Comparación entre cinco técnicas de PCR para el diagnóstico del SARS-CoV-2 / Comparison between five PCR techniques for the diagnosis of SARS-CoV-2

Introducción. Desde que aparecieron los primeros casosde SARS-CoV-2 son numerosas las técnicas que se han desarrollado para el diagnóstico o seguimiento de la infección,tanto técnicas directas como serológicas. La elección de unabuena herramienta diagnóstica es fundamental para el controlepidemiológico. El objetivo ha sido comparar cinco técnicascomercializadas de RT-PCR a tiempo real, en sensibilidad, especificidad y concordancia para la detección del SARS-CoV-2.Material y métodos. Se compararon cinco kits comerciales de RT-PCR para la detección del SARS-CoV-2. Se tomaronocho muestras positivas conocidas que se sometieron a sietediluciones o concentraciones diferentes y otras 135 muestrasnegativas para determinar valores de sensibilidad, especificidad y concordancia.Resultados. La sensibilidad, especificidad, valor predictivopositivo (VPP) y valor predictivo negativo (VPN) para las técnicas de Palex, Roche y GeneXpert respecto a Seegene fueronidénticas, correspondientes a 98,21%, 100%, 100% y 99,26%respectivamente. Para Becton Dickinson la sensibilidad fue del89,28%, la especificidad del 100%, el VPP del 100% y el VPNdel 95,74%. La concordancia mediante el índice Kappa paraPalex, Roche y GeneXpert fue del 0,9892, mientras que la concordancia para Becton Dickinson fue con un índice Kappa de0,9215.Conclusión. Todos los kits de RT-PCR comerciales presentaron elevadas sensibilidades y especificidades, así como VPP,VPN y concordancia. (AU)

Introduction. Since the first cases of SARS-CoV-2appeared, there have been numerous techniques that havebeen developed for the diagnosis or monitoring of infection, both direct and serological techniques. Choosing agood diagnostic tool is essential for epidemiological control. The objective was to compare five commercializedRT-PCR techniques in real time, in sensitivity, specificityand agreement for the detection of SARS-CoV-2.Material and methods. Five commercial RT-PCR kitsfor the detection of SARS-CoV-2 were compared. Eightknown positive samples were taken and subjected to seven different dilutions or concentrations, and another 135negative samples were used to determine sensitivity, specificity, and agreement values.Results. The sensitivity, specificity, positive predictivevalue (PPV) and negative predictive value (NPV) for thePalex, Roche and GeneXpert techniques with respect toSeegene were identical, corresponding to 98.21%, 100%,100% and 99.26% respectively. For Becton Dickinson thesensitivity was 89.28%, the specificity of 100%, the PPVof 100% and the NPV of 95.74%. The agreement using theKappa index for Palex, Roche and GeneXpert was 0.9892,while the agreement for Becton Dickinson was with aKappa index of 0.9215.Conclusion. All commercial RT-PCR kits had highsensitivities and specificities, as well as PPV, NPV, andconcordance. (AU)

Psychological distress in women and men living with HIV in Spain: a cross-sectional telephone survey.

BACKGROUND: Psychological distress includes a broader range of experiences, varying from less severe symptoms of depression and anxiety to severe psychiatric disease. Global estimates for depression and anxiety in 2017 were 3.4% and 3.8%, respectively. While for people living with HIV, global estimates were 16% and 33%, respectively. OBJECTIVE: We aimed to determine the prevalence of psychological distress by gender and associated characteristics in patients living with HIV. METHODS: A cross-sectional study was conducted within the Spanish HIV Research Network CoRIS. Participants were interviewed by telephone between 2010 and 2014 about their psychological distress, sociodemographics, drug consumption, self-perceived health and combined antiretroviral therapy (cART) adherence. Laboratory tests and medical history details were collected from CoRIS. Logistic regression was used to identify characteristics associated with psychological distress. FINDINGS: We interviewed 99 women and 464 men, both living with HIV. A greater proportion of women (51, 51.5%) reported psychological distress than men (179, 38.6%; p<0.01). Non-adherence to cART (OR 4.6 and 2.3, 95% CI 1.4‒15.1 and 1.3‒4.2) and non-use of cART (8.4 and 1.8, 2.2‒32.4 and 1.1‒2.8) were related to psychological distress in women and men, respectively. Spending little time in leisure-based physical activity was related to psychological distress in women (3.1, 1.1‒9.0). Living alone (2.0, 1.3‒3.0) and being unemployed (2.3, 1.4‒3.6) were related to psychological distress in men. CONCLUSIONS AND CLINICAL IMPLICATIONS: As people living with HIV have a high prevalence of psychological distress, their regular screening appointments should include psychological assessment. A gendered approach is needed to detect and manage psychological distress.

Actividad comparativa de tedizolid frente a Staphylococcus coagulasa negativos resistentes a linezolid y Staphylococcus aureus resistentes a meticilina / Comparative activity of tedizolid against clinical isolates of linezolid-resistant coagulase-negative staphylococci and methicillin-resistant Staphylococcus aureus

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In vitro efficacy of daptomycin and teicoplanin combined with ethanol, clarithromycin or gentamicin as catheter lock solutions.

BACKGROUND: Despite widespread use, optimum choice of antimicrobial agents, concentrations, combinations and exposure times have not been determined for antibiotic lock technique (ALT). Our objective was to evaluate the efficacy of different antibiotic combinations using an in vitro model of catheter-related infection. Daptomycin (DAP) 5 mg/mL, teicoplanin (TEC) 5 mg/mL, both alone and combined with gentamicin (GM) 2.5 mg/mL, clarythromycin (CLA) 5 mg/mL or ethanol 35 % were evaluated against four clinical strains of methicillin resistant coagulase negative staphylococci. Lock solutions were renewed every 24 h. RESULTS: After 72 h catheters were reincubated with culture media to investigate bacterial regrowth. All antibiotic combinations resulted in significant reductions (p < 0.05) of Log(10) cfu/mL at 72 h for both organisms compared with controls. DAP resulted in significant reductions of Log(10) for all organism versus TEC (p = 0.001). Only DAP reached the limit of detection at 72 h, however did not prevent regrowth after 24 h of ALT removal. DAP + Ethanol and TEC + ethanol eradicated biofilm at 72 h, but only DAP + ethanol (against all strains) and DAP + CLA (against two strains) prevented regrowth at 24 h after ALT removal. CONCLUSIONS: Based on these data, ALT with DAP + ethanol and DAP + CLA should be explored in clinical trials.

Sensibilidad in vitro a ceftarolina de Staphylococcus aureus / In vitro sensitivity to ceftaroline of Staphylococcus aureus

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Elution kinetics, antimicrobial activity, and mechanical properties of 11 different antibiotic loaded acrylic bone cement.

Antibiotic-loaded acrylic bone cements (ALABC) spacers are routinely used in the treatment of prosthetic joint infections. The objectives of our study were to evaluate different ALABC for elution kinetics, thermal stability, and mechanical properties. A 10 or 20% mixture (w/w) beads of medium viscosity bone cement (DePuy, Inc) and vancomycin (VAN), gentamycin (GM), daptomycin (DAP), moxifloxacin (MOX), rifampicin (RIF), cefotaxime (CTX), cefepime (FEP), amoxicillin clavulanate (AmC), ampicillin (AMP), meropenem (MER), and ertapenem (ERT) were formed and placed into wells filled with phosphate-buffered saline. Antibiotic concentrations were determined using high-performance liquid chromatography. Antimicrobial activity was tested against Micrococcus luteus ATCC 9341 or Escherichia coli ATCC 25922. AmC, AMP, and FEP concentration rapidly decreased after day 2, being almost undetectable at day 4. Sustained and high elution rates were observed with VAN, GM, MOX, and RIF for the 30-day duration of the experiment. DAP, MER, ERT, and CTX elution rates constantly decreased from day 4. All antibiotics tested retained antimicrobial activity proving thermal stability. Mechanical properties of ALABC were maintained except when RIF was used.

Baja prevalencia de resistencias primarias frente al virus de la hepatitis B en el sur de España / Low prevalence of hepatitis B virus primary drug resistance in Southern Spain

Introducción Para decidir si es necesario investigar resistencias primarias en pacientes naïve con hepatitis B crónica es necesario conocer su prevalencia. Pacientes y métodos Hemos analizado la secuencia genética de la polimerasa en 105 pacientes naïve. Resultados En 2 pacientes (1,9%) detectamos el cambio rtV173L, mutación compensatoria para lamivudina, en un caso la mutación rtI233V y en otro la «mutación de escape» sG145R.ConclusiónNuestro estudio demuestra que, por el momento, no está justificado realizar estudio de resistencias frente al VHB en pacientes naïve (AU)

Introduction: To know the prevalence of primary resistance in chronic hepatitis B naïve patients isessential to decide on the need of routine laboratory testing. Patients and methods: The genetic sequence of the HBV polymerase from 105 naïve patients was analysed. Results: rtV173L, a lamivudine compensatory mutation, was detected in two patients (1.9%), rtI233V inone patient, and another one carried the sG145R vaccine escape mutation. Conclusion: Our study shows that studying HBV resistance in naïve patients should not be recommended in the routine laboratory setting, for the time being (AU)

[Low prevalence of hepatitis B virus primary drug resistance in Southern Spain]. / Baja prevalencia de resistencias primarias frente al virus de la hepatitis B en el sur de España.

INTRODUCTION: To know the prevalence of primary resistance in chronic hepatitis B naïve patients is essential to decide on the need of routine laboratory testing. PATIENTS AND METHODS: The genetic sequence of the HBV polymerase from 105naïve patients was analysed. RESULTS: rtV173L, a lamivudine compensatory mutation, was detected in two patients (1.9%), rtI233V in one patient, and another one carried the sG145R vaccine escape mutation. CONCLUSION: Our study shows that studying HBV resistance in naïve patients should not be recommended in the routine laboratory setting, for the time being.

Activity of linezolid and high-dose daptomycin, alone or in combination, in an in vitro model of Staphylococcus aureus biofilm.

OBJECTIVES: The aim of the study was to assess the in vitro activity of linezolid and daptomycin, alone and in combination, against three Staphylococcus aureus isolates using a pharmacokinetic/pharmacodynamic (PK/PD) model of biofilm for 3 days. METHODS: One non-clinical methicillin-resistant S. aureus isolate (N315) and two clinical methicillin-resistant S. aureus isolates were evaluated. Simulated regimens included high-dose daptomycin (10 mg/kg once daily) and linezolid (600 mg twice daily), alone and in combination. RESULTS: Against all three strains, neither linezolid nor daptomycin alone was bactericidal against biofilm-embedded bacteria (BB). Against planktonic bacteria (PB) only daptomycin was bactericidal. In contrast, the combination of linezolid and daptomycin demonstrated greater activity than either of the two agents alone, being bactericidal against both PB and BB, almost reaching the limit of detection at 72 h. CONCLUSIONS: In this in vitro PK/PD model of mature biofilms, a combination of linezolid plus daptomycin was more effective than each agent alone, representing another potential option to treat S. aureus biofilm-associated infections.

Endocarditis de rápida evolución / Rapidly progressive endocarditis

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Septic arthritis due to Cellulosimicrobium cellulans.

Cellulosimicrobium cellulans has been reported as a rare cause of human pathogenesis. Infections mainly occur in immunocompromised patients and very often are associated with a foreign body. We report the first case of septic arthritis caused by C. cellulans in an immunocompetent patient. Our patient suffered a penetrating palm tree thorn injury to his left knee 8 weeks before admission. Although no foreign objects were found, they were suspected because previous reports suggest a frequent association with this microorganism, and open debridament was performed. Removal of foreign bodies related to this organism must be considered a high-priority treatment in these patients to achieve a complete recovery.

Eficacia y seguridad de daptomicina en dosis elevadas (mayor o igual que 8mg/kg/día) / Efficacy and safety of high dose (≥ 8 mg/kg/day) daptomycin

Introducción Se disponen de pocos datos acerca de la seguridad y eficacia de daptomicina en dosis elevadas (> 8mg/kg/día).Material y métodos Estudio ambispectivo de todos los pacientes que recibieron daptomicina (..) (AU)

Introduction: There is a paucity of data regarding efficacy and safety of high dose (> 8 mg/kg/day)daptomycin. Material and methods: This ambispective study included all patients that received (..) (AU)

[Efficacy and safety of high dose (≥8 mg/kg/day) daptomycin]. / Eficacia y seguridad de daptomicina en dosis elevadas (≥8 mg/kg/día).

INTRODUCTION: There is a paucity of data regarding efficacy and safety of high dose (>8mg/kg/day) daptomycin. MATERIAL AND METHODS: This ambispective study included all patients that received ≥8 mg/kg/day of daptomycin and had efficacy and safety data. RESULTS: Sixty-nine patients were included. Fifty-nine patients (85.5%) were recorded as having been cured or improved. Six patients (8.6%) had a raised CPK during follow-up with no clinical signs of myopathy in any of them. CONCLUSIONS: High dose daptomycin shows good efficacy without concerns about toxicity.