1
|
Morata Ruiz L, Ruggieri A, Falcone M, Pasquau Liaño J, Gentile I, Salavert Lletí M, Moreno Núñez L, Cascio A, Tascini C, Loeches Yagüe M, De Rosa FG, Ori A, Comandini A, Cattaneo A, Grossi PA. Dalbavancin real-life utilization among diabetic patients suffering from infections in Italy and Spain: The DALBADIA retrospective cohort study. J Glob Antimicrob Resist 2024; 36:200-209. [PMID: 38211660 DOI: 10.1016/j.jgar.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/14/2023] [Accepted: 11/29/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES To retrospectively describe the patterns of use of dalbavancin for treating infections in diabetic patients in Italian and Spanish standard clinical practice. METHODS DALBADIA [NCT04959799] was a multicentre, observational, retrospective cohort study, conducted in Italy and Spain. The study enrolled 97 adults with type 1 or 2 diabetes mellitus, treated with dalbavancin as per standard clinical practice for a Gram-positive bacterial infection or the Gram-positive component of a mixed infection. RESULTS Dalbavancin was used to treat cellulitis (18/92 patients, 19.6%), followed by prosthetic joint infection (14 patients, 15.2%), endocarditis (13 patients, 14.1%), and primary bacteraemia (10 patients, 10.9%); 78/92 (84.8%) patients had Gram-positive infections only, and 14 (15.2%) had mixed infections. The most frequently isolated microorganisms were Staphylococcus aureus in 43 (55.8% of the patients with microbial isolation), 25.6% of which methicillin-resistant; Staphylococcus epidermidis in 13 (16.9%), 53.8% of which methicillin-resistant; Enterococcus faecalis in 11 (14.3%). The main reason for the dalbavancin choice was the intent to simplify the antibiotic regimen (81.5% of cases). A multidisciplinary team participated in the treatment choice process for 53 (57.6%) patients. Dalbavancin was given as first-line antibiotic in 34 (37.0%) patients and administered as one infusion in 32 (34.8%), and as two infusions in 39 (42.4%). In total, 57/62 (91.9%) eligible patients with available assessment were judged clinically cured or improved at the end of observation. CONCLUSION In clinical practice, dalbavancin was used in diabetic patients to treat ABSSSIs and other difficult-to-treat infections with a favourable safety profile and a high rate of positive clinical responses.
Collapse
Affiliation(s)
- Laura Morata Ruiz
- Hospital Clìnic, Department of Infectious Diseases, University of Barcelona, Barcelona, Spain
| | | | - Marco Falcone
- AOU Pisana PO Cisanello, UO Malattie Infettive, University of Pisa, Pisa, Italy
| | - Juan Pasquau Liaño
- Hospital Universitario Virgen de las Nieve, Unidad de Enfermedades Infecciosas, Granada, Spain
| | - Ivan Gentile
- AOU Federico II, Malattie Infettive, Patologia Clinica e Medicina Interna, Università di Napoli Federico II, Naples, Italy
| | - Miguel Salavert Lletí
- Hospital Universitario y Politécnico La Fe, Unidad de Enfermedades Infecciosas, Valencia, Spain
| | - Leonor Moreno Núñez
- Hospital Universitario Fundación Alcorcón, Enfermedades Infecciosas, Madrid, Spain
| | - Antonio Cascio
- AOU Policlinico Giaccone, UOC Malattie Infettive e Tropicali, Palermo, Italy
| | | | | | - Francesco Giuseppe De Rosa
- Ospedale Cardinal Massaia, SC Malattie Infettive, Asti, Italy, AOU Città della Salute e Scienza, Presidio Molinette, Turin, Italy
| | | | | | | | - Paolo Antonio Grossi
- ASST Sette Laghi, SC Malattie Infettive e Tropicali, University of Insubria, Varese, Italy
| |
Collapse
|
2
|
de la Calle-Prieto F, Estébanez Muñoz M, Ramírez G, Díaz-Menéndez M, Velasco M, Azkune Galparsoro H, Salavert Lletí M, Mata Forte T, Blanco JL, Mora-Rillo M, Arsuaga M, de Miguel Buckley R, Arribas JR, Membrillo FJ. Treatment and prevention of monkeypox. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:629-634. [PMID: 36624034 PMCID: PMC9823286 DOI: 10.1016/j.eimce.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 01/08/2023]
Abstract
Monkeypox is a zoonosis that is spread mainly through direct contact with fluids and skin lesions of infected people with vesicles still active. Although the virus was isolated for the first time in 1958 and the first human case was identified in a child in 1970, in the Democratic Republic of the Congo, the disease has progressively increased its incidence in Africa reaching in May 2022 sustained transmission outside this continent. As it is a newly introduced virus in our health system, it is necessary to learn the epidemiological pattern in a different environment from that of traditionally endemic areas and to know the available antiviral treatments, as well as the prophylactic measures that could be considered, knowing that as a virus emerging in our regions, scientific evidence is still limited. There are antivirals that have been shown, in animal models, to effectively combat the disease with very good clinical tolerance. This disease has also forced us to review the characteristics of smallpox vaccines, because they have shown a protective effect against monkeypox. For this reason, it is important to have a document that compiles all the scientific information published in this regard.
Collapse
Affiliation(s)
- Fernando de la Calle-Prieto
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco, IdiPAZ, CIBERINFEC, Madrid, Spain.
| | - Miriam Estébanez Muñoz
- Unidad NRBQ-Infecciosas, Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - Germán Ramírez
- Unidad NRBQ-Infecciosas, Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - Marta Díaz-Menéndez
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco, IdiPAZ, CIBERINFEC, Madrid, Spain
| | - María Velasco
- Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| | - Harkaitz Azkune Galparsoro
- Servicio de Enfermedades Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Universitario Donostia, Biodonostia, Universidad del Pais Vasco, Gipuzkoa, Spain
| | - Miguel Salavert Lletí
- Unidad de Enfermedades Infecciosas, Área Clínica Médica, Unidad de Aislamiento de Alto Nivel La Fe, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, Spain
| | - Tatiana Mata Forte
- Unidad NRBQ-Infecciosas, Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - José Luis Blanco
- Departamento de Enfermedades Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Clínic-IDIBAPS, Universidad de Barcelona, CIBERINFEC, Barcelona, Spain
| | - Marta Mora-Rillo
- Unidad de Enfermedades Infecciosas y Microbiología Clínica, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco, IdiPAZ, CIBERINFEC, Madrid, Spain
| | - Marta Arsuaga
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco, IdiPAZ, CIBERINFEC, Madrid, Spain
| | - Rosa de Miguel Buckley
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco, IdiPAZ, CIBERINFEC, Madrid, Spain
| | - Jose Ramón Arribas
- Unidad de Enfermedades Infecciosas, Departamento de Medicina Interna, Hospital Universitario La Paz-Carlos III-Cantoblanco, Escuela de Medicina, Universidad Autónoma de Madrid, IdiPAZ, CIBERINFEC, Madrid, Spain
| | - Francisco Javier Membrillo
- Unidad NRBQ-Infecciosas, Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| |
Collapse
|
3
|
de la Calle-Prieto F, Estébanez Muñoz M, Ramírez G, Díaz-Menéndez M, Velasco M, Azkune Galparsoro H, Salavert Lletí M, Mata Forte T, Blanco JL, Mora-Rillo M, Arsuaga M, de Miguel Buckley R, Arribas JR, Membrillo FJ. [Treatment and prevention of monkeypox]. Enferm Infecc Microbiol Clin 2022; 41:S0213-005X(22)00167-7. [PMID: 36249471 PMCID: PMC9534155 DOI: 10.1016/j.eimc.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022]
Abstract
Monkeypox is a zoonosis that is spread mainly through direct contact with fluids and skin lesions of infected people with vesicles still active. Although the virus was isolated for the first time in 1958 and the first human case was identified in a child in 1970, in the Democratic Republic of the Congo, the disease has progressively increased its incidence in Africa reaching in May 2022 sustained transmission outside this continent. As it is a newly introduced virus in our health system, it is necessary to learn the epidemiological pattern in a different environment from that of traditionally endemic areas and to know the available antiviral treatments, as well as the prophylactic measures that could be considered, knowing that as a virus emerging in our regions, scientific evidence is still limited. There are antivirals that have been shown, in animal models, to effectively combat the disease with very good clinical tolerance. This disease has also forced us to review the characteristics of smallpox vaccines, because they have shown a protective effect against monkeypox. For this reason, it is important to have a document that compiles all the scientific information published in this regard.
Collapse
Affiliation(s)
- Fernando de la Calle-Prieto
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco. IdiPAZ. CIBERINFEC. Madrid, España
| | - Miriam Estébanez Muñoz
- Unidad NRBQ-Infecciosas. Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, España
| | - Germán Ramírez
- Unidad NRBQ-Infecciosas. Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, España
| | - Marta Díaz-Menéndez
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco. IdiPAZ. CIBERINFEC. Madrid, España
| | - María Velasco
- Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, España
| | - Harkaitz Azkune Galparsoro
- Servicio de Enfermedades Infecciosas. Unidad de Aislamiento de Alto Nivel, Hospital Universitario Donostia, Biodonostia. Universidad del Pais Vasco, Gipuzkoa, España
| | - Miguel Salavert Lletí
- Unidad de Enfermedades Infecciosas, Área Clínica Médica. Unidad de Aislamiento de Alto Nivel La Fe, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, España
| | - Tatiana Mata Forte
- Unidad NRBQ-Infecciosas. Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, España
| | - José Luis Blanco
- Departamento de Enfermedades Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Clinic-IDIBAPS, Universidad de Barcelona. CIBERINFEC, Barcelona, España
| | - Marta Mora-Rillo
- Unidad de Enfermedades Infecciosas y Microbiología Clínica. Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco, IdiPAZ. CIBERINFEC, Madrid, España
| | - Marta Arsuaga
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco. IdiPAZ. CIBERINFEC. Madrid, España
| | - Rosa de Miguel Buckley
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco. IdiPAZ. CIBERINFEC. Madrid, España
| | - Jose Ramón Arribas
- Unidad de Enfermedades Infecciosas. Departamento de Medicina Interna, Hospital Universitario La Paz-Carlos III-Cantoblanco, Escuela de Medicina, Universidad Autónoma de Madrid. IdiPAZ. CIBERINFEC, Madrid, España
| | - Francisco Javier Membrillo
- Unidad NRBQ-Infecciosas. Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, España
| |
Collapse
|
4
|
Ruiz-Algueró M, Alejos B, García Yubero C, Riera Jaume M, Antonio Iribarren J, Asensi V, Pasquau F, Galera CE, Pascual-Carrasco M, Muñoz A, Jarrín I, Suárez-García I, Moreno S, Jarrín I, Dalmau D, Navarro ML, González MI, Blanco JL, Garcia F, Rubio R, Iribarren JA, Gutiérrez F, Vidal F, Berenguer J, González J, Alejos B, Hernando V, Moreno C, Iniesta C, Garcia Sousa LM, Perez NS, Muñoz-Fernández MÁ, García-Merino IM, Fernández IC, Rico CG, de la Fuente JG, Concejo PP, Portilla J, Merino E, Reus S, Boix V, Giner L, Gadea C, Portilla I, Pampliega M, Díez M, Rodríguez JC, Sánchez-Payá J, Gómez JL, Hernández J, Alemán MR, del Mar Alonso M, Inmaculada Hernández M, Díaz-Flores F, García D, Pelazas R, Lirola AL, Moreno JS, Caso AA, Hernández Gutiérrez C, Novella Mena M, Rubio R, Pulido F, Bisbal O, Hernando A, Domínguez L, Crestelo DR, Bermejo L, Santacreu M, Antonio Iribarren J, Arrizabalaga J, Aramburu MJ, Camino X, Rodríguez-Arrondo F, von Wichmann MÁ, Tomé LP, Goenaga MÁ, Bustinduy MJ, Azkune H, Ibarguren M, Lizardi A, Kortajarena X, Gutiérrez F, Masiá M, Padilla S, Navarro A, Montolio F, Robledano C, Gregori Colomé J, Adsuar A, Pascual R, Fernández M, García E, García JA, Barber X, Muga R, Sanvisens A, Fuster D, Berenguer J, de Quirós JCLB, Gutiérrez I, Ramírez M, Padilla B, Gijón P, Aldamiz-Echevarría T, Tejerina F, José Parras F, Balsalobre P, Diez C, Latorre LP, Vidal F, Peraire J, Viladés C, Veloso S, Vargas M, López-Dupla M, Olona M, Rull A, Rodríguez-Gallego E, Alba V, Montero Alonso M, López Aldeguer J, Blanes Juliá M, Tasias Pitarch M, Hernández IC, Calabuig Muñoz E, Cuéllar Tovar S, Salavert Lletí M, Navarro JF, González-Garcia J, Arnalich F, Arribas JR, de la Serna JIB, Castro JM, Escosa L, Herranz P, Hontañón V, García-Bujalance S, López-Hortelano MG, González-Baeza A, Martín-Carbonero ML, Mayoral M, Mellado MJ, Micán RE, Montejano R, Luisa Montes M, Moreno V, Pérez-Valero I, Rodés B, Sainz T, Sendagorta E, Stella Alcáriz N, Valencia E, Ramón Blanco J, Antonio Oteo J, Ibarra V, Metola L, Sanz M, Pérez-Martínez L, Arazo P, Sampériz G, Dalmau D, Jaén A, Sanmartí M, Cairó M, Martinez-Lacasa J, Velli P, Font R, Xercavins M, Alonso N, Repáraz J, de Alda MGR, de León Cano MT, de Galarreta BPR, Segura F, José Amengual M, Navarro G, Sala M, Cervantes M, Pineda V, Calzado S, Navarro M, de los Santos I, Sanz Sanz J, Aparicio AS, Sarriá Cepeda C, Garcia-Fraile Fraile L, Martín Gayo E, Moreno S, Luis Casado J, Dronda F, Moreno A, Jesús Pérez Elías M, Gómez Ayerbe C, Gutiérrez C, Madrid N, del Campo Terrón S, Martí P, Ansa U, Serrano S, Jesús Vivancos M, Cano A, García AA, Bravo Urbieta J, Muñoz Á, Jose Alcaraz M, Villalba MDC, García F, Hernández J, Peña A, Muñoz L, Casas P, Alvarez M, Chueca N, Vinuesa D, Martinez-Montes C, Romero JD, Rodríguez C, Puerta T, Carlos Carrió J, Vera M, Ballesteros J, Ayerdi O, Antela A, Losada E, Riera M, Peñaranda M, Leyes M, Ribas MA, Campins AA, Vidal C, Fanjul F, Murillas J, Homar F, Santos J, Ayerbe CG, Viciana I, Palacios R, González CM, Viciana P, Espinosa N, López-Cortés LF, Podzamczer D, Ferrer E, Imaz A, Tiraboschi J, Silva A, Saumoy M, Ribera E, Curran A, Olalla J, del Arco A, de la torre J, Prada JL, de Lomas Guerrero JMG, Stachowski JP, Martínez OJ, Vera FJ, Martínez L, García J, Alcaraz B, Jimeno A, Iglesias AC, Souto BP, de Cea AM, Muñoz J, Zubero MZ, Baraia-Etxaburu JM, Ugarte SI, Beneitez OLF, de Munain JL, López MMC, de la Peña M, Lopez M, Galera C, Albendin H, Pérez A, Iborra A, Moreno A, Merlos MA, Vidal A, Amador C, Pasquau F, Ena J, Benito C, Fenoll V, Anguita CG, Rabasa JTA, Suárez-García I, Malmierca E, González-Ruano P, Rodrigo DM, Seco MPR, Vidal MAG, de Zarraga MA, Pérez VE, Molina MJT, García JV, Moreno JPS, Górgolas M, Cabello A, Álvarez B, Prieto L, Sanz Moreno J, Arranz Caso A, Gutiérrez CH, Novella Mena M, Galindo Puerto MJ, Fernando Vilalta R, Ferrer Ribera A, Román AR, Brieva Herrero MT, Juárez AR, López PL, Sánchez IM, Martínez JP, Jiménez MC, Perea RT, Ruiz-Capillas JJJ, Pineda JA. Use of Generic Antiretroviral Drugs and Single-Tablet Regimen De-Simplification for the Treatment of HIV Infection in Spain. AIDS Res Hum Retroviruses 2022; 38:433-440. [PMID: 35357907 DOI: 10.1089/aid.2021.0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The present study sought to describe the use of generic drugs and single-tablet regimen (STR) de-simplification for the treatment of human immunodeficiency virus (HIV) infection among 41 hospitals from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). In June 2018, we collected information on when generic antiretroviral drugs (ARVs) were introduced in the different hospitals, how the decisions to use them were made, and how the information was provided to the patients. Most of the nine available generic ARVs in Spain by June 2018 had been introduced in at least 85% of the participating hospitals, except for zidovudine (AZT)/lamivudine (3TC) and AZT. The time difference between the effective marketing date of each generic ARV and its first dispensing date in the hospitals was much shorter for the more recently approved generic ARV since the year 2017. However, only up to 20% of the hospitals de-simplified efavirenz (EFV)/tenofovir disoproxil (TDF)/emtricitabine (FTC), dolutegravir (DTG)/abacavir (ABC)/3TC, and rilpivirine (RPV)/TDF/FTC (to generic EFV+TDF/FTC, DTG+generic ABC/3TC, and RPV+generic TDF/FTC, respectively), whereas the generic STR EFV/TDF/FTC was introduced in 87.8% of the centers. The median times between the date of effective marketing of generic TDF/FTC and the date of de-simplification of EFV/TDF/FTC and RPV/TDF/FTC were 723 [interquartile range (IQR): 369-1,119] and 234 (IQR: 142-264) days, respectively; this time was 155 (IQR: 28-287) days for de-simplification of DTG/ABC/3TC. In conclusion, despite the widespread use of generic ARVs, STRs de-simplification was only undertaken in <20% of the hospitals. There was wide variability in the timing of the introduction of each generic ARV after they were available in the market.
Collapse
Affiliation(s)
- Marta Ruiz-Algueró
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
| | - Belén Alejos
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
| | | | | | - José Antonio Iribarren
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, Instituto de Investigación BioDonostia, San Sebastián, Spain
| | - Víctor Asensi
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Mario Pascual-Carrasco
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Unidad de Investigación en Telemedicina y Salud Digital (UITes), Instituto de Salud Carlos III, Madrid, Spain
| | - Adolfo Muñoz
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Unidad de Investigación en Telemedicina y Salud Digital (UITes), Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Jarrín
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
| | - Inés Suárez-García
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain
- Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Moral PM, Cabañero-Navalon D, Garcia-Bustos V, Beltrán MN, Lletí MS. Norovirus infection as a model of chronic or recurrent infection in common variable immunodeficiency. Rev Esp Quimioter 2022; 35 Suppl 3:63-66. [PMID: 36285861 PMCID: PMC9717449 DOI: 10.37201/req/s03.14.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Common variable immunodeficiency (CVID) is the most frequent symptomatic primary immunodeficiency (PID) in general population. PID are genetic diseases that share a dysfunction in the immune system entailing a greater risk of both chronic and recurrent infections. These patients can also develop chronic gastrointestinal infections caused by norovirus with persistent viral dissemination, which can be detected months after primoinfection. Additionally, a proportion of CVID patients show a typical severe enteropathy presenting with recurrent diarrhoea, intestinal malabsorption, inflammatory lesions, and villous atrophy. Some studies have related this enteropathy with chronic intestinal infection caused by norovirus.
Collapse
Affiliation(s)
- Pedro Moral Moral
- Primary Immunodeficiencies Unit. Internal Medicine Section. University and Polytechnic Hospital La Fe. Valencia, Spain,Correspondence: Pedro Moral Moral Primary Immunodeficiencies Unit. Internal Medicine Section. University and Polytechnic Hospital La Fe. Valencia, Spain E-mail:
| | - Dafne Cabañero-Navalon
- Primary Immunodeficiencies Unit. Internal Medicine Section. University and Polytechnic Hospital La Fe. Valencia, Spain
| | - Victor Garcia-Bustos
- Primary Immunodeficiencies Unit. Internal Medicine Section. University and Polytechnic Hospital La Fe. Valencia, Spain
| | - María Núñez Beltrán
- Primary Immunodeficiencies Unit. Internal Medicine Section. University and Polytechnic Hospital La Fe. Valencia, Spain
| | - Miguel Salavert Lletí
- Infectious Diseases Unit. University and Polytechnic Hospital La Fe. Valencia, Spain
| |
Collapse
|
6
|
Garcia-Bustos V, Moral Moral P, Cabañero-Navalon MD, Salavert Lletí M, Calabuig Muñoz E. Does Autoimmunity Play a Role in the Immunopathogenesis of Vasculitis Associated With Chronic Chagas Disease? Front Cell Infect Microbiol 2021; 11:671962. [PMID: 34295833 PMCID: PMC8290184 DOI: 10.3389/fcimb.2021.671962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/18/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Victor Garcia-Bustos
- Department of Internal Medicine and Infectious Diseases, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Pedro Moral Moral
- Department of Internal Medicine and Infectious Diseases, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Marta Dafne Cabañero-Navalon
- Department of Internal Medicine and Infectious Diseases, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Miguel Salavert Lletí
- Department of Internal Medicine and Infectious Diseases, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Eva Calabuig Muñoz
- Department of Internal Medicine and Infectious Diseases, University and Polytechnic La Fe Hospital, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| |
Collapse
|
7
|
Gómez-López A, Martín-Gómez MT, Salavert Lletí M. A survey to describe common practices on antifungal monitoring among Spanish clinicians. Enferm Infecc Microbiol Clin 2021; 41:S0213-005X(21)00193-2. [PMID: 34238595 DOI: 10.1016/j.eimc.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/16/2021] [Accepted: 05/22/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION We developed a survey to obtain information on the monitoring practices of major systemic antifungals for treatment and prevention of serious fungal infection. METHODS The survey included questions relating to methodology and practice and was distributed among 137 colleagues of the Study Group of Medical Mycology (GEMICOMED) from July to December 2019. RESULTS Monitoring was routinely carried out by most respondents, mainly for voriconazole, and was more likely used to determine the efficacy of the dose administered and less for minimizing drug toxicity. Most responders did not follow the strategies of voriconazole dosage based on CYP2C19 genotyping. Monitoring of posaconazole, itraconazole, or other azole metabolites was not carried out or scarcely demanded. Most responders rarely used flucytosine in their clinical practice nor did they monitor it. According to the answers given by some responders, monitoring isavuconazole, amphotericin B, caspofungin and fluconazole exposure would be also interesting in daily clinical practice in selected patient populations. CONCLUSIONS The survey reveals common practices and attitudes towards antifungal monitoring, sometimes not performed as per best recommendations, offering an opportunity for education and research. Appropriate use of therapeutic drug monitoring may be an objective of antifungal stewardship programmes.
Collapse
Affiliation(s)
- Alicia Gómez-López
- Laboratorio de Referencia e Investigación en Micología, CNM, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
| | | | - Miguel Salavert Lletí
- Unidad de Enfermedades Infecciosas, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| |
Collapse
|
8
|
Martín Gómez MT, Salavert Lletí M. [Mucormycosis: Current and future management perspective]. Rev Iberoam Micol 2021; 38:91-100. [PMID: 34144835 DOI: 10.1016/j.riam.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/20/2021] [Accepted: 04/08/2021] [Indexed: 02/06/2023] Open
Abstract
Infections caused by mucorales, with an increasing incidence after candidiasis and aspergillosis, are characterized by the fast angioinvasion of blood vessels and invasion of neighboring organs or structures. Mucorales most commonly cause rhinocerebral, pulmonary, cutaneous, digestive or disseminated infections, and their spread is favored by certain underlying diseases (diabetes, kidney failure) and risk factors (neutropenia, immunosuppression, iron overload). These infections have a high mortality rate, over 40% in many series, and the key to their cure depends on both an early diagnosis and an antifungal treatment, associated in most cases with extensive surgical debridement and other adjunctive therapies. Currently, there are international guidelines, not only local ones, for the management of mucormycosis, in which it is considered by consensus and with a strong recommendation that first-line treatment with high-dose liposomal amphotericin B is the best choice. The combined antifungal treatment of polyene agents with triazoles or candins remains in open debate.
Collapse
Affiliation(s)
- María Teresa Martín Gómez
- Sección de Micología, Servicio de Microbiología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - Miguel Salavert Lletí
- Unidad de Enfermedades Infecciosas (Área Clínica Médica), Hospital Universitario y Politécnico La Fe, Valencia, España.
| |
Collapse
|
9
|
Escudero-Sánchez R, Valencia-Alijo A, Cuéllar Tovar S, Merino-de Lucas E, García Fernández S, Gutiérrez-Rojas Á, Ramos-Martínez A, Salavert Lletí M, Castro Hernández I, Giner L, Cobo J. Real-life experience with fidaxomicin in Clostridioides difficile infection: a multicentre cohort study on 244 episodes. Infection 2021; 49:475-482. [PMID: 33417171 DOI: 10.1007/s15010-020-01567-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/14/2020] [Indexed: 02/08/2023]
Abstract
The high cost of fidaxomicin has restricted its use despite the benefit of a lower Clostridioides difficile infection (CDI) recurrence rate at 4 weeks of follow-up. This short follow-up represents the main limitation of pivotal clinical trials of fidaxomicin, and some recent studies question its benefits over vancomycin. Moreover, the main risk factors of recurrence after treatment with fidaxomicin remain unknown. We designed a multicentre retrospective cohort study among four Spanish hospitals to assess the efficacy of fidaxomicin in real life and to investigate risk factors of fidaxomicin failure at weeks 8 and 12. Two-hundred forty-four patients were included. Fidaxomicin was used in 96 patients (39.3%) for a first episode of CDI, in 95 patients (38.9%) for a second episode, and in 53 patients (21.7%) for a third or subsequent episode. Patients treated with fidaxomicin in a first episode were younger (59.9 years vs 73.5 years), but they had more severe episodes (52.1% vs. 32.4%). The recurrence rates for patients treated in the first episode were 6.5% and 9.7% at weeks 8 and 12, respectively. Recurrence rates increased for patients treated at second or ulterior episodes (16.3% and 26.4% at week 8, respectively). Age greater than or equal to 85 years and having had a previous episode of CDI were identified as recurrence risk factors at weeks 8 and 12. We conclude that the outcomes with fidaxomicin in real life are at least as good as those observed in clinical trials despite a more demanding evaluation. Be it 85 years of age or older, and the use after a first episode appears to be independent factors of CDI recurrence after treatment with fidaxomicin.
Collapse
Affiliation(s)
- Rosa Escudero-Sánchez
- Infectious Disease Department, University Hospital Ramon Y Cajal, Ctra. Colmenar Viejo, Km 9,1. Zip code 28034, Madrid, Spain. .,Spanish Network for Research in Infectious Disease (REIPI), Madrid, Spain.
| | - Angela Valencia-Alijo
- Internal Medicine Department, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | | | - Sergio García Fernández
- Spanish Network for Research in Infectious Disease (REIPI), Madrid, Spain.,Microbiology Department, University Hospital Ramón Y Cajal, Madrid, Spain
| | - Ángela Gutiérrez-Rojas
- Internal Medicine Department, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Antonio Ramos-Martínez
- Internal Medicine Department, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | | | - Livia Giner
- Internal Medicine Department, University Hospital General de Alicante, Alicante, Spain
| | - Javier Cobo
- Infectious Disease Department, University Hospital Ramon Y Cajal, Ctra. Colmenar Viejo, Km 9,1. Zip code 28034, Madrid, Spain.,Spanish Network for Research in Infectious Disease (REIPI), Madrid, Spain
| |
Collapse
|
10
|
Pérez-Nadales E, Alastruey-Izquierdo A, Linares-Sicilia MJ, Soto-Debrán JC, Abdala E, García-Rodríguez J, Montejo M, Muñoz P, Lletí MS, Rezusta A, de Pipaón MRP, Yáñez L, Merino E, Campos-Herrero MI, Costa-Mateo JM, Fortún J, García-Lozano T, Garcia-Vidal C, Fernández-Ruiz M, Sánchez-Reus F, Castro-Méndez C, Guerrero-Lozano I, Soler-Palacín P, Aguado JM, Martínez-Martínez L, Torre-Cisneros J, Nucci M. Invasive Fusariosis in Nonneutropenic Patients, Spain, 2000-2015. Emerg Infect Dis 2021; 27:24-36. [PMID: 33352085 PMCID: PMC7774531 DOI: 10.3201/eid2701.190782] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Invasive fusariosis (IF) is associated with severe neutropenia in patients with concurrent hematologic conditions. We conducted a retrospective observational study to characterize the epidemiology of IF in 18 Spanish hospitals during 2000-2015. In that time, the frequency of IF in nonneutropenic patients increased from 0.08 cases per 100,000 admissions in 2000-2009 to 0.22 cases per 100,000 admissions in 2010-2015. Nonneutropenic IF patients often had nonhematologic conditions, such as chronic cardiac or lung disease, rheumatoid arthritis, history of solid organ transplantation, or localized fusariosis. The 90-day death rate among nonneutropenic patients (28.6%) and patients with resolved neutropenia (38.1%) was similar. However, the death rate among patients with persistent neutropenia (91.3%) was significantly higher. We used a multivariate Cox regression analysis to characterize risk factors for death: persistent neutropenia was the only risk factor for death, regardless of antifungal therapy.
Collapse
|
11
|
Suárez-García I, Moreno C, Ruiz-Algueró M, Pérez-Elías MJ, Navarro M, Díez Martínez M, Viciana P, Pérez-Martínez L, Górgolas M, Amador C, de Zárraga MA, Jarrín I, Moreno S, Jarrín I, Dalmau D, Navarro ML, González MI, Garcia F, Poveda E, Iribarren JA, Gutiérrez F, Rubio R, Vidal F, Berenguer J, González J, Muñoz-Fernández MÁ, Jarrin I, Alejos B, Moreno C, Iniesta C, Sousa LMG, Perez NS, Rava M, Muñoz-Fernández MÁ, Fernández IC, Merino E, García G, Portilla I, Agea I, Portilla J, Sánchez-Payá J, Rodríguez JC, Gimeno L, Giner L, Díez M, Carreres M, Reus S, Boix V, Torrús D, Lirola AL, García D, Díaz-Flores F, Gómez JL, del Mar Alonso M, Pelazas R, Hernández J, Alemán MR, Hernández MI, Asensi V, Valle E, Carmenado MER, Secades TSZ, Is LP, Rubio R, Pulido F, Bisbal O, Hernando A, Domínguez L, Crestelo DR, Bermejo L, Santacreu M, Iribarren JA, Arrizabalaga J, Aramburu MJ, Camino X, Rodríguez-Arrondo F, von Wichmann MÁ, Tomé LP, Goenaga MÁ, Bustinduy MJ, Azkune H, Ibarguren M, Lizardi A, Kortajarena X, Oyaga MPC, Igartua MU, Gutiérrez F, Masiá M, Padilla S, Navarro A, Montolio F, Robledano C, Colomé JG, Adsuar A, Pascual R, Fernández M, García E, García JA, Barber X, Muga R, Sanvisens A, Fuster D, Berenguer J, de Quirós JCLB, Gutiérrez I, Ramírez M, Padilla B, Gijón P, Aldamiz-Echevarría T, Tejerina F, Parras FJ, Balsalobre P, Diez C, Latorre LP, Fanciulli C, Vidal F, Peraire J, Viladés C, Veloso S, Vargas M, Olona M, Rull A, Rodríguez-Gallego E, Alba V, Castellanos AJ, López-Dupla M, Alonso MM, Aldeguer JL, Juliá MB, Pitarch MT, Hernández IC, Muñoz EC, Tovar SC, Lletí MS, Navarro JF, González-Garcia J, Arnalich F, Arribas JR, de la Serna JIB, Castro JM, Escosa L, Herranz P, Hontañón V, García-Bujalance S, López-Hortelano MG, González-Baeza A, Martín-Carbonero ML, Mayoral M, Mellado MJ, Micán RE, Montejano R, Montes ML, Moreno V, Pérez-Valero I, Rodés B, Sainz T, Sendagorta E, Alcáriz NS, Valencia E, Blanco JR, Oteo JA, Ibarra V, Metola L, Sanz M, Pérez-Martínez L, Arazo P, Sampériz G, Dalmau D, Jaén A, Sanmartí M, Cairó M, Martinez-Lacasa J, Velli P, Font R, Xercavins M, Alonso N, Marcotegui MR, Repáraz J, de Alda MGR, de León Cano MT, de Galarreta BPR, Amengual MJ, Navarro G, Garcia MC, Isbert SC, Vilasaro MN, de los Santos I, Sanz JS, Aparicio AS, Cepeda CS, Fraile LGF, Gayo EM, Moreno S, Osorio JLC, Nuñez FD, Zamora AM, Elías MJP, Gutiérrez C, Madrid N, del Campo Terrón S, Villar SS, Gallego MJV, Sanz JM, Urroz UA, Velasco T, Bernal E, Sanchez AC, García AA, Urbieta JB, Perez AM, Alcaraz MJ, del Carmen Villalba M, García F, Quero JH, Medina LM, Alvarez M, Chueca N, García DV, Martinez-Montes C, Beltran CG, de Salazar Gonzalerz A, Lopez AF, Utrilla MR, Del Romero J, Rodríguez C, Puerta T, Carrió JC, Vera M, Ballesteros J, Ayerdi O, Antela A, Losada E, Riera M, Peñaranda M, Leyes M, Ribas MA, Campins AA, Vidal C, Fanjul F, Murillas J, Homar F, Santos J, Ayerbe CG, Viciana I, Palacios R, López CP, Gonzalez-Domenec CM, Viciana P, Espinosa N, López-Cortés LF, Podzamczer D, Imaz A, Tiraboschi J, Silva A, Saumoy M, Prieto P, Ribera E, Curran A, Sierra JO, Stachowski JP, del Arco A, de la torre J, Prada JL, de Lomas Guerrero JMG, Martínez OJ, Vera FJ, Martínez L, García J, Alcaraz B, Jimeno A, Iglesias AC, Souto BP, de Cea AM, Muñoz J, Zubero MZ, Baraia-Etxaburu JM, Ugarte SI, Beneitez OLF, de Munain JL, López MMC, de la Peña M, Lopez M, Azkarreta IL, Galera C, Albendin H, Pérez A, Iborra A, Moreno A, Merlos MA, Vidal A, Meca M, Amador C, Pasquau F, Ena J, Benito C, Fenoll V, Anguita CG, Rabasa JTA, Suárez-García I, Malmierca E, González-Ruano P, Rodrigo DM, Seco MPR, Mohamed-Balghata MO, Vidal MAG, de Zarraga MA, Pérez VE, Molina MJT, García JV, Moreno JPS, Górgolas M, Cabello A, Álvarez B, Prieto L, Moreno JS, Caso AA, Gutiérrez CH, Mena MN, Puerto MJG, Vilalta RF, Ribera AF, Román AR, Juárez AR, López PL, Sánchez IM, Casas MF, Espejo AC, Jiménez MC, Perea RT, Pineda JA, Mayo PR, Sanchez JM, Gutierrez NM, Real LM, Gomez AC, Fuertes MF, Gonzalez-Serna A, Poveda E, Pérez A, Crespo M, Morano L, Miralles C, Ocampo A, Pousada G. Effectiveness of the combination elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COB/TFV/FTC) plus darunavir among treatment-experienced patients in clinical practice: a multicentre cohort study. AIDS Res Ther 2020; 17:45. [PMID: 32690099 PMCID: PMC7372769 DOI: 10.1186/s12981-020-00302-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 07/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the effectiveness and tolerability of the combination elvitegravir/cobicistat/tenofovir/emtricitabine plus darunavir (EVG/COB/TFV/FTC + DRV) in treatment-experienced patients from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). METHODS Treatment-experienced patients starting treatment with EVG/COB/TFV/FTC + DRV during the years 2014-2018 and with more than 24 weeks of follow-up were included. TFV could be administered either as tenofovir disoproxil fumarate or tenofovir alafenamide. We evaluated virological response, defined as viral load (VL) < 50 copies/ml and < 200 copies/ml at 24 and 48 weeks after starting this regimen, stratified by baseline VL (< 50 or ≥ 50 copies/ml at the start of the regimen). RESULTS We included 39 patients (12.8% women). At baseline, 10 (25.6%) patients had VL < 50 copies/ml and 29 (74.4%) had ≥ 50 copies/ml. Among patients with baseline VL < 50 copies/ml, 85.7% and 80.0% had VL < 50 copies/ml at 24 and 48 weeks, respectively, and 100% had VL < 200 copies/ml at 24 and 48 weeks. Among patients with baseline VL ≥ 50 copies/ml, 42.3% and 40.9% had VL < 50 copies/ml and 69.2% and 68.2% had VL < 200 copies/ml at 24 and 48 weeks. During the first 48 weeks, no patients changed their treatment due to toxicity, and 4 patients (all with baseline VL ≥ 50 copies/ml) changed due to virological failure. CONCLUSIONS EVG/COB/TFV/FTC + DRV was well tolerated and effective in treatment-experienced patients with undetectable viral load as a simplification strategy, allowing once-daily, two-pill regimen with three antiretroviral drug classes. Effectiveness was low in patients with detectable viral loads.
Collapse
|
12
|
Jerusalem K, Salavert Lletí M. Probable cutaneous loxoscelism with mild systemic symptoms: A case report from Spain. Toxicon 2018; 156:7-12. [PMID: 30391580 DOI: 10.1016/j.toxicon.2018.10.304] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/26/2018] [Accepted: 10/24/2018] [Indexed: 11/19/2022]
Abstract
We present a case from Valencia, Spain, of a 25-year-old woman who presented with a painful erythematous skin lesion, initially diagnosed as cellulitis. The lesion was unresponsive to antibiotic treatments and progressed into a hemorrhagic blister with necrotic ulcer formation. Posterior collection of a spider from the patient's home and expert identification of the spider as Loxosceles rufescens was achieved, establishing the diagnosis of probable cutaneous loxoscelism. Symptomatic treatment, general wound care and ultimately surgery, resulted in complete recovery with minor residual scarring. This case illustrates some of the difficulties encountered in the diagnosis and treatment of loxoscelism and adds to the increasing reports of loxoscelism in the Mediterranean Basin.
Collapse
Affiliation(s)
- Koen Jerusalem
- Department of Internal Medicine and Infectious Diseases, Manises Hospital, Av. Generalitat Valenciana 50, 46940, Manises, Spain.
| | - Miguel Salavert Lletí
- Head of the Unit of Infectious Diseases, University and Polytechnic Hospital La Fe, Avinguda de Fernando Abril Martorell 106, 46026, Valencia, Spain
| |
Collapse
|
13
|
González-Mazarío R, Suárez Álvarez L, Micó L, Moret Tatay I, Salavert Lletí M. Immunologic Storm Simulating Systemic Lupus Erythematosus Following Parvovirus B19 Infection. Eur J Case Rep Intern Med 2015. [DOI: 10.12890/2015_000154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
| | | | - Luisa Micó
- Department of Internal Medicine, Hospital Universitari i Politècnic La Fe, Valencia
| | - Inés Moret Tatay
- Instituto de Investigación Sanitaria, Hospital La Fe, Valencia CIBERehd, Barcelona
| | | |
Collapse
|
14
|
García-Vidal C, Salavert Lletí M. [Immunopathogenesis of invasive mould infections]. Rev Iberoam Micol 2014; 31:219-28. [PMID: 25442381 DOI: 10.1016/j.riam.2014.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 07/28/2014] [Accepted: 09/01/2014] [Indexed: 10/24/2022] Open
Abstract
Invasive fungal infections caused by filamentous fungi are devastating diseases that occur in patients with a variety of immunosuppressive conditions. This review focuses on the pathogenesis of the most important invasive mycosis in the human being caused by the filamentous fungi Aspergillus, Fusarium, Scedosporium and mucorales. The first contact between the mould and the patient, the host defense to different fungi, including the role of mucosa in the innate immune system, the whole innate immune recognition receptors, and the pathways connecting innate and adaptive immunity, as well as the virulence factors of fungi, are discussed in this paper.
Collapse
Affiliation(s)
- Carolina García-Vidal
- Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
| | | |
Collapse
|
15
|
Pinazo MJ, Miranda B, Rodríguez-Villar C, Altclas J, Serra MB, García-Otero EC, de Almeida EA, de la Mata García M, Gascon J, Rodríguez MG, Manito N, Camacho AM, Oppenheimer F, Puente SP, Riarte A, Coronas JS, Lletí MS, Sanz GF, Torrico F, Tendero DT, Ussetti P, Shikanai-Yasuda MA. Recommendations for management of Chagas disease in organ and hematopoietic tissue transplantation programs in nonendemic areas. Transplant Rev (Orlando) 2011; 25:91-101. [DOI: 10.1016/j.trre.2010.12.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 12/15/2010] [Indexed: 12/22/2022]
|
16
|
|
17
|
Salavert Lletí M, Jarque Ramos I, Pemán García J. Los aspectos epidemiológicos cambiantes de la candidemia y sus implicaciones clinicoterapéuticas. Enferm Infecc Microbiol Clin 2006; 24 Suppl 1:36-45. [PMID: 17125667 DOI: 10.1157/13094277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Candida species are a major cause of healthcare-related bloodstream and invasive infections. Studies assessing nosocomial bloodstream infections during the two last decades ranked Candida species as the fourth most common nosocomial bloodstream pathogen. The incidence of Candida species has risen steadily during this period due to the increase in the number and type of patients at risk for these yeasts. Infections caused by Candida are especially frequent and serious in onco-hematological patients. Over the past decade, the introduction of azole antifungals as prophylactic agents, together with other factors, has led to a shift in the species of Candida that cause infection. During the period under review (1996 to 2005) several studies have confirmed the impact of antifungal prophylaxis with azoles on the emergence of Candida species other than Candida albicans. The widespread use of fluconazole has contributed to a relative decrease in the prevalence of C. albicans, while species inherently less susceptible, such as Candida glabrata and Candida krusei, appear to be isolated with greater frequency. Moreover, laboratory studies to determine the antifungal susceptibilities and virulence of non-albicans Candida species have enabled the design of microbe-specific management strategies. More of these studies will be necessary as we enter an age in which multiple antifungal compounds (echinocandins, new azoles) will become available for clinical use in invasive candidiasis or candidemia. The present review aims to highlight the different trends in the incidence, distribution and behavior of Candida bloodstream infections in the distinct types of patients at risk.
Collapse
|
18
|
Arribas López JR, Sanz Baena S, Hernández Albujar S, Lorenzo Hernández A, Montes Ramiréz ML, Palacios Muñoz R, Márquez Solero M, Santos González J, Ocampo Hermida A, Miralles Alvarez C, López Aldeguer J, Salavert Lletí M, Tordera Higón P, Santamaría Jáuregui JM, Teira Cobo RM, Moreno Guillén S, Moreno Zamora A, Gatell Artigas JM, Mallotas Masferrer J, Callau Cabrera P, Gonzáles de Suso MT, Costa Cerdá A, Cepeda Gonzáles C, Pulido Ortega F, Condes Moreno E, Barros Aguado C, del Llano Señarís J, Coduras A, Olivia J, Burgos Ramírez A, González-Lahoz J, Díaz B. [Retrospective epidemiological study on the durability of the treatment of HIV infection or AIDS in Spain]. Med Clin (Barc) 2002; 119:721-4. [PMID: 12487966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND AND OBJECTIVE To know the durability of consecutive regimens of antiretroviral treatment is important to design a long-term therapy, but there is not much information about this subject. PATIENTS AND METHOD Retrospective epidemiological study of a sample of 401 patients who began antiretroviral treatment between January 1997 and April 2000 at ten Spanish hospitals. The duration of each consecutive antiretroviral regimen was calculated and the reasons for modification and discontinuation were described. RESULTS In the 3 years and 3 months covered by the study, 48.6% of the patients received more than one regimen of therapy. Seventy five of the initial prescribed combinations included protease inhibitors. Median duration of consecutive lines of therapy was decreasing: 560, 360, 330 and 202 days for the first, second, third and fourth regimens, respectively. The main reason to modification was intolerance or toxicity (46.2, 49.1 and 47.1% for the first, second and third modification). A fifth of changes was originated by difficulties to follow the therapy. Virological failure was the reason for modification in 21.8, 24.5 and 26.5% of first, second and third changes. CONCLUSIONS Duration of consecutive antiretroviral regimens progressively decreases. Intolerance or drug toxicity were the main reasons conditioning the change of treatment.
Collapse
|
19
|
Lletí MS. [Acinetobacter: multiresistance or survival?]. Rev Esp Quimioter 1999; 12:290-3. [PMID: 10855006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
|