p><p><strong>Conclusions: </strong>HPV16 was the most frequent genotype and was more commonly observed as a monoinfection than several other HR-HPV types. However, HPV16 monoinfections were not significantly associated with a higher frequency of HSIL compared with HPV16 coinfections. The observed genotype distribution patterns should be interpreted cautiously within the epidemiological context of opportunistic prevaccination screening.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"375-379"},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261296","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":"Long-term persistence, effectiveness, safety, and metabolic impact of bictegravir/emtricitabine/tenofovir alafenamide fixed-dose combination in people living with HIV in the BICTARG cohort.","authors":"Diego Cecchini, Martín Brizuela, Gastón Copertari, Brenda Bacelar, Cinthia Lamaizon, Macarena Roel, Edgardo Bottaro, Isabel Cassetti","doi":"10.37201/req/187.2026","DOIUrl":"10.37201/req/187.2026","url":null,"abstract":"<p><strong>Introduction: </strong>Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is a preferred antiretroviral regimen in international guidelines, but long-term real-world data in Latin American people living with HIV (PLWH) are scarce. This study describes 48-month persistence, virological effectiveness, safety and metabolic changes in the Argentine BICTARG cohort.</p><p><strong>Material and methods: </strong>We conducted an observational, retrospective, open cohort study including treatment-naïve (TN) and treatment-experienced (TE) adults with HIV who initiated B/F/TAF between October 2019 and December 2022 at a large HIV centre. Persistence on B/F/TAF, virological suppression (VS, <50 copies/mL), B/F/TAF-related adverse events (AEs), and metabolic parameters (fasting glucose, cholesterol, and triglycerides) were assessed at 24, 36 and 48 months.</p><p><strong>Results: </strong>Overall, 3,057 PLWH were included: 425 TN (14%) and 2,632 TE (86%). In TN, persistence at 24, 36 and 48 months was 99%, 97% and 95%, and VS rates were 95%, 93% and 90%, respectively, with no AEs reported. In TE, persistence was 98%, 96%, and 88%, and VS rates were 96%, 98%, and 98%; AE rates were ≤0.4%, with no virological failure. Fasting glucose remained unchanged; TN participants showed increases in total, LDL, and HDL cholesterol, whereas in TE participants, lipid levels were stable and triglycerides decreased over time (p<0.001).</p><p><strong>Conclusions: </strong>In this large Argentine cohort, B/F/TAF demonstrated high persistence, sustained VS, low AE rates and an overall favourable metabolic profile over 48 months in both TN and TE PLWH, providing the first long-term real-world evidence from Latin America.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"357-364"},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261276","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":"[Infectious complications following intravesical bacillus Calmette-Guérin therapy: a case series].","authors":"Vanessa Vento, Luis Cabeza-Osorio, Erika Esperanza Lozano-Rincon","doi":"10.37201/req/155.2026","DOIUrl":"10.37201/req/155.2026","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"380-383"},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261287","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":"Diagnostic accuracy of PCT, IL-6, and MR-ProADM for early identification of sepsis in the emergency department.","authors":"Sofía Tejada, Antonio Clemente, Antonia Socias, Andrés Giglio, María Aranda, Alberto Del Castillo, Joana Mena, Joana María Ribas, Luisa Martín, Karla Milagritos Llerena, María Magdalena Arellano, Miguel Agudo, Roberto de la Rica, Marcio Borges","doi":"10.37201/req/145.2026","DOIUrl":"10.37201/req/145.2026","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic accuracy of the biomarkers procalcitonin (PCT), interleukin-6 (IL-6), and mid-regional pro-adrenomedullin (MR-ProADM), individually and in combination, for early detection of sepsis and septic shock during emergency department (ED) triage.</p><p><strong>Materials and methods: </strong>A retrospective observational study was conducted in adults presenting to the ED with triage levels 2 and 3 between December 2021 and July 2023. Blood samples were collected at admission, prior to any therapeutic intervention. Plasma concentrations of PCT, IL-6, and MR-ProADM were measured using CMIA or ELISA. Diagnostic accuracy was assessed using ROC curves and AUC analysis.</p><p><strong>Results: </strong>A total of 248 patients were included (214 with sepsis and 34 non-septic controls). Simultaneous elevation of PCT, IL-6, and MR-ProADM was observed in 70% of septic patients compared with 3% of controls. Each biomarker showed high diagnostic accuracy for sepsis (AUROC >0.90). The combined assessment increased specificity and was strongly associated with sepsis and septic shock, with progressively higher odds as the number of elevated biomarkers increased. Higher biomarker burden was also associated with indicators of greater clinical severity, including higher SOFA scores and ICU admission.</p><p><strong>Conclusions: </strong>Combined measurement of PCT, IL-6, and MR-ProADM at ED triage, before therapeutic intervention, improves early identification of patients with sepsis and provides relevant information on initial disease severity. This multiplex platform approach may support clinical prioritization and protocol activation in the ED.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"238-252"},"PeriodicalIF":2.2,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059271","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":"Pediatric septic arthritis caused by <i>Staphylococcus argenteus</i>.","authors":"Geysel Bosch-Gálvez, Montserrat Piñana-Alcalde, José Rafael Bretón-Martínez, Estela Giménez-Quiles, Laura Pino-Almero, Javier Colomina-Rodríguez","doi":"10.37201/req/170.2026","DOIUrl":"10.37201/req/170.2026","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"283-286"},"PeriodicalIF":2.2,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059300","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}