González-Corralejo C, García-Salguero C, Martínez-Rodríguez M
… +2 more, Delgado-Iribarren García-Campero A, Culebras-López E
Rev Esp Quimioter
· 2026 Feb · PMID 41697221
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The emergence of carbapenemase-producing species represents a growing concern due to their potential role as reservoirs and disseminators of antimicrobial resistance genes in aquatic and clinical environments. In this s...The emergence of carbapenemase-producing species represents a growing concern due to their potential role as reservoirs and disseminators of antimicrobial resistance genes in aquatic and clinical environments. In this study, we describe the genomic characterization of a clinical isolate harboring a plasmid-encoded KPC-type carbapenemase. This microorganism was isolated from a stool sample from a patient with acute gastroenteritis in May 2025. Whole-genome sequencing followed by bioinformatic analysis using ResFinder, PlasmidFinder, and MobileElementFinder revealed the presence of the gene located on an IncP-6 plasmid. The plasmid carried multiple insertion sequences and composite transposons, including IS26, ISKpn3, and IS6100, suggesting a highly mobile genetic platform. Comparative analysis indicates that the plasmid structure resembles previously reported KPC-harboring plasmids found in Enterobacterales, highlighting potential interspecies transfer events. To our knowledge, this is one of the few reports describing an IncP-6 plasmid carrying in . These findings underscore the importance of environmental and clinical surveillance of carbapenemase-producing bacteria.
Favier P, Suárez-Urquiza P, Raffo C
… +12 more, Torres D, Kumar L, Pérez J, Primost I, Gallino MI, Pinilla-Huayta F, Muñoz-Soto C, Ravelli M, Serio E, Pemán-García J, Valentín-Martín A, González-Barberá EM
Rev Esp Quimioter
· 2026 Feb · PMID 41627047
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BACKGROUND: Carbapenem-resistant Enterobacterales (CRE) cause hard-to-treat infections. Rectal surveillance is widely used to detect carriers, but its predictive value where different carbapenemases co-circulate is uncle...BACKGROUND: Carbapenem-resistant Enterobacterales (CRE) cause hard-to-treat infections. Rectal surveillance is widely used to detect carriers, but its predictive value where different carbapenemases co-circulate is unclear. We assessed whether CRE rectal and extra-rectal colonization predicts subsequent infection in an intensive care unit with concurrent KPC and NDM circulation. METHODS: We performed a retrospective observational study in a 60-bed adult intensive care unit in Buenos Aires, Argentina, from July 2016 to September 2019. All patients underwent weekly rectal surveillance, and extra rectal samples were taken when clinically indicated. Following up lasted 90 days from the first positive culture or from admission for non-carriers. Outcomes were any CRE infection and bacteremia. We estimated predictive values and fitted multivariable logistic regression models. RESULTS: We included 495 patients, median age 66 years, 58% male. Of them, 66% had rectal colonization and 8% had extra-rectal colonization. CRE rectal carriage showed low PPV for any infection, about 10%, with high NPV near 94%, and it was not independently associated with infection (aOR 1.9 [0.9-4.4], p=0.1). CRE extra-rectal colonization was an independent predictor of any CRE infection (aOR 3.4 [1.4-7.9] p<0.01) and bacteremia (aOR 3.3 [1.3-8.9] p<0.05), with specificity >93% but sensitivity ≈ 20%. CONCLUSIONS: In this mixed KPC and NDM CRE setting, weekly rectal surveillance was not a predictor of later infection, while extra rectal colonization retained independent predictive value for overall infection and for bacteremia.
Albanell-Fernández M, Verdejo MÁ, Barberán J
… +2 more, Mensa J, Soriano Á
Rev Esp Quimioter
· 2026 Jan · PMID 41575374
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Eravacycline is a novel, fully synthetic fluorocycline antibiotic with broad-spectrum activity against Gram-positive, Gram-negative, aerobic, and anaerobic pathogens, including multidrug-resistant (MDR) strains. It maint...Eravacycline is a novel, fully synthetic fluorocycline antibiotic with broad-spectrum activity against Gram-positive, Gram-negative, aerobic, and anaerobic pathogens, including multidrug-resistant (MDR) strains. It maintains efficacy despite common tetracycline resistance mechanisms, such as efflux pumps and ribosomal protection proteins. Its pharmacokinetic profile is characterized by extensive tissue penetration, particularly into the epithelial lining fluid and alveolar macrophages. Eravacycline is particularly active against MDR pathogens such as carbapenem-resistant Enterobacterales and . It also demonstrates efficacy against spp., complex, , and rapidly growing mycobacteria. Moreover, owing to its minimal disruption of the intestinal microbiota, it may help reduce the risk of infection and could serve as an adjunctive therapeutic option in severe or fulminant cases. Phase III trials (IGNITE1 and IGNITE4) demonstrated noninferiority of eravacycline compared with carbapenems in complicated intra-abdominal infections (cIAIs), supporting its approval for this indication. It is generally well tolerated, with adverse effects mainly limited to mild gastrointestinal. Beyond its approved indication for cIAIs, eravacycline shows therapeutic potential in multiple clinical contexts, such as polymicrobial infections from skin and soft tissue (necrotizing fasciitis) or pelvic inflammatory disease, pulmonary and biliary tract infections, β-lactam allergy, infections in immunocompromised patients, infection, and community-acquired sepsis of unknown source. Collectively, real-world evidence and its broad-spectrum antimicrobial activity support eravacycline as a promising therapeutic option with potential utility extending beyond its current indications.
Cobo F, Olvera-Porcel MDC, Ceballos-Atienza R
… +1 more, Navarro-Marí JM
Rev Esp Quimioter
· 2026 Jan · PMID 41528182
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INTRODUCTION: Bacteremia and sepsis cause high morbidity and mortality worldwide. Rapid identification of bacteria and timely antimicrobial susceptibility testing (AST) can be crucial for patient survival. In the present...INTRODUCTION: Bacteremia and sepsis cause high morbidity and mortality worldwide. Rapid identification of bacteria and timely antimicrobial susceptibility testing (AST) can be crucial for patient survival. In the present study, we have compared isolates from patients whose ASTs were processed using MicroScan Walkaway Plus with those patients whose ASTs were processed more quickly using Vitek® Reveal™. We analyzed mortality, turnaround time to targeted therapy, and length of stay between the two groups, as well as other parameters. MATERIAL AND METHODS: In this prospective study, 120 patients with bacteremia caused by Gram-negative bacilli were included. In 60 patients, conventional AST (MicroScan WalkAway Plus) was performed, whereas in the other 60 patients, rapid AST (Vitek® Reveal™) was carried out. RESULTS: The mortality rates were 13.3% and 38.3% for patients whose ASTs were performed with Vitek® Reveal™ and MicroScan WalkAway Plus, respectively (p=0.002). The average length of stay was 18 days per patient in the Vitek® Reveal™ group and 24.5 days for the MicroScan group (p=0.128). The average turnaround time was 12 hours per patient for Vitek® Reveal™ and 40 hours for MicroScan (p<0.001). CONCLUSIONS: The introduction of rapid AST techniques such as Vitek® Reveal™ has allowed a shorter turnaround time for reports on AST than when using normal AST techniques. This allows most AST results to be available earlier in the Laboratory Information System, allowing physicians to initiate more quickly in establishing correct treatment. Finally, these actions have resulted in reduced mortality due to faster clinical decision-making in these critically ill patients.
Fayos M, Bouza E, Burillo A
… +3 more, Galar A, Álvarez-Uría A, Muñoz P
Rev Esp Quimioter
· 2026 Jan · PMID 41521958
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Most evaluations of the burden of pneumonia in hospitalized patients are partial and concern specific subgroups of patients. However, few studies allow for the assessment of the global scope of the problem and the potent...Most evaluations of the burden of pneumonia in hospitalized patients are partial and concern specific subgroups of patients. However, few studies allow for the assessment of the global scope of the problem and the potential for intervention with guidance that could improve its diagnosis and treatment. This descriptive study conducted in a tertiary-care center aimed to determine the prevalence of pneumonia in hospitalized adults, to characterize its origins and etiology, and to evaluate the feasibility of a telematic intervention to advise on its diagnosis and treatment. A prevalence study was performed on the 653 adult inpatients admitted in July 2025. The pneumonia prevalence per 1,000 admitted patients was overall 36.8, community-acquired 24.5, nosocomial non-ventilator-associated 9.2, and nosocomial ventilator-associated 3.1. An etiological agent was identified in 29.2% of cases. In a critical review of the cases, opportunities to optimize either diagnosis or treatment were detected in 100% of pneumonia patients. After 30 days of dynamic follow-up of the selected cohort, overall mortality was 16.7%.
Motos-Bescós M, Ruiz-Ramos J, Agra-Montava I
… +4 more, Moliné-Pareja A, Palacio-Alvarez P, Villarejo-Jiménez A, Pomar-Solchaga V
Rev Esp Quimioter
· 2026 Jan · PMID 41521957
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INTRODUCTION: Management of septic patients continues to be a major challenge in emergency departments, with hospital mortality exceeding 30%. Early and appropriate administration of antibiotic therapy is an essential pi...INTRODUCTION: Management of septic patients continues to be a major challenge in emergency departments, with hospital mortality exceeding 30%. Early and appropriate administration of antibiotic therapy is an essential pillar of initial treatment for sepsis, as delays or inadequacies significantly increase morbidity and mortality. However, the factors contributing to inadequate empirical treatment are still poorly understood. The objective of our study was to identify the risk factors associated with inadequate initial treatment in patients treated as code sepsis, as well as to evaluate the impact of the initial adequacy of empirical treatment on mortality. MATERIAL AND METHODS: Observational, retrospective cohort study conducted in the emergency department of a tertiary hospital (2021-2024). Inclusion: adults over 18 years of age with activated sepsis codes and positive blood cultures. The adequacy of initial empirical treatment, associated risk factors, and their effect on 7- and 30-day mortality were analyzed. RESULTS: 339 patients with sepsis were included; 56.9% were over 80 years of age. Factors associated with inadequate antibiotic treatment were and multidrug-resistant bacteria. A total of 33.6% of patients received inadequate empirical treatment. Mortality was 10.9% at 7 days and 17.1% at 30 days. CONCLUSION: A significant proportion of patients with sepsis in emergency departments receive inadequate empirical therapy, which is associated with higher early mortality, especially in infections caused by S. aureus and multidrug-resistant bacteria.