Bacteremia in Patients with Solid Organ Cancer: Insights into Epidemiology and Antibiotic Consumption.

Epidemiology and risk factors associated to bacterial resistance in solid organ cancer (SOC) patients has been barely described. This retrospective monocentric study analyzed clinical variables in SOC patients who developed bacteremia between 1 January 2019 and 31 December 2022. We described rates of bacterial resistance in Gram negative bacteria (80.6%): E. coli-ESBL, K. pneumoniae-ESBL, Carbapenem-Resistant K. pneumoniae and Meropenem-Resistant P. aeruginosa, as well as antibiotic consumption, and compared these rates between the medical and oncology wards. In total, we included 314 bacteremias from 253 patients. SOC patients are frequently prescribed antibiotics (40.8%), mainly fluoroquinolones. Nosocomial bacteremia accounted for 18.2% of the cases and only 14.3% of patients were neutropenic. Hepatobiliary tract was the most frequent tumor (31.5%) and source of bacteremia (38.5%). Resistant bacteria showed a decreased rate of resistance during the years studied in the oncology ward. Both K-ESBL and K-CBP resistance rates decreased (from 45.8% to 20.0%, and from 29.2% to 20.0%, respectively), as well as MRPA, which varied from a resistance rate of 28% to 16.7%. The presence of a urinary catheter (p < 0.001) and previous antibiotic prescription (p = 0.002) were risk factors for bacterial resistance. Identifying either of these risk factors could help in guiding antibiotic prescription for SOC patients.

Disparities between Latinx migrants and Spanish natives in COVID-19 outcome in Madrid.

Previous studies have suggested an increased susceptibility of COVID-19 among certain populations. We analyzed whether COVID-19 presentation and mortality differ between Latinx migrants and Spanish natives. METHODS AND MATERIALS: COVID-19 patients between 35-64 years old admitted between January 26th-May-5th 2020 were reviewed. Demographics, major comorbidities, symptoms, signs and analytical parameters on admission were recorded. Respiratory failure was defined as PaO2/FiO2 ≤ 200 mmHg, noninvasive or invasive mechanical ventilation requirement at any time during hospitalization. A propensity score (PS) adjustment was created between Latinx and Spanish. A multivariable logistic regression model adjusted by the PS was performed to evaluate the effects of different variables on mortality. RESULTS: 894 patients: 425 (47.5%) Latinx and 469 (52.5%) Spanish natives were included. Latinx were younger (50 vs 55 years p < 0.001) and had less comorbidities (29.4% vs 55.0% p < 0.001) than Spanish natives. More often they exhibited fever (22.1% vs 9.8% p = 0.018) and had higher inflammatory markers (PCR) (11.3 mg/dl vs 7.7 mg/dl p < 0.001). Mortality seemed lower among Latinx (4.7% vs 8.7%, p = 0.017). No association was found between ethnicity and mortality. Respiratory failure [OR = 23.978 (CI 95% 9.4-60.1) p < 0.001], LDH [OR (per unitary increment) = 1.002; CI95% (1.000-1.004;p = 0.036] and PCR [OR (per unitary increment) = 1.044 (CI95% 1.06-1.08); p = 0.02] were independently associated to mortality. CONCLUSIONS: We were unable to identify significant ethnic disparities between Latinx and Spanish natives in terms of COVID-19 mortality. Universal access to the health care system in Spain may have contributed to a better outcome of Latinx patients. Differences previously described might be a consequence of socioeconomic disparities.

Making EHRs Trustable: A Quality Analysis of EHR-Derived Datasets for COVID-19 Research.

One approach to verifying the quality of research data obtained from EHRs is auditing how complete and correct the data are in comparison with those collected by manual and controlled methods. This study analyzed data quality of an EHR-derived dataset for COVID-19 research, obtained during the pandemic at Hospital Universitario 12 de Octubre. Data were extracted from EHRs and a manually collected research database, and then transformed into the ISARIC-WHO COVID-19 CRF model. Subsequently, a data analysis was performed, comparing both sources through this convergence model. More concepts and records were obtained from EHRs, and PPV (95% CI) was above 85% in most sections. In future studies, a more detailed analysis of data quality will be carried out.

Cognitive Impairment Is a Common Comorbidity in Deceased COVID-19 Patients: A Hospital-Based Retrospective Cohort Study.

We analyzed the frequency of cognitive impairment (CI) in deceased COVID-19 patients at a tertiary hospital in Spain. Among the 477 adult cases who died after admission from March 1 to March 31, 2020, 281 had confirmed COVID-19. CI (21.1% dementia and 8.9% mild cognitive impairment) was a common comorbidity. Subjects with CI were older, tended to live in nursing homes, had shorter time from symptom onset to death, and were rarely admitted to the ICU, receiving palliative care more often. CI is a frequent comorbidity in deceased COVID-19 subjects and is associated with differences in care.

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