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: Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is a human skin and mucosa colonizer being this colonization a risk factor for infections by this germ. It's unknown the role that domestic canines and felines (CF) play in human colonization. The objective of this study was to demonstrate the association between MRSA isolation in clinical samples from skin and soft tissue infections (SSTIs) in adults living with CF.

Material and methods: A retrospective model of cases (SSTIs with isolation of MRSA) and controls (SSTIs without isolation of MRSA) was used. We included 166 SSTI episodes treated in two hospitals, in Buenos Aires, Argentina, between October 2014 and January 2018. Samples were taken by puncture through healthy skin and the material obtained was sown in usual culture media. For bacterial identification, mass spectrometry and automated nephelometry were used. Methicillin-resistance was confirmed by disc-diffusion with cefoxitin discs. Data on living habits with CF and classic risk factors for SSTIs by MRSA were collected.

Results: Patients with SSTIs due to MRSA live more with CF (crude OR 1.9; [1.1-3.7] p<0.05) and tend to live more closely with them (crude OR 1.8; [0.99-3.43] p=0.08). In the multivariate analysis, those who live closely with CF have 1.3 times more chances of SSTIs due to MRSA (adjusted OR 2.32; [1.12-4.78] p<0.02).

Conclusions: We conclude that there is an association between human MRSA SSTIs and living with CF.

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: 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.

Material and 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: 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).