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

Introduction: To describe the epidemiology pattern of the COVID-19 pandemic during all Spanish State of Alarm.

Methods: Retrospective, observational, cohort and multicenter study. Inclusion criteria: age ≥18 years, admitted for COVID-19 pneumonia in any HM Hospitals Group center. Exclusion criteria: voluntary discharge, death in the emergency department, transfer outside HM or incomplete data.

Results: During the study period, 2,992 patients were admitted for COVID-19 pneumonia, of whom 295 died (9.86%). Survivors vs. non-survivors: differences in age and comorbidities, but a similar interaction network. 197 (6.48%) required ICU admission, with 52 (26.39%) deaths. Incidence for variants: original 4.05 cases/day, alpha 3.82, delta 1.16, omicron 1.35.

Conclusions: Almost 1 in 10 patients with COVID-19 pneumonia died, a proportion that rose to 1 in 4 in the ICU. Unexpectedly, the comorbidity network was similar between survivors and non-survivors. Different variants were associated with varying hospital admission rates but did not alter the "peaks and troughs" pattern of the pandemic.

Introduction: The prevalence, clinical characteristics, and antibiotic susceptibility of the slow-growing microorganisms Corynebacterium urealyticum, Corynebacterium glucuronolyticum, Lactobacillus delbrueckii, and Aerococcus spp. in urine cultures are analyzed.

Material and methods: Descriptive and retrospective cross-sectional study carried out in a Regional Hospital. Reports of clinical episodes with single isolation of the aforementioned microorganisms were selected between January 2016 and December 2023.

Results: A total of 186 single-isolation episodes were included, corresponding to 0.44% of the total. The most frequently isolated species was Aerococcus urinae. Overall, the risk factors were the presence of an indwelling bladder catheter (24.73%), immunosuppression (24.19%), health care (35.48%), diabetes mellitus (19.89%), nephrourological disorders (31.18%) and previous antibiotherapy (35.48%). Urinary tract infections due to Aerococcus spp. predominated in elderly patients, with nephrourological disorders and a history of antibiotic therapy in the previous 3 months. C. glucuronolyticum, C. urealyticum and L. delbrueckii were associated with immunosuppression, healthcare contact and previous antibiotherapy. C. urealyticum was also associated with the presence of an indwelling bladder catheter.

Conclusions: Slow-growing opportunistic emerging microorganisms represent a small percentage of the aetiological agents in urinary tract infections, although of important and growing clinical interest given their pathogenic role in the presence of certain circumstances and risk factors, as well as the challenges they pose for laboratory diagnosis. It is essential to perform antibiograms for an adequate targeted treatment.

Introduction: The incidence of coinfections and superinfections following SARS-CoV-2 pneumonia has garnered increasing attention, with complications arising from various pathogens, including viruses, bacteria, and fungi. Nevertheless, the relationship between COVID-19 and tuberculosis (TB) is not fully understood. This study investigates the incidence and risk factors for post-COVID-19 pulmonary TB in a low TB prevalence area in southeastern Spain, alongside the influence of COVID-19 on indeterminate results in the Quantiferon-TB Gold Plus (QFT-Plus) test and its prognostic role.

Material and methods: A retrospective cohort study was conducted involving 475 hospitalized COVID-19 from March 2020 to March 2022, all of them with a QFT-Plus performed.

Results: The study found three cases of pulmonary TB in the post-COVID-19 period, yielding an incidence density of 3.56 cases per 1000 patient-years, all associated with chronic systemic corticosteroid therapy. Notably, the percentage of indeterminate QFT-Plus results during COVID-19 was significantly higher than when it was performed before the disease (16.82% vs. 3.37%). Patients with indeterminate results exhibited elevated inflammatory markers and a greater need for invasive mechanical ventilation, correlating with more severe disease, although without statistical significance.

Conclusions: The findings suggest that prolonged systemic corticosteroid therapy is a common risk factor for pulmonary TB development and that systematic LTBI screening may not be necessary for all COVID-19 patients unless prolonged corticosteroid treatment is foreseen. This study highlights the need for further research to clarify the relationship between COVID-19 and post-COVID-19 pulmonary TB, as well as the prognostic implications of QFT-Plus results.

Introduction: This study aims to describe antimicrobial use in primary care across Spain by analyzing the prescriptions dispensed in pharmacies. Antimicrobials were categorized into therapeutic action groups based on the ATC-2 classification: antibacterials (J01), antimycotics (J02), antimycobacterials (J04), and antivirals (J05). Additionally, the study explores epidemiological patterns of use.

Methods: A retrospective observational study was conducted using data from the Primary Care Clinical Database (BDCAP) for 2023. The analysis focused on defined daily doses (DDD) per 1,000 persons/day (DHD), and the number of individuals with at least one antimicrobial prescription in primary care. Data were stratified by age, sex, municipality size, income level, country of birth, and employment status. Changes in prescriptions percentages in 2017 and 2023, as well as variations by age group and sex were compared.

Results: An overall upward temporal trend in the antimicrobial DHD was observed from 2017 to 2023 (increase of 20.2%), with a decrease in usage during 2020 and 2021. Women exhibited higher DHD for antibacterials, antimycotics, and antivirals, whereas men demonstrated higher DHD for antimycobacterials. Notably, antimycobacterial agents had higher DHD in municipalities with populations exceeding 100,000 inhabitants and among foreign-born individuals. Out of 46,762,487 people assigned to primary care, 14,056,450 received prescribed antimicrobials in 2023.

Conclusions: These findings indicate a rising trend in antimicrobial use in primary care, underscoring the need for targeted interventions to encourage the rational use of antimicrobials, particularly in high-use groups.