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1. Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Author

Laura Herrera-Hidalgo, Patricia Muñoz, Ana Álvarez-Uría, David Alonso-Menchén, Rafael Luque-Marquez, Encarnación Gutiérrez-Carretero, María Del Carmen Fariñas, Jose Maria Miró, Miguel Angel Goenaga, Luis Eduardo López-Cortés, Basilio Angulo-Lara, Lucia Boix-Palop, Arístides de Alarcón, Fernando Fernández Sánchez, José Mª García de Lomas, Gabriel Rosas, Javier de la Torre Lima, Elena Bereciartua, María José Blanco Vidal, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Laura Guio Carrión, Mikel Del Álamo Martínez de Lagos, Gorane Euba Ugarte, Ane Josune Goikoetxea, Marta Ibarrola Hierro, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodrigo, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, Mª Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ignacio Álvarez Rodríguez, Harkaitz Azkune Galparsoro, Elisa Berritu Boronat, Mª Jesús Bustinduy Odriozola, Cristina del Bosque Martín, Tomás Echeverría, Alberto Eizaguirre Yarza, Ana Fuentes, Miguel Ángel Goenaga, Muskilda Goyeneche del Río, Ángela Granda Bauza, José Antonio Iribarren, Xabier Kortajarena Urkola, José Ignacio Pérez-Moreiras López, Ainhoa Rengel Jiménez, Karlos Reviejo, Alberto Sáez Berbejillo, Elou Sánchez Haza, Rosa Sebastián Alda, Itziar Solla Ruiz, Irati Unamuno Ugartemendia, Diego Vicente Anza, Iñaki Villanueva Benito, Mar Zabalo Arrieta, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Alberto Bouzas, Brais Castelo, José Cuenca, Laura Gutiérrez, Lucía Ramos, María Rodríguez Mayo, Joaquín Manuel Serrano, Dolores Sousa Regueiro, Francisco Javier Martínez, Mª del Mar Alonso, Beatriz Castro, Teresa Delgado Melian, Javier Fernández Sarabia, Dácil García Rosado, Julia González González, Juan Lacalzada, Lissete Lorenzo de la Peña, Alina Pérez Ramírez, Pablo Prada Arrondo, Fermín Rodríguez Moreno, Antonio Plata Ciezar, José Mª Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Guillermo Cuervo, Carlos Falces, Mariana J Fernández-Pittol, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, José M. Miró, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Mercè Roque, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, David Alonso, Juan Carlos Alonso, Javier Bermejo, Emilio Bouza, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Agustín Estévez, Ramón Fortuny Ribas, Esther Gargallo, Mª Eugenia García Leoni, Ana González Mansilla, Francisco Javier González Moraga, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Marina Machado, Mercedes Marín, Manuel Martínez-Sellés, Rosa Melero, Diego Monzón, María Olmedo, Álvaro Pedraz, Blanca Pinilla, Ángel Pinto, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Eduardo Sánchez-Pérez, Antonio Segado, Neera Toledo, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Sofía de la Villa, Isabel Antorrena, Belén Loeches, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Sandra Rosillo, Jesús Agüero Balbín, Cristina Amado Fernández, Carlos Armiñanzas Castillo, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Marta Fernández Sampedro, Iván García, Claudia González Rico, Laura Gutiérrez-Fernández, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Pablo García Pavía, Ana Fernández Cruz, Antonio Ramos-Martínez, Isabel Sánchez Romero, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Jorge Rodríguez-Roda Stuart, Soledad Ruiz, Carmen Hidalgo Tenorio, Sergio Sequera, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, José Antonio Lepe, José López-Haldón, Rafael Luque-Márquez, Guillermo Marín, Antonio Ortiz-Carrellán, Eladio Sánchez-Domínguez, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Estíbaliz Corral Armas, Lara García-Álvarez, José Antonio Oteo, Antonio Barros Membrilla, Antonino Ginel Iglesias, Sara Grillo, Rubén Leta Petracca, Joaquín López-Contreras, María Alba Rivera Martínez, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Amaia Aguirre Quiñonero, Ángela Alonso Miñambres, Juan Carlos Gainzarain Arana, Sara González de Alaiza Ortega, Miguel Ángel Morán Rodríguez, Anai Moreno Rodríguez, Zuriñe Ortiz de Zárate, José Joaquín Portu Zapirain, Ester Sáez de Adana Arroniz, Daisy Carolina Sorto Sánchez, Sánchez-Porto Antonio, Úbeda Iglesias Alejandro, José Mª Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Mª Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Ivan Keituqwa Yañez, Julián Navarro Martínez, Ana Peláez Ballesta, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Mª Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Mª Pilar Palacián Ruiz, Juan Carlos Porres, Begoña Alcaraz Vidal, María Jesús Del Amor Espín, Francisco Buendía, Roberto Jiménez Sánchez, Rosario Mármol, Francisco Martínez, Antonio Meseguer, Beatriz Pérez, Leticia Risco, Zoser Saura, Vanina Silva, Mª Belén Villmarín, Mª Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Miquel Vives Borràs, Mª Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars, Xerach Bosch, Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego, Imanol Pulido, Héctor Marrero Santiago, Isabel de Miguel Martínez, Elena Pisos Álamo, Daniel San Román Sánchez, Jorge Boan Pérez, Eva Mª Aguilar Blanco, Mercedes Catalán González, María Angélica Corres Peiretti, Andrea Eixerés Esteve, Laura Domínguez Pérez, Santiago de Cossío Tejido, Francisco Galván Román, José Antonio García Robles, Francisco López Medrano, Mª Jesús López Gude, Mª Ángeles Orellana Miguel, Patrick Pilkington, Yolanda Revilla Ostalaza, Juan Ruiz Morales, Sebastián Ruiz Solís, Ana Sabín Collado, Marcos Sánchez Fernández, Javier Solera Rallo, Jorge Solís Martín, Francesc Escrihuela-Vidal, Jordi Carratalà, Inmaculada Grau, Carmen Ardanuy, Dámaris Berbel, José Carlos Sánchez Salado, Oriol Alegre, Alejandro Ruiz Majoral, Fabrizio Sbraga, Arnau Blasco, Laura Gracia Sánchez, Iván Sánchez-Rodríguez, Gonzalo Aldamiz, Beatriz Álvarez, Marina Bernal Palacios, Alfonso Cabello Úbeda, Ricardo Fernández Roblas, Rafael Hernández, Victoria Andrea Hortigüela Martín, Andrea Kallmeyer, Cristina Landaeta Kancev, Marta Martín, Miguel Morante Ruiz, Miguel Ángel Navas Lobato, Ana María Pello, Laura Prieto, Marta Tomás Mallebrera, Laura Varela, Mireia de la Peña Triguero, Ruth Esther Figueroa Cerón, Lara Ruiz Gómez, Mireia Ble, Juan Pablo Horcajada Gallego, Antonio José Ginel, Inmaculada López, Alexandra Mas, Antoni Mestres, Lluís Molina, Ramón Serrat, Núria Ribas, Francisca Sánchez, Ana Silverio, Marina Suárez, Luisa Sorlí, Lluís Recasens, Manuel Taurón, María Fernández Regueras, María Ángeles Mantecón Vallejo, José Ángel Pérez Rivera, Nuria Sánchez Mata, Antonia Calvo Cano, Miguel Fajardo Olivares, María Victoria Millán Núñez, and Agustín Muñoz Sanz

Subjects
Infective endocarditis, Methicillin-susceptible Staphylococcus aureus, Cefazolin, Antistaphylococcal penicillin, Infectious and parasitic diseases, RC109-216
Abstract

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P

Published
2023
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2. Systematic genomic analysis of SARS-CoV-2 co-infections throughout the pandemic and segregation of the strains involved

Author

Daniel Peñas-Utrilla, Laura Pérez-Lago, Andrea Molero-Salinas, Agustín Estévez, Amadeo Sanz, Marta Herranz, Carolina Martínez-Laperche, Cristina Andrés-Zayas, Cristina Veintimilla, Pilar Catalán, Roberto Alonso, Patricia Muñoz, Darío García de Viedma, and on behalf of the Gregorio Marañón Microbiology-ID COVID 19 Study Group

Subjects
SARS-CoV-2, Co-infections, WGS, Segregation, Medicine, Genetics, QH426-470
Abstract

Abstract Background SARS-CoV-2 recombinants involving the divergent Delta and Omicron lineages have been described, and one of them, “Kraken” (XBB.1.5), has recently been a matter of concern. Recombination requires the coexistence of two SARS-CoV-2 strains in the same individual. Only a limited number of studies have focused on the identification of co-infections and are restricted to co-infections involving the Delta/Omicron lineages. Methods We performed a systematic identification of SARS-CoV-2 co-infections throughout the pandemic (7609 different patients sequenced), not biassed towards the involvement of highly divergent lineages. Through a comprehensive set of validations based on the distribution of allelic frequencies, phylogenetic consistency, re-sequencing, host genetic analysis and contextual epidemiological analysis, these co-infections were robustly assigned. Results Fourteen (0.18%) co-infections with ≥ 8 heterozygous calls (8–85 HZs) were identified. Co-infections were identified throughout the pandemic and involved an equal proportion of strains from different lineages/sublineages (including pre-Alpha variants, Delta and Omicron) or strains from the same lineage. Co-infected cases were mainly unvaccinated, with mild or asymptomatic clinical presentation, and most were at risk of overexposure associated with the healthcare environment. Strain segregation enabled integration of sequences to clarify nosocomial outbreaks where analysis had been impaired due to co-infection. Conclusions Co-infection cases were identified throughout the pandemic, not just in the time periods when highly divergent lineages were co-circulating. Co-infections involving different lineages or strains from the same lineage were occurring in the same proportion. Most cases were mild, did not require medical assistance and were not vaccinated, and a large proportion were associated with the hospital environment.

Published
2023
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3. Early SARS-CoV-2 Reinfections Involving the Same or Different Genomic Lineages, Spain

Author

Cristina Rodríguez-Grande, Agustín Estévez, Rosalía Palomino-Cabrera, Andrea Molero-Salinas, Daniel Peñas-Utrilla, Marta Herranz, Amadeo Sanz-Pérez, Luis Alcalá, Cristina Veintimilla, Pilar Catalán, Carolina Martínez-Laperche, Roberto Alonso, Patricia Muñoz, Laura Pérez-Lago, and Darío García de Viedma

Subjects
COVID-19, SARS-CoV-2, respiratory infections, severe acute respiratory syndrome coronavirus 2, SARS, coronavirus disease, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Centers for Disease Control and Prevention guidelines consider SARS-CoV-2 reinfection when sequential COVID-19 episodes occur >90 days apart. However, genomic diversity acquired over recent COVID-19 waves could mean previous infection provides insufficient cross-protection. We used genomic analysis to assess the percentage of early reinfections in a sample of 26 patients with 2 COVID-19 episodes separated by 20–45 days. Among sampled patients, 11 (42%) had reinfections involving different SARS-CoV-2 variants or subvariants. Another 4 cases were probable reinfections; 3 involved different strains from the same lineage or sublineage. Host genomic analysis confirmed the 2 sequential specimens belonged to the same patient. Among all reinfections, 36.4% involved non-Omicron, then Omicron lineages. Early reinfections showed no specific clinical patterns; 45% were among unvaccinated or incompletely vaccinated persons, 27% were among persons

Published
2023
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4. Systematic Genomic and Clinical Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 Reinfections and Recurrences Involving the Same Strain

Author

Cristina Rodríguez-Grande, Luis Alcalá, Agustín Estévez, Pedro J. Sola-Campoy, Sergio Buenestado-Serrano, Carolina Martínez-Laperche, Víctor Manuel de la Cueva, Roberto Alonso, Cristina Andrés-Zayas, Javier Adán-Jiménez, Carmen Losada, Carla Rico-Luna, Iñaki Comas, Fernando González-Candelas, Pilar Catalán, Patricia Muñoz, Laura Pérez-Lago, and Darío García de Viedma

Subjects
COVID-19, coronavirus disease, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, viruses, respiratory infections, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Estimates of the burden of severe acute respiratory syndrome coronavirus 2 reinfections are limited by the scarcity of population-level studies incorporating genomic support. We conducted a systematic study of reinfections in Madrid, Spain, supported by genomic viral analysis and host genetic analysis, to cleanse laboratory errors and to discriminate between reinfections and recurrences involving the same strain. Among the 41,195 cases diagnosed (March 2020–March 2021), 93 (0.23%) had 2 positive reverse transcription PCR tests (55–346 days apart). After eliminating cases with specimens not stored, of suboptimal sequence quality, or belonging to different persons, we obtained valid data from 22 cases. Of those, 4 (0.01%) cases were recurrences involving the same strain; case-patients were 39–93 years of age, and 3 were immunosuppressed. Eighteen (0.04%) cases were reinfections; patients were 19–84 years of age, and most had no relevant clinical history. The second episode was more severe in 8 cases.

Published
2022
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5. IgG anti-RBD levels during 8-month follow-up post-vaccination with BNT162b2 and mRNA-1273 vaccines in healthcare workers: A one-center study

Author

Sergio Gil-Manso, Roberto Alonso, Pilar Catalán, Ignacio Sánchez-Arcilla, Marco Marzola, Rafael Correa-Rocha, Marjorie Pion, Patricia Muñoz, Gregorio Marañón Microbiology-ID COVID-19 Study Group, Luis Alcalá, Teresa Aldámiz, Beatriz Álvarez, Ana Álvarez-Uría, Alexi Arias, Elena Bermúdez, Emilio Bouza, Sergio Buenesta do-Serrano, Almudena Burillo, Raquel Carrillo, Emilia Cercenado, Alejandro Cobos, Cristina Díez, Pilar Escribano, Agustín Estévez, Chiara Fanciulli, Alicia Galar, Mª Dolores García, Darío García de Viedma, Paloma Gijón, Adolfo González, Helmuth Guillén, Jesús Guinea, Marta Herranz, Álvaro Irigoyen, Laura Vanessa Haces, Martha Kestler, Juan Carlos López, Carmen Narcisa Losada, Marina Machado, Mercedes Marín, Pablo Martín-Rabadán, Andrea Molero-Salinas, Pedro Montilla, Patricia Muñoz, María Olmedo, Belén Padilla, Rosalía Palomino-Cabrera, María Palomo, María Jesús Pérez-Granda, Daniel Peñas-Utrilla, Laura Pérez-Lago, Leire Pérez, Elena Reigadas, Cristina Rincón, Belén Rodríguez, Sara Rodríguez, Cristina Rodríguez-Grande, Adriana Rojas, María Jesús Ruiz-Serrano, Carlos Sánchez, Mar Sánchez, Amadeo Sanz-Pérez, Julia Serrano, Francisco Tejerina, Maricela Valerio, Mª Cristina Veintimilla, Lara Vesperinas, Teresa Vicente, and Sofíade la Villa

Subjects
COVID-19, mRNA vaccines, antibodies, humoral response, IgG Anti-S, Microbiology, QR1-502
Abstract

IntroductionSince the COVID-19 outbreak, specific mRNA-based anti-SARS-CoV-2 vaccines have been developed and distributed worldwide. Because this is the first time that mRNA vaccines have been used, there are several questions regarding their capacity to confer immunity and the durability of the specific anti-SARS-CoV-2 response. Therefore, the objective of this study was to recruit a large cohort of healthcare workers from the Gregorio Marañón Hospital vaccinated with the mRNA-1273 or BNT126b2 vaccines and to follow-up on IgG anti-RBD levels at 8 months post-vaccination.MethodsWe recruited 4,970 volunteers and measured IgG anti-RBD antibodies on days 30 and 240 post-vaccination.ResultsWe observed that both vaccines induced high levels of antibodies on day 30, while a drastic wane was observed on day 240, where mRNA-1273 vaccinated induced higher levels than BNT162b2. Stratifying by vaccine type, age, gender, and comorbidities, we identified that older mRNA-1273-vaccinated volunteers had higher antibody levels than the younger volunteers, contrary to what was observed in the BNT162b2-vaccinated volunteers.DiscussionIn conclusion, we observed that mRNA-1273 has a higher capacity to induce a humoral response than BNT162b2 and that age is a factor in the specific response.

Published
2022
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6. Abiotrophia spp. and Granulicatella spp. Infective Endocarditis: A Contemporary Perspective

Author

Agustín Estévez, Mercedes Marín, Carlos Sánchez-Carrillo, Marina Machado, Luís Alcalá, Blanca Pinilla, Antonia Delgado, Víctor González-Ramallo, Álvaro Pedraz, Manuel Martínez-Sellés, Emilio Bouza, Maricela Valerio, Patricia Muñoz, and on behalf of GAME-HGUGM

Subjects
abiotrophia, granulicatella, infective endocarditis, Environmental sciences, GE1-350, Microbiology, QR1-502
Abstract

Background: Abiotrophia spp. and Granulicatella spp. are Gram-positive cocci, formerly known as nutritionally variant or deficient Streptococcus. Their role as causative agents of infective endocarditis (IE) is numerically uncertain, as well as diagnostic and clinical management of this infection. The aim of our study is to describe the clinical, microbiological, therapeutic, and prognosis of patients with IE caused by these microorganisms in a large microbiology department. Methods: Retrospective analysis of all the patients with Abiotrophia spp. and Granulicatella spp. IE registered in our centre in the period 2004–2021. Results: Of the 822 IE in the study period, 10 (1.2%) were caused by Abiotrophia spp. (7) or Granulicatella spp. (3). The species involved were A.defectiva (7), G.adiacens (2) and G.elegans (1). Eight patients were male, their mean age was 46 years and four were younger than 21 years. The most frequent comorbidities were congenital heart disease (4; 40%) and the presence of intracardiac prosthetic material (5; 50%). IE occurred on 5 native valves and 5 prosthetic valve or material. Blood cultures were positive in 8/10 patients, within a mean incubation period of 18.07 hours. In the other two patients, a positive 16SPCR from valve or prosthetic material provided the diagnosis. Surgery for IE was performed in seven patients (70%) and in all cases positive 16S rRNA PCR and sequencing from valve or prosthetic material was demonstrated. Valves and/or prosthetic removed material cultures were positive in four patients. Nine patients received ceftriaxone (4 in monotherapy and 5 in combination with other antibiotics). The mean length of treatment was 6 weeks and IE-associated mortality was 20% at one year follow-up. Conclusions: Abiotrophia spp. or Granulicatella spp. IE were infrequent but not exceptional in our environment and particularly affected patients with congenital heart disease or prosthetic material. Blood cultures and molecular methods allowed the diagnosis. Most of them required surgery and the associated mortality, in spite of a mean age of 46 years, was high.

Published
2022
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7. Incidence of Candidemia Is Higher in COVID-19 versus Non-COVID-19 Patients, but Not Driven by Intrahospital Transmission

Author

Marina Machado, Agustín Estévez, Carlos Sánchez-Carrillo, Jesús Guinea, Pilar Escribano, Roberto Alonso, Maricela Valerio, Belén Padilla, Emilio Bouza, and Patricia Muñoz

Subjects
COVID-19, candidemia, viral–fungal coinfection, epidemiology, risk factors, invasive fungal infection, Biology (General), QH301-705.5
Abstract

There is scarce information on the actual incidence of candidemia in COVID-19 patients. In addition, comparative studies of candidemia episodes in COVID-19 and non-COVID-19 patients are heterogeneous. Here, we assessed the real incidence, epidemiology, and etiology of candidemia in COVID-19 patients, and compared them with those without COVID-19 (2020 vs. 2019 and 2020, respectively). We also genotyped all C. albicans, C. parapsilosis, and C. tropicalis isolates (n = 88), causing candidemia in both groups, providing for the first time a genotypic characterization of isolates gathered in patients with either COVID-19 or non-COVID-19. Incidence of candidemia was higher in patients with COVID-19 than non-COVID-19 (4.73 vs. 0.85 per 1000 admissions; 3.22 vs. 1.14 per 10,000 days of stay). No substantial intergroup differences were found, including mortality. Genotyping proved the presence of a low number of patients involved in clusters, allowing us to rule out rampant patient-to-patient Candida transmission. The four patients, involved in two clusters, had catheter-related candidemia diagnosed in the first COVID-19 wave, which demonstrates breaches in catheter management policies occurring in such an overwhelming situation. In conclusion, the incidence of candidemia in patients with COVID-19 is significantly higher than in those without COVID-19. However, genotyping shows that this increase is not due to uncontrolled intrahospital transmission.

Published
2022
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9. Conflictos bioéticos en investigación clínica: una perspectiva histórica

Author

Agustín Estévez

Subjects
bioéticos, investigación clínica, conflictos, Education (General), L7-991, Special aspects of education, LC8-6691
Abstract

El Código de Nuremberg cerraba un pasado vergonzoso para la investigación clínica e iniciaba el mérito de reivindicar el valor ético y social de la experimentación como un momento esencial del proceso médico.

Published
2008

10. La habilidad de relacionar genéticamente las sustancias: Aporte a la concepción científica de los profesionales

Author

Blas Agustín Estévez Tamayo, Idalberto Clemente Morales Rodríguez, and Magnolia Esperanza Claro Quintana

Subjects
Technology, Production management. Operations management, TS155-194
Abstract

Se presenta la realización de las reacciones de modo consecutivo de forma tal que se propone la habilidad de relacionar las sustancias químico inorgánicas como forma de comprobar la unidad material del mundo.

Published
2010

12. Sample pooling is efficient in PCR testing of SARS-CoV-2: a study in 7400 healthcare professionals

Author

Mercedes Marín, Roberto Alonso, Luis Alcalá, Agustín Estévez, Emilio Bouza, Patricia Muñoz, and Pilar Catalán

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, 2019-20 coronavirus outbreak, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 030106 microbiology, Pooling, Sample (statistics), Polymerase Chain Reaction, Sensitivity and Specificity, Specimen Handling, 03 medical and health sciences, 0302 clinical medicine, Nasopharynx, Health care, Epidemiology, Pandemic, Prevalence, Medicine, Humans, pooling, False Positive Reactions, 030212 general & internal medicine, Health professionals, business.industry, SARS-CoV-2, COVID-19, Reproducibility of Results, General Medicine, Personnel, Hospital, PCR, Infectious Diseases, Spain, COVID-19 Nucleic Acid Testing, Emergency medicine, Original Article, business
Abstract

SARS-CoV-2 pandemic shows the importance of having efficient virus diagnosis, especially in groups of particular relevance such as health care professionals, without involving a large economic expense. This is a prevalence study carried out in 7400 health care professionals in a 1350-bed hospital in Madrid, Spain. Pools of 10 samples were performed, using the Xpert® Xpress SARS-CoV-2 test for the diagnosis from clinical samples of nasopharyngeal exudate. A previous study was performed to evaluate the effect of the dilution in terms of sensitivity. The estimated sensitivity was over 95%. A total of 740 pools were performed, with a final result of 218 health care professionals being positive. Using the pooling system, the reagent cost reduction to the institution was 75.3%. It can be concluded that the described sample pooling system is a useful and efficient tool in the diagnosis of SARS-CoV-2 in certain groups, assuming a cost reduction without reducing the sensitivity.

Published
2021
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13. Epidemiological, clinical and genomic snapshot of the first 100 B.1.1.7 SARS-CoV-2 cases in Madrid

Author

Darío García de Viedma, Pilar Catalán Pharmacy, Agustín Estévez, Pedro J Sola Campoy, Laura Pérez-Lago, Julia Suárez-González, Mariana G. López, Patricia Muñoz, Iñaki Comas, Fernando González-Candelas, Víctor Manuel de la Cueva Technician, Luis Alcalá, Marta Herranz Tecnichian, Sergio Buenestado-Serrano, Instituto de Salud Carlos III, and Consejo Superior de Investigaciones Científicas (España)

Subjects
Adult, Male, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Adolescent, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 030231 tropical medicine, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Research Letter, Medicine, Humans, 030212 general & internal medicine, UK, Child, B.1.1.7, travel, Aged, Aged, 80 and over, Travel, business.industry, SARS-CoV-2, Infant, COVID-19, General Medicine, Genomics, Middle Aged, Spain, Child, Preschool, Female, business, Humanities, AcademicSubjects/MED00295
Abstract

A new SARS-CoV-2 variant, B.1.1.7, emerged in September in the UK, and is responsible for 76.6% of COVID-19 cases.1 This variant has also been reported in another 45 countries, 17 of them European.2,3 B.1.1.7 is considered to have higher transmissibility.4 It carries an unusually high number of specific mutations/deletions, 18, mostly non-synonymous and eight concentrate in the S gene,5 including several which might have relevant functional roles. The 69/70 deletion may be associated to immune response evasion6 and the N501Y substitution increases the affinity to the ACE2 receptor.7 These findings have raised the alarm of having to face a new variant with the potential to accelerate the spread of the pandemic. A recent report finds a realistic possibility that B.1.1.7 is associated with an increased risk of death., This work was supported by Instituto de Salud Carlos III (Ref COV20/00140: SeqCOVID—Consorcio para la epidemiología genómica de SARS-CoV-2 en España) and by Consejo Superior de Investigaciones Científicas (CSIC) (PTI Salud Global). LPL holds a Miguel Servet Contract CP15/00075).

Published
2021

14. Inference of Active Viral Replication in Cases with Sustained Positive Reverse Transcription-PCR Results for SARS-CoV-2

Author

Darío García de Viedma, Luis Alcalá, Pilar Catalán, Cristina Rodríguez-Grande, Laura Pérez-Lago, Agustín Estévez, Patricia Muñoz, and Javier Adán-Jiménez

Subjects
Microbiology (medical), Adult, Male, RNase P, viruses, Genome, Viral, Biology, Virus Replication, Virus, Coronavirus Envelope Proteins, Nasopharynx, Virology, Humans, Viral shedding, Gene, Subgenomic mRNA, Aged, Aged, 80 and over, subgenomic RNA, SARS-CoV-2, RNA, COVID-19, persistence, Middle Aged, Virus Shedding, Reverse transcription polymerase chain reaction, Viral replication, COVID-19 Nucleic Acid Testing, RNA, Viral, Female
Abstract

The purpose of this study was to detect coronavirus disease 2019 (COVID-19) cases with persistent positive reverse transcription-PCR (RT-PCR) results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for which viable virus can be inferred due to the presence of subgenomic (SG) viral RNA, which is expressed only in replicating viruses. RNA remnants purified from diagnostic nasopharyngeal specimens were used as the templates for RT-PCR-specific detection of SG E gene RNA., The purpose of this study was to detect coronavirus disease 2019 (COVID-19) cases with persistent positive reverse transcription-PCR (RT-PCR) results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for which viable virus can be inferred due to the presence of subgenomic (SG) viral RNA, which is expressed only in replicating viruses. RNA remnants purified from diagnostic nasopharyngeal specimens were used as the templates for RT-PCR-specific detection of SG E gene RNA. As controls, we also detected viral genomic RNA for the E gene and/or a human housekeeping gene (RNase P). We assessed the samples of 60 RT-PCR-positive cases with prolonged viral SARS-CoV-2 shedding (24 to 101 days) since the first diagnostic RT-PCR. SG viral RNA was detected in 12/60 (20%) of the persistent cases, 28 to 79 days after the onset of symptoms. The age range of the cases with prolonged viral shedding and the presence of SG RNA was quite wide (40 to 100 years), and the cases were equally distributed between males (42%) and females (58%). No case was HIV positive, although seven were immunosuppressed. According to the severities of the COVID-19 episodes, they were mild (40%), intermediate (20%), and severe (40%). In a percentage of persistent SARS-CoV-2 PCR-positive cases, the presence of actively replicating virus may be inferred, far beyond diagnosis. We should not assume a universal lack of infectiousness for COVID-19 cases with prolonged viral shedding.

Published
2020

15. Las habilidades de observación y descripción de sustancias y reacciones químicas en el estudio de la Química General de las carreras de ingeniería

Author

Pablo Alexis Rodríguez Bruceta, José Ramón Pérez Díaz, and Blas Agustín Estévez Tamayo

Subjects
lcsh:T, lcsh:Production management. Operations management, lcsh:TS155-194, lcsh:Technology
Abstract

En el estudio de las sustancias y las reacciones químicas, el "aprender a observar" y el "aprender a describir" son necesarios para un aprendizaje activo de los estudiantes. Este trabajo tiene como objetivo presentar una estrategia didáctica que potencie estas habilidades, mediante el uso de las concepciones teóricas y metodológicas de la enseñanza desarrolladora, para lo cual se emplearon, entre otros, los métodos de análisis y crítica de fuentes, la observación y la modelación, que favorecen el aprendizaje de la Química General de los estudiantes de Ingeniería Industrial.

Published
2010

16. Bio-Ethical Conflicts in Clinical Research: A Historical Perspective

Author

Agustín Estévez

Subjects
investigación clínica, lcsh:LC8-6691, conflictos, lcsh:Special aspects of education, General Engineering, bioéticos, lcsh:L7-991, lcsh:Education (General)
Abstract

El Código de Nuremberg cerraba un pasado vergonzoso para la investigación clínica e iniciaba el mérito de reivindicar el valor ético y social de la experimentación como un momento esencial del proceso médico. The Nuremberg Code closed a shameful past for clinical research and began the merit of claiming the ethical and social value of experimentation as an essential moment in the medical process.

Published
2008
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