M C Martín-Delgado, P De Lucas Ramos, A García-Botella, R Cantón, A García-Lledó, T Hernández-Sampelayo, J Gómez-Pavón, J González Del Castillo, F J Martín Sánchez, M Martínez-Sellés, J M Molero García, S Moreno Guillén, F J Rodríguez-Artalejo, J Ruiz-Galiana, A Burillo, P Muñoz, C Calvo Rey, M Catalán-González, E Cendejas-Bueno, V Halperin-Benito, R Recio, C Viñuela-Benítez, E Bouza
{"title":"Invasive group A Streptococcus infection (Streptococcus pyogenes): Current situation in Spain.","authors":"M C Martín-Delgado, P De Lucas Ramos, A García-Botella, R Cantón, A García-Lledó, T Hernández-Sampelayo, J Gómez-Pavón, J González Del Castillo, F J Martín Sánchez, M Martínez-Sellés, J M Molero García, S Moreno Guillén, F J Rodríguez-Artalejo, J Ruiz-Galiana, A Burillo, P Muñoz, C Calvo Rey, M Catalán-González, E Cendejas-Bueno, V Halperin-Benito, R Recio, C Viñuela-Benítez, E Bouza","doi":"10.37201/req/067.2024","DOIUrl":"10.37201/req/067.2024","url":null,"abstract":"<p><p>Group A ß-hemolytic Streptococcus (S. pyogenes), also known as GAS, is a Gram-positive bacterium. It can be easily identified in the microbiology laboratory by its ability to hemolyse blood in culture media. This bacterium is highly virulent due to its production of enzymes and toxins, and its ability to cause immunologically mediated diseases such as rheumatic fever and post-streptococcal glomerulonephritis. GAS is the primary cause of bacterial pharyngotonsillitis, although it is typically a benign and non-invasive disease. However, it also has the potential to cause severe skin and soft tissue infections, necrotising fasciitis, bacteraemia and endocarditis, pneumonia and empyema, and streptococcal toxic shock syndrome, without any age or predisposition limits. The term invasive GAS disease (iGAS) is used to refer to this group of conditions. In more developed countries, iGAS disease has declined thanks to improved hygiene and the availability of antibiotics. For example, rheumatic fever has practically disappeared in countries such as Spain. However, recent data suggests a potential increase in some iGAS diseases, although the accuracy of this data is not consistent. Because of this, the COVID and Emerging Pathogens Committee of the Illustrious Official College of Physicians of Madrid (ICOMEM) has posed several questions about invasive GAS infection, especially its current situation in Spain. The committee has enlisted the help of several experts in the field to answer these questions. The following lines contain the answers that we have collaboratively produced, aiming to assist not only the members of ICOMEM but also anyone interested in this topic.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"454-471"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794430","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}
D Cecchini, J Sfalcin, I Zapiola, A Gomez, S Fernandez-Giuliano, C Rodriguez, L Mammana, A Seravalle, F Fay, M C Torroija, G Bugarín, M B Bouzas
{"title":"Integrase strand transfer inhibitors resistance-associated mutations in HIV-infected pregnant women.","authors":"D Cecchini, J Sfalcin, I Zapiola, A Gomez, S Fernandez-Giuliano, C Rodriguez, L Mammana, A Seravalle, F Fay, M C Torroija, G Bugarín, M B Bouzas","doi":"10.37201/req/074.2024","DOIUrl":"10.37201/req/074.2024","url":null,"abstract":"<p><strong>Objective: </strong>To date, no data exist regarding the prevalence of integrase inhibitor (INSTI) resistance-associated mutations (HIVDRM) in HIV-infected pregnant women (HPW) in Latin America. We describe the prevalence and transmissibility of integrase HIVDRM in a historical cohort of INSTI-naïve HPW from Argentina (n=56) with Next Generation Sequencing (NGS).</p><p><strong>Methods: </strong>Bioinformatics analysis was performed by HyDRA software for 20%, 10%, 5%, 2%, and 1% sensitivity thresholds. We calculated the mutational viral load for each INSTI-HIVDRM, considering those with >1000 c/mL as of high risk of transmissibility.</p><p><strong>Results: </strong>The predominant HIV subtype was BF (78.5%). Major HIVDRM were not detected with the population sequencing 20% filter. With a 1% threshold, the prevalence increased to 8.9%; Y143C/S, E92G, E138K, and T66I mutations were found. The median (range) mutational load (expressed in c/mL) was: 355 (50.2-11705); with only 1 case >1000 c/mL Accessory mutations (G163R/K, T97A) were detected mostly with a 20% sensitivity threshold with an overall prevalence of 23.2%; the median (IQR) mutational load was: 23929 (4009-63158) c/mL; all of them above 1000 c/mL.</p><p><strong>Conclusions: </strong>Our results show evidence of the presence of major INSTI-HIVDRM as aleatory mutations and a high frequency of accessory mutations with potential transmissibility in HPW.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"479-485"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373958","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":"[Reactive infectious mucocutaneous eruption (RIME) in paediatric patients: extrapulmonary Mycoplasma pneumoniae involvement].","authors":"C González, B Croche, E Gómez","doi":"10.37201/req/061.2024","DOIUrl":"10.37201/req/061.2024","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"518-520"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396507","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}
F Cobo, J A Reguera-Márquez, J A Marín-Rodríguez, F J Martín-Pérez, P Pérez-Palacios, E Recacha, J M Navarro-Marí
{"title":"A 5-year study of bloodstream infections caused by carbapenemase-producing Gram-negative bacilli in southern Spain.","authors":"F Cobo, J A Reguera-Márquez, J A Marín-Rodríguez, F J Martín-Pérez, P Pérez-Palacios, E Recacha, J M Navarro-Marí","doi":"10.37201/req/045.2024","DOIUrl":"10.37201/req/045.2024","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the microbiological epidemiology of carbapenemase-producing Gram-negative bacilli (CPGNB) isolated from blood during a 5-year period.</p><p><strong>Methods: </strong>A total of 80 isolates from 78 patients were finally included; fifty-five (70.5%) were men and the mean age was 60 years. Detection of carbapenemase production was performed by immunocromatography (IC) and polymerase chain reaction (PCR). Genotyping was carried-out by pulsedfield gel electrophoresis (PFGE) and multi-locus sequence typing (MLST), and characterization of carbapenemase-producing isolates was performed by whole genome sequencing (WGS).</p><p><strong>Results: </strong>The main microorganisms isolated were K. pneumoniae (29.4%), E. cloacae (28.2%), A. baumannii (17.9%) and P. aeruginosa (15.3%). Overall, the most common carbapenemase in Enterobacterales was OXA-48 group (57.7%). The most common carbapenemase in non-fermenting bacilli was OXA-23 (60.8%). The most common ST in K. pneumoniae producing OXA-48 types was ST45 and in E. cloacae ST114, while in E. cloacae producing VIM types was ST78. In OXA-23 types, the most common clone in A. baumannii was ST2, whereas in P. aeruginosa producing IMP types was ST253.</p><p><strong>Conclusions: </strong>There was an increase in cases recorded in the years of highest incidence and severity of the SARS-CoV-2 pandemic, with a significant number of cases in patients admitted to the ICU. All bacteremias caused by A. baumannii were caused by the same clone, and 12 of the 14 cases caused by A. baumannii were part of outbreaks in the ICU.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"472-478"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305213","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}
R Cantón, P De Lucas Ramos, A García-Botella, A García-Lledó, T Hernández-Sampelayo, J Gómez-Pavón, J González Del Castillo, M C Martín-Delgado, F J Martín Sánchez, M Martínez-Sellés, J M Molero García, S Moreno Guillén, F J Rodríguez-Artalejo, E Reigadas, R Del Campo, S Serrano, J Ruiz-Galiana, E Bouza
{"title":"Human intestinal microbiome: Role in health and disease.","authors":"R Cantón, P De Lucas Ramos, A García-Botella, A García-Lledó, T Hernández-Sampelayo, J Gómez-Pavón, J González Del Castillo, M C Martín-Delgado, F J Martín Sánchez, M Martínez-Sellés, J M Molero García, S Moreno Guillén, F J Rodríguez-Artalejo, E Reigadas, R Del Campo, S Serrano, J Ruiz-Galiana, E Bouza","doi":"10.37201/req/056.2024","DOIUrl":"10.37201/req/056.2024","url":null,"abstract":"<p><p>The study of the microbiota and the microbiome, and specifically the intestinal one, has determined great interest due to the possible association of their alterations with numerous diseases. These include entities as diverse as Crohn's disease, autism, diabetes, cancer or situations as prevalent today as obesity. In view of this situation, different recommendations have been performed regarding the use of probiotics, prebiotics, and postbiotics as modulators of the microbiota and the microbiome, seeking both preventive and therapeutic effects, and faecal material transfer (FMT) is proposed as an alternative. The latter has emerged as the only proven beneficial intervention on the intestinal microbiome, specifically in the treatment of recurrent colitis associated with Clostridioides difficile (R-CDI). In the rest of the entities, the lowering of laboratory costs has favored the study of the microbiome, which is resolved by delivering reports with catalogs of microorganisms, metabolites or supposed biomarkers without consensus on their composition associated with healthy or diseased microbiota and the disease. There is still insufficient evidence in any disease for interventions on the microbiome beyond FMT and R-CDI. Multi- and multi-disciplinary work with extensive research and the application of artificial intelligence in this field may shed light on the questions raised currently. Ethical issues must also be resolved in light of possible interventions within the umbrella of personalized medicine.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"438-453"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560664","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}
J Cabañas Morafraile, E de Rafael González, L Serrano Martín, R Rubio Díaz, M Torres Fernández, E Heredero Gálvez, W E López Forero, L Morell Jurado, R Canabal Berlanga, M F Calafell Mas, E Chaves Prieto, M R Asensio Nieto, A Thomas-Balaguer Cordero, M C Lorenzo Lozano, A Julián-Jiménez
{"title":"[Poder diagnóstico de infección bacteriana de LIAISON MeMed BV® en los pacientes adultos atendidos en urgencias por sospecha de infección].","authors":"J Cabañas Morafraile, E de Rafael González, L Serrano Martín, R Rubio Díaz, M Torres Fernández, E Heredero Gálvez, W E López Forero, L Morell Jurado, R Canabal Berlanga, M F Calafell Mas, E Chaves Prieto, M R Asensio Nieto, A Thomas-Balaguer Cordero, M C Lorenzo Lozano, A Julián-Jiménez","doi":"10.37201/req/078.2024","DOIUrl":"10.37201/req/078.2024","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the diagnostic accuracy of the new MeMed® test to predict bacterial infection in adult patients seen in emergency departments (ED) with clinical suspicion of infection, as well as to compare its performance with other commonly used biomarkers (protein C reactive-PCR-, procalcitonin -PCT-).</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 diagnosis of bacterial infection (BI) was considered as the dependent variable. The predictive ability was analyzed with the area under the curve (AUC) of the receiver operating characteristic (COR) and the values of sensitivity (Se), specificity (Es), positive predictive value (PPV) and negative predictive value (NPV) of the PCR, PCT, leukocyte count and the LIAISON® MeMed® test.</p><p><strong>Results: </strong>The study included 258 patients, 54 (15.6%) of whom died within 30 days of visiting the ED. The mean age was 68.28 (SD 19.53) years, 57.4% (148) were men. At 30 days, the group with the IB diagnosis had 137 patients, the viral infection group 68 cases and 17 in the indeterminate group. The AUC-COR achieved by MeMed® in the group that analyzes all patients was 0.920 (95% CI: 0.877-0.962) and the PCT was 0.811 (95% CI: 0.754-0.867). With a cut-off point (PC) > 65 points of the MeMed® test, achieves a Se: 79.2% and Es: 91.2% and with PC > 90 points a Se: 57% and Es: 95.9%. Applying the Youden index, the PC > 50 points achieves Se:84.1% and Es:88.2%.</p><p><strong>Conclusions: </strong>In adult patients treated with clinical suspicion of infection in the ED, the LIAISON MeMed® test has a great ability to diagnose its bacterial origin and achieves better performance than PCT, PCR and leukocyte count.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"486-497"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484635","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}
M Fayos, A Severo, M D García-Cosío, C Prados, M Alonso, F López-Medrano
{"title":"Nocardia and mucoral co-infection in heart transplant recipient.","authors":"M Fayos, A Severo, M D García-Cosío, C Prados, M Alonso, F López-Medrano","doi":"10.37201/req/075.2024","DOIUrl":"10.37201/req/075.2024","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"523-526"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396506","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":"[Impact in the adult population of immunization with nirsevimab in children under 6 months of age against respiratory syncytial virus].","authors":"J Reina, J Viana-Ramirez","doi":"10.37201/req/049.2024","DOIUrl":"10.37201/req/049.2024","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"512-514"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141622076","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}
P Favier, L Abusamra, S Moncalero, L Errecalde, S Montibello, O Rodríguez, S Cogut, M Erbin, M J Rolón
{"title":"Change in Klebsiella pneumoniae susceptibility profile after the arrival of ceftazidime-avibactam in an Argentinean intensive care unit: a new ecological landscape.","authors":"P Favier, L Abusamra, S Moncalero, L Errecalde, S Montibello, O Rodríguez, S Cogut, M Erbin, M J Rolón","doi":"10.37201/req/042.2024","DOIUrl":"10.37201/req/042.2024","url":null,"abstract":"<p><strong>Objective: </strong>Ceftazidime-avibactam (CZA) is a good option for Gram-negative bacilli infections that produce carbapenemase Classes A (especially blaKPC) and D (blaOXA). However, it is unknown whether it would have an impact on metallo-β-lactamases (blaMBL) selection. The aim of the study was to compare carbapenem and CZA Klebsiella pneumoniae (KPN) susceptibility profiles for a period of two years following the introduction of CZA.</p><p><strong>Methods: </strong>The study was conducted in a 36-bed adult ICU of a tertiary hospital in Buenos Aires, Argentina. Antimicrobial consumption was expressed as days of treatment per 100 patients-day (DOT).</p><p><strong>Results: </strong>A total of 123 KPN strains in the first year and 172 in the second year were analyzed. An alarming decrease in carbapenem susceptibility was detected in the second year (OR 0.5 [0.3-0.8] p<.001). In parallel, there was a decrease in CZA susceptibility (OR 0.5 [0.3-0.9] p<.05). These findings were linked to a rise in blaMBL-KPN (32.1% vs. 45.1%, OR 1.7 [1.1-2.9], p <.04) during the second year. This new KPN susceptibility profile promoted an increment in CZA (1.0 DOT vs. 6.6 DOT, OR 6.6 [4.9-9.1] p<.001) and aztreonam (0.3 DOT vs. 4.1 DOT, OR 16.3 [9.1-29.3] p<.001) consumption. Thus, there was a decrease in carbapenem prescription (17.8 DOT vs. 15.4 DOT, OR 0.8 [0.8-0.9] p<.001).</p><p><strong>Conclusions: </strong>There was an escalation of blaMBL-KPN rate two years after CZA introduction, leading to a decrease in CZA and carbapenem susceptibility and an increase in CZA and aztreonam prescriptions.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"415-421"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494716","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}
A Maldonado-Barrueco, C Sanz-González, D Grandioso-Vas, I Falces-Romero, J García-Rodríguez, I Quiles-Melero
{"title":"AllplexTM NG-DR (Seegene) utility for switching oral regimens with fluoroquinolones in gonococcal arthritis.","authors":"A Maldonado-Barrueco, C Sanz-González, D Grandioso-Vas, I Falces-Romero, J García-Rodríguez, I Quiles-Melero","doi":"10.37201/req/030.2024","DOIUrl":"10.37201/req/030.2024","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":"425-426"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474195","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}