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

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[Pre-exposure prophylaxis and the rise in sexually transmitted infections: Misunderstood safety?] 暴露前预防与性传播感染的上升:安全性被误解?]
IF 2.2
Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia Pub Date : 2025-09-15 Epub Date: 2025-07-23 DOI: 10.37201/req/059.2025
Marta Domínguez-Gil González, José María Eiros-Bouza, Laura Rita Iotti, Lucía Puente-Fuertes
{"title":"[Pre-exposure prophylaxis and the rise in sexually transmitted infections: Misunderstood safety?]","authors":"Marta Domínguez-Gil González, José María Eiros-Bouza, Laura Rita Iotti, Lucía Puente-Fuertes","doi":"10.37201/req/059.2025","DOIUrl":"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":"442-443"},"PeriodicalIF":2.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692796","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}
引用次数: 0
Pseudoglutamicibacter cumminsii in outpatient samples: analysis of isolates and antimicrobial susceptibility. 门诊样本中的康明斯假谷氨酰胺杆菌:分离株和药敏分析。
IF 2.2
Carlos J Téllez-Castillo, Lukas Müller, Ann-Katrin Rekendt, Laura Pra-Mio, Claas Scharmann
{"title":"<i>Pseudoglutamicibacter cumminsii</i> in outpatient samples: analysis of isolates and antimicrobial susceptibility.","authors":"Carlos J Téllez-Castillo, Lukas Müller, Ann-Katrin Rekendt, Laura Pra-Mio, Claas Scharmann","doi":"10.37201/req/060.2025","DOIUrl":"10.37201/req/060.2025","url":null,"abstract":"<p><strong>Introduction: </strong><i>Pseudoglutamicibacter cumminsii</i> is an aerobic, Gram-positive coryneform bacterium whose clinical relevance has not yet been clearly established. Although an increasing number of isolates have been documented in clinical settings, its role in human pathogenesis remains uncertain and warrants further characterization.</p><p><strong>Methods: </strong>We retrospectively analyzed 116 <i>P. cumminsii</i> isolates obtained from symptomatic outpatients in the Rhine-Ruhr metropolitan area (Germany) between January 2021 and February 2023. Clinical and demographic data, specimen types, and co-isolated organisms were recorded. Antimicrobial susceptibility testing (AST) was performed using broth microdilution, and results were interpreted according to EUCAST guidelines.</p><p><strong>Results: </strong>Most isolates were recovered from urine (58.6%) and wound swabs (30.2%), primarily from older adults. A statistically significant association was found between specimen type and patient sex and age. While <i>P. cumminsii</i> was usually detected in polymicrobial cultures (75%), two pure-culture cases were identified: one in urine and one in synovial fluid. AST revealed high susceptibility to beta-lactams and linezolid, with variable response to fluoroquinolones.</p><p><strong>Conclusions: </strong><i>P. cumminsii</i> is a rare opportunistic pathogen with potential clinical relevance in urogenital and wound infections. Its low pathogenicity suggests it is more likely a secondary colonizer or commensal. Further studies are needed to better understand its clinical significance and impact on human health.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"412-419"},"PeriodicalIF":2.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067100","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}
引用次数: 0
Acute infectious gastroenteritis in childhood: the role of rapid multiplex molecular syndromic panels in diagnosis and clinical management. 儿童急性感染性肠胃炎:快速多重分子症候群在诊断和临床管理中的作用。
Ana Belén Jiménez-Jiménez, Fátima Galán-Sánchez, Milagros García-López Hortelano, Victoria Fumadó, Llanos Salar-Vidal, José Tomás Ramos-Amador, Ana Isabel Menasalvas-Ruiz
{"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}
引用次数: 0
[Epidemiological characteristics of patients with carbapenemase-producing NDM Enterobacterales isolates in a high-complexity hospital]. [在高度复杂的医院中分离出产生碳青霉烯酶-NDM的肠杆菌患者的流行病学特征]。
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
{"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}
引用次数: 0
Comparison of perceived versus actual care complexity in HIV-positive patients receiving antiretroviral treatment: The STRATPATIENT study. 接受抗逆转录病毒治疗的hiv阳性患者感知与实际护理复杂性的比较:STRATPATIENT研究。
IF 2.2
Cristina Galindo García, Enrique Contreras-Macías, Gema Araceli Naranjo-Pérez, Ramón Morillo-Verdugo
{"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":2.2,"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}
引用次数: 0
Conjunctival and cutaneous Kaposi's Sarcoma as the first manifestation of HIV infection. 结膜和皮肤卡波西肉瘤是HIV感染的第一表现。
Raúl Parra-Fariñas, Carlota Insua, Lucía Buznego, Paula Runza, Carlos Armiñanzas, Manuel Gutierrez-Cuadra, Sara Marcos-González, Francisco Arnaiz de Las Revillas
{"title":"Conjunctival and cutaneous Kaposi's Sarcoma as the first manifestation of HIV infection.","authors":"Raúl Parra-Fariñas, Carlota Insua, Lucía Buznego, Paula Runza, Carlos Armiñanzas, Manuel Gutierrez-Cuadra, Sara Marcos-González, Francisco Arnaiz de Las Revillas","doi":"10.37201/req/013.2025","DOIUrl":"10.37201/req/013.2025","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"352-354"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164351","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}
引用次数: 0
[Impact of increasing the frequency of meetings in which the Antimicrobial Stewardship Programme team conducted prospective audit and feedback on antimicrobial consumption]. [增加抗菌素管理规划团队对抗菌素消耗进行前瞻性审核和反馈的会议频率的影响]。
María Inmaculada Zas-García, José Manuel Fernández-Carreira, Jorge Rodríguez-Prida, Ana Blanco-Suárez, Marcos Álvarez-Pérez, Jesús Rubio-Sanz, Elsa Castelo-Alvárez, Daniel González-Fernández, Tania Rubio-Alfonso
{"title":"[Impact of increasing the frequency of meetings in which the Antimicrobial Stewardship Programme team conducted prospective audit and feedback on antimicrobial consumption].","authors":"María Inmaculada Zas-García, José Manuel Fernández-Carreira, Jorge Rodríguez-Prida, Ana Blanco-Suárez, Marcos Álvarez-Pérez, Jesús Rubio-Sanz, Elsa Castelo-Alvárez, Daniel González-Fernández, Tania Rubio-Alfonso","doi":"10.37201/req/022.2025","DOIUrl":"10.37201/req/022.2025","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate how antimicrobial consumption was influenced by increasing the frequency of meetings in which the Antimicrobial Stewardship Program (ASP) team conducted prospective audit and feedback (PAF).</p><p><strong>Materials and methods: </strong>Retrospective cohort study comparing consumption in DDD per 1000 beds-day and DDD per 1000 admissions across groups of anti-infectives, antibacterial groups, agents against methicillin-susceptible <i>Staphylococcus aureus</i> (anti-MSSA agents)/agents against methicillin-resistant <i>Staphylococcus aureus</i> (anti-MRSA agents), antibiotics targeting sensitive Gram-negative bacteria/antibiotics targeting resistant Gram-negative bacteria and antimicrobial agents, during two comparative periods of ASP activity (2 weekly meetings in 2023 versus 1 weekly meeting in 2022).</p><p><strong>Results: </strong>Comparing 2023 to 2022: antibacterials for systemic use consumption increased in DDD per 1000 beds-day (+0.13%) and decreased in DDD per 1000 admissions (-3.55 %); consumption in DDD per 1000 beds-day and DDD per 1000 admissions increased for penicillins, glycopeptides and aminoglycosides while it decreased for cephalosporins and carbapenems, quinolones use increased per beds-days but decreased per admissions; regarding anti-MSSA and anti-MRSA agents, consumption of cefazolin, cloxacillin, vancomycin and daptomycin increased in DDD per 1000 beds-day and DDD per 1000 admissions, linezolid consumption increased per beds-day but decreased per admissions; for antibiotics targeting sensitive Gram-negative bacteria and antibiotics targeting resistant Gram-negative bacteria, consumption of amoxicillin-clavulanate, piperacillin-tazobactam, aminoglycosides, ceftazidime, cefepime and polymyxins increased per DDD/1000 bed-days and DDD per 1000 admissions, carbapenems consumption decreased per bed-days and admissions.</p><p><strong>Conclusions: </strong>The increase in the frequency of meetings seems to be related to better use of antimicrobials in our center.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"305-318"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164331","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}
引用次数: 0
[Early diagnosis of a case of septic arthritis thanks to the BioFire® joint infection panel]. 【利用BioFire®关节感染面板进行脓毒性关节炎的早期诊断】。
José Carlos De Gracia-Díaz, Ana Madueño, Sara Díaz-Martín, María Lecuona-Fernández
{"title":"[Early diagnosis of a case of septic arthritis thanks to the BioFire® joint infection panel].","authors":"José Carlos De Gracia-Díaz, Ana Madueño, Sara Díaz-Martín, María Lecuona-Fernández","doi":"10.37201/req/023.2025","DOIUrl":"10.37201/req/023.2025","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"355-357"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164281","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}
引用次数: 0
[Ability of midregional proadrenomedullin (MR-proADM) to predict poor clinical outcome and stratify prognosis in adult patients seen for suspected infection in the Emergency Department]. [中区域肾上腺髓质素原(MR-proADM)对急诊科疑似感染成人患者不良临床结局和分层预后的预测能力]。
IF 2.2
Elena de Rafael-González, Javier Cabañas-Morafraile, Laura Serrano-Martín, Agustín Julián-Jiménez, María Torres-Fernández, Elia Chaves-Prieto, Laura Morell-Jurado, William Esneider López-Forero, María Francisca Calafell-Mas, Álvaro Thomas-Balaguer Cordero, María Remedios Asensio-Nieto, Isabel Nieto-Rojas, Rafael Rubio-Díaz, Eva Heredero-Gálvez, María Carmen Lorenzo-Lozano, Raúl Canabal-Berlanga
{"title":"[Ability of midregional proadrenomedullin (MR-proADM) to predict poor clinical outcome and stratify prognosis in adult patients seen for suspected infection in the Emergency Department].","authors":"Elena de Rafael-González, Javier Cabañas-Morafraile, Laura Serrano-Martín, Agustín Julián-Jiménez, María Torres-Fernández, Elia Chaves-Prieto, Laura Morell-Jurado, William Esneider López-Forero, María Francisca Calafell-Mas, Álvaro Thomas-Balaguer Cordero, María Remedios Asensio-Nieto, Isabel Nieto-Rojas, Rafael Rubio-Díaz, Eva Heredero-Gálvez, María Carmen Lorenzo-Lozano, Raúl Canabal-Berlanga","doi":"10.37201/req/031.2025","DOIUrl":"10.37201/req/031.2025","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze and compare the accuracy of midregional proadrenomedullin (MR-proADM) to predict poor clinical outcome (understood as progression to septic shock or admission to the Critical Care Unit -CCU-) and 30-day mortality in adult patients seen for suspected infection in the Emergency Department (ED). We also compared their performance with other biomarkers (C-reactive protein -CRP-, procalcitonin -PCT-, lactate and leukocyte count) and clinical scales widely used in routine practice (qSOFA, SRIS, NEWS-2).</p><p><strong>Methods: </strong>A prospective, observational and analytical study was carried out on adult patients who were treated in an ED with the clinical diagnosis of an infectious process. Follow-up was carried out for 30 days. The main outcome was a composite measure that included progression to septic shock or admission to the CCU and 30-day mortality. The predictive ability was analyzed with the area under the curve (AUC) of the receiver operating characteristic (ROC) and the values of sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of MR-proADM, PCR, PCT, lactate, leukocyte count and the clinical scales.</p><p><strong>Results: </strong>214 patients were included, of whom 31 (14.5%) fulfilled the combined variable. The mean age was 68.6 (SD 20.75) years, 55.1% (118) were men. The MR-proADM concentration achieved the best AUC-ROC of 0.920 (95% CI: 0.850-0.989) compared to the other biomarkers and clinical scales. With a cut-off point (Cp) according to the Youden index > 2.105 nmol/L, a Se: 68%, Es: 98% and NPV: 97% were obtained. The NEWS-2 scale ≥ 5 achieves an AUC-ROC of 0.733 (95% CI: 0.630-0.835) with a Se: 87%, Es: 55% and NPV: 96%. The mixed model (MR-proADM ≥2.1 nmol/l + NEWS-2 ≥5) improved the AUC-ROC to 0.849 (95% CI: 0.782-0.915) and Se: 68%, Es: 98%, PPV: 74% and NPV: 88%.</p><p><strong>Conclusions: </strong>In adult patients attended with clinical suspicion of infection in the ED, MR-proADM presents a high ability to predict poor clinical evolution (progression to septic shock or ICU admission) and 30-day mortality and performs better than PCT, lactate, CRP, leukocyte count and the clinical scales qSOFA, SRIS, NEWS-2. The combined model (MR-proADM ≥2.1 nmol/L + NEWS-2 ≥5) improves prediction of both MR-proADM and clinical scales.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"319-334"},"PeriodicalIF":2.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164279","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}
引用次数: 0
[Impact of a dedicated multidisciplinary committee (endocarditis team) on the management and outcome of infective endocarditis in a reference center]. [一个专门的多学科委员会(心内膜炎小组)对参考中心感染性心内膜炎的管理和结果的影响]。
Javier Iglesias-Varea, Mario Fernández-Ruiz, Laura Domínguez, Jorge Boán, Eduardo Aparicio-Minguijón, Antonio Terrón, María Asunción Pérez-Jacoiste Asín, José María Aguado, Francisco López-Medrano
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