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

Introduction: Invasive pneumococcal disease is the most severe form of pneumococcal disease, with a high incidence rate that is associated with age and the existence of risk factors. The Residential Care Units (RCU) of the Community of Madrid have been designed with the primary objective of improving the quality and safety of care for institutionalised patients. The aim of the study was to describe pneumococcal vaccination coverage and administration periods in institutionalised patients, as well as to analyse the possible association of different variables with vaccination status.

Materials and methods: A retrospective observational study was conducted on institutionalised patients with an indicated vaccination who were in active status in their electronic health records as of May 2024. The study variables were age, sex, type of centre, Barthel Index, comorbidities, number of pneumococcal vaccine doses, and date of vaccination. A logistic regression model was used to assess the association of the variables age, sex, and Barthel Index with vaccination status.

Results: The total number of patients in the study population was 40,660. A total of 32,436 doses of pneumococcal vaccine were administered. Pneumococcal vaccination coverage was found to be 81.10% in centres for the elderly and 71.36% in centres for the disabled. Sex-adjusted variables associated with vaccination were age (OR:1.30; 95% CI: 1.12-1.50) in patients with older age and Barthel Index (OR: 1.87; 95% CI: 1.68-2.08) in patients with total dependency.

Conclusions: The establishment of the RCUs has improved vaccination coverage. Moreover, adequate vaccination is associated with older age and a higher level of dependency. Strategies must be implemented to increase vaccination rates among both institutionalised patients and adults in the general population.

Introduction: Advances in antiretroviral therapy (ARV) have improved the life expectancy of people living with HIV (PLWH), shifting the focus to quality of life (QoL). However, aging, polypharmacy, and comorbidities pose challenges. This study aimed to evaluate the evolution of QoL over five years and identify associated sociodemographic, clinical, and pharmacotherapeutic factors.

Methods: A single-center retrospective observational study was conducted in PLWH attending a tertiary hospital outpatient pharmacy. QoL was assessed using the EQ-5D-5L questionnaire. Sociodemographic, clinical, and pharmacotherapeutic variables-including age, polypharmacy, comorbidities, and Medication Regimen Complexity Index (MRCI)-were analyzed. Multivariate logistic regression identified predictors of good QoL, defined as a Visual Analogue Scale (VAS) score ≥76.

Results: A total of 437 PLWH were included with median age 52 years. The participants were majority male (82.8%). Throughout the study, mean VAS scores remained stable, with 63.7-73.4% of participants reporting good QoL each year. The most frequently reported issues were related to mobility (8.9%), pain/discomfort (5.1%), and anxiety/depression (3.0%). Multivariate analysis showed that advanced age (OR: 1.55, 95%CI: 1.14-2.11), polypharmacy (OR: 1.87, 95%CI: 1.35-2.59), comorbidities (OR: 2.13, 95%CI: 1.76-2.89), and socioeconomic problems (OR: 2.47, 95%CI: 1.44-4.21) were significantly associated with lower QoL.

Conclusion: Aging, polypharmacy, and socioeconomic disparities significantly impact QoL in PLWH. Integrating QoL assessments into routine care and addressing these factors through comprehensive management strategies could enhance long-term well-being.

Introduction: An observational study is presented on a community outbreak of parvovirus B19 (PVB19) infection that occurred between January and July 2024 in Mallorca.

Methods: PVB19 infection was diagnosed by serology (IgM) and specific PCR.

Results: A total of 151 patients were diagnosed. Of these, 63 (41.7%) were <15 years old. The age groups with the highest number of cases were 5-10 years (19.8%) and 30-45 years (33.7%). Overall, 33.1% were male and 66.9% female, with age-related differences; among adults, 81.9% were female. The most frequent pathologies in the child population were fever, rash and petechiae, while in adults, fever and arthralgia predominated. Among the women, 8 were pregnant (11.1%) and 4 had fetal involvement. In addition to serum, PVB19 was detected in 10 pharyngeal swabs, 6 skin swabs, 3 cerebrospinal fluid (CSF) samples, and 1 amniotic fluid sample. Specific IgM was detected in 98.4% of cases, along with cross-reactions with Epstein-Barr virus (69.5%) and mumps virus (42.8%), mainly in adults. In 6 cases, positive IgM was detected to PVB19, Epstein-Barr virus and mumps were simultaneously detected (4 adults and 2 children). PCR was positive in 95.4% of all samples and in 94.6% of serum samples.

Conclusions: The specific diagnosis of PVB19 infection should be based not only on clinical findings but also on serological detection (IgM) and genomic detection (PCR).

Objective: To evaluate the impact of a multifaceted antimicrobial stewardship intervention on potentially unnecessary antibiotic prescribing.

Material and methods: Before and after quality control study carried out in three different settingsgeneral practice, out-of-hours services, and nursing homesin Spain. Healthcare professionals (both doctors and nurses) self-registered common infections using a specific template for each setting before (2022) and after (2023) receiving a 5-hour intervention on prudent antibiotic use.

Results: Eighty-nine professionals participated in the first registration (48 in general practice, 23 in out-of-hours services, and 15 in nursing homes), with 71 (79.8%) completing the intervention and second registration. Potentially unnecessary antibiotic prescriptions were 68.5%, 41.7%, and 77.7% in the first registration, respectively, and 61.4%, 34.8%, and 86.8% after the intervention, showing reductions of 10.4% in general practice and 16.5% in out-of-hours services, and an 11.7% increase in nursing homes, albeit without statistically significant differences.

Conclusions: The study found that this intervention slightly improved antibiotic use, with minimal impact, but worsened in nursing homes.

Pneumonia is the leading cause of death from infection in the developed world. In recent years, researchers and healthcare professionals have worked extensively to reduce this burden. Prevention is better than cure, and significant advances have been made in areas such as vaccination and the prevention of nosocomial pneumonia in intensive care units. Comprehensive surveillance programmes and new diagnostic methods have been developed to assess trends in this disease and to identify the infectious agents involved. Clinical presentation can be challenging in elderly patients or those with certain comorbidities, prompting new studies in these populations to address these issues. Correct and early management of severe community-acquired pneumonia represents a major opportunity to reduce its associated mortality. Although fungal pathogens are an uncommon cause of lung infection, they are associated with high morbidity and mortality, highlighting the need for new approaches. Finally, new drugs are available for the treatment of pneumonia, and a thorough understanding of them is key to ensuring their correct use, particularly to combat multi-resistance. To provide an update on these points, a multidisciplinary team of Spanish experts convened at the Sixth Annual Meeting of Pneumonia Day, under the scientific sponsorship of GEIPC-SEIMC. This paper reflects the information shared at this meeting, offering the latest insights on these topics and supporting a holistic approach to pneumonia management.