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

Human infections by Bordetella bronchiseptica are increasing in recent years. However, due to the lack of clinical susceptibility/resistance breakpoints, antimicrobial treatment is complex. Business Intelligence (BI) is a tool that allows to record and analyze large amounts of data in a very short time. The aim of this study was to analyze a cohort of patients with B. bronchiseptica infections focusing on how BI can help guide empirical antimicrobial therapy Demographic, clinical, and microbiological data about B. bronchiseptica infections were recovered. Then, MIC_50/90 of several antibiotics was automatically calculated through the BI. Thirteen B. bronchiseptica infections were identified. The lowest MICs₉₀ were for carbapenem, aminoglycoside, fluoroquinolones, and tetracyclines. The EUCAST PK-PD (non-species related) breakpoints showed that only piperacillin/tazobactam, imipenem and meropenem would be appropriate treatments to use empirically. In conclusion, BI systems have great potential to optimize the empirical antibiotic treatment in these types of infections.

Introduction: To analyse the concordance between theoretical and actual stratification of people living with HIV infection attending a pharmaceutical care outpatient clinic in a tertiary regional hospital.

Methods: Observational, retrospective, analytical, cross-sectional and single-centre study in people living with HIV infection. Study period: April 2024. Inclusion criteria: patients with HIV infection aged over 18 years who had been receiving active antiretroviral therapy (ART) for at least two years prior to inclusion. The 2022 version of the pharmaceutical care stratification model for people living with HIV infection was used. Reliability was evaluated from a qualitative perspective using Cohen's Kappa coefficient.

Results: Of the 199 patients attended during the study period, 100 were consecutively selected, of whom 93 were ultimately stratified. Men accounted for 77.41% of the cohort, with a mean age of 47.81 ± 12.53 years. The obtained stratification percentages were: Priority 1: 7.52%; Priority 2: 26.88%; Priority 3: 65.59%. Quantitative analysis of concordance between the models yielded a Cohen Kappa value of K=0.866.

Conclusions: There is a good concordance between the distribution percentages of the theoretical stratification and the actual one obtained in our study.

Introduction: The increased risk of tuberculosis (TB) reactivation in solid organ transplant recipients supports the recommendation of screening for latent tuberculosis infection (LTBI). Adherence to available screening tests has not been studied in the kidney transplant (KT) population. We aimed to assess screening compliance within the ATALANTA-DOS population study.

Methods: ATALANTA-DOS studied an intervention bundle aimed at preventing infection in KT recipients. We compared LTBI screening rates between the pre-intervention (February 2016 - September 2017) and intervention (February 2018 - September 2019) cohorts and evaluated adherence rates between the interferon-gamma release assay (IGRA) and the tuberculin skin test (TST).

Results: A total of 307 KT recipients were included (155 in the pre-intervention cohort; 148 in the intervention cohort). A systematic assessment of screening compliance by an infectious disease specialist on day +30 post-KT improved LTBI screening adherence (82.6% [114/138] vs 1.3% [2/155]; p-value <0.001). In the intervention cohort, compliance was higher with IGRA (83.3% [52/62]) than with TST (68.1% [49/72]). Two cases of LTBI were detected in the pre-intervention cohort and five in the intervention cohort (4.4% [5/114]). All patients completed LTBI treatment after ruling out active TB. No cases of active TB were identified during follow-up.

Conclusions: Systematic evaluation of LTBI screening compliance significantly increased screening completion rates among KT recipients. IGRA-based strategies increased screening compliance, supporting their implementation over TST for LTBI screening among KT recipients. Increased adherence would allow a more targeted and effective treatment of LTBI.

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.