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1. Pneumocystis jirovecii pneumonia: still a concern in patients with haematological malignancies and stem cell transplant recipients

Author

Cordonnier, Catherine, Cesaro, Simone, Maschmeyer, Georg, Einsele, Hermann, Peter Donnelly, J., Alanio, Alexandre, Hauser, Philippe M., Lagrou, Katrien, Melchers, Willem J. G., Helweg-Larsen, Jannik, Matos, Olga, Bretagne, Stephane, Maertens, Johan, Agrawal, Samir, Kibbler, Christopher, Pagliuca, Antonio, Ward, Katherine, Akova, Murat, Herbrecht, Raoul, Mallet, Vincent, Ribaud, Patricia, Aljurf, Mahmoud, Averbuch, Dina, Engelhard, Dan, Berg, Thomas, Cornely, Oliver, Penack, Olaf, van Boemmel, Florian, von Lilienfeld-Toal, Marie, Blennow, Ola, Ljungman, Per, Bruggemann, Roger, Donnelly, Peter, Kullberg, Bart-Jan, Melchers, Willem, Calandra, Thierry, Hirsch, Hans, Marchetti, Oscar, Orasch, Christina, Tissot, Frederic, Castagnola, Elio, Girmenia, Corrado, Mikulska, Malgorzata, Pagano, Livio, Viscoli, Claudio, De La Camara, Rafael, Duarte, Rafael, Munoz, Patricia, Drgona, Lubos, Hargreaves, Ruth, Hubacek, Petr, Kouba, Michal, Racil, Zdenek, Klyasova, Galina, Pettrikos, George, Roilides, Emmanuel, Skiada, Anna, Rizzi-Puechal, Valã©rie, Sinko, Janos, Slavin, Monica, Styczynski, Jan, Tweddle, Lorraine, Wood, Craig, Service d'hématologie clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Department of Haematology, Oncoematologia Pediatrica, Policlinico G. B. Rossi, Medizinische Klinik, Hämatologie und Onkologie, Klinikum Ernst von Bergmann, Julius-Maximilians-Universität Würzburg [Wurtzbourg, Allemagne] (JMU), Radboud university [Nijmegen], Université Sorbonne Paris Cité (USPC), Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Mycologie moléculaire, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Lausanne University Hospital, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Rigshospitalet [Copenhagen], Copenhagen University Hospital, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Department of Hematology, University Hospital Gasthuisberg, The ECIL-5 meeting was supported by unrestricted educational grants from Astellas Pharma, Gilead Sciences, Merck, and Pfizer. The ECIL-6 meeting was supported by unrestricted educational grants from Basilea, Gilead Sciences, Merck, and Pfizer, on behalf of the Fifth European Conference on Infections in Leukemia (ECIL-5†), a joint venture of The European Group for Blood and Marrow Transplantation (EBMT), The European Organization for Research and Treatment of Cancer (EORTC), the Immunocompromised Host Society (ICHS) and The European Leukemia Net (ELN) (61 collabrators), Radboud University [Nijmegen], University Hospital Gasthuisberg [Leuven], Julius-Maximilians-Universität Würzburg (JMU), and Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Antifungal Agents, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 030106 microbiology, Disease, Hematopoietic stem cell transplantation, Pneumocystis carinii, Chemoprevention, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Immunocompromised Host, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Pneumocystis jirovecii, Pharmacology (medical), Intensive care medicine, Hematologic Neoplasms, Pneumonia, Pneumocystis, Stem Cell Transplantation, Transplant Recipients, Pharmacology, Infectious Diseases, Women's cancers Radboud Institute for Molecular Life Sciences [Radboudumc 17], Hematology, biology, Pneumocystis, business.industry, Mortality rate, Pneumonia, biology.organism_classification, medicine.disease, Penumocytis pneumonia, 3. Good health, Leukemia, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], 030220 oncology & carcinogenesis, immunocomrpomised host, Pnemocystis jirovecii, Stem cell, immunocomrpomised host, Penumocytis pneumonia, Pnemocystis jirovecii, business, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5]
Abstract

Contains fulltext : 171209.pdf (Publisher’s version ) (Closed access) Pneumocystis jirovecii can cause life-threatening pneumonia following treatment for haematological malignancies or after HSCT. The mortality rate of P. jirovecii pneumonia (PCP) in these patients is 30%-60%, especially after HSCT. The clinical presentation of PCP in haematology differs from that associated with HIV infection, with the disease being acute and more often severe, having a lower fungal burden and being more frequently linked to treatment with corticosteroids. Most cases occur in patients not receiving adequate prophylaxis. The development of new therapies, including targeted treatments and monoclonal antibodies in various haematological diseases, justifies constant vigilance in order to identify new at-risk populations and give prophylaxis accordingly. The fifth and sixth European Conferences on Infections in Leukaemia (ECIL-5 and ECIL-6) aimed to review risk factors for PCP in haematology patients and to establish evidence-based recommendations for PCP diagnosis, prophylaxis and treatment. This article focuses on the magnitude of the problem, the main differences in clinical presentation between haematology patients and other immunocompromised populations, especially HIV-infected patients, and the main risk factors.

Published
2016

2. Pneumocystis jirovecii pneumonia: still a concern in patients with haematological malignancies and stem cell transplant recipients-authors' response

Author

Cordonnier, Catherine, Alanio, Alexandre, Cesaro, Simone, Maschmeyer, Georg, Einsele, Hermann, Donnelly, J. Peter, Hauser, Philippe M., Lagrou, Katrien, Melchers, Willem J. G., Helweg-Larsen, Jannik, Matos, Olga, Bretagne, Stéphane, Maertens, Johan, Agrawal, Samir, Akova, Murat, Aljurf, Mahmoud, Averbuch, Dina, Berg, Thomas, Blennow, Ola, Brüggemann, Roger, Calandra, Thierry, Castagnola, Elio, Cornely, Oliver, De La Camara, Rafael, Drgona, Lubos, Duarte, Rafael, Engelhard, Dan, Girmenia, Corrado, Hargreaves, Ruth, Herbrecht, Raoul, Hirsch, Hans, Hubacek, Petr, Kibbler, Christopher, Klyasova, Galina, Kouba, Michal, Kullberg, Bart-Jan, Ljungman, Per, Mallet, Vincent, Marchetti, Oscar, Mikulska, Malgorzata, Munoz, Patricia, Orasch, Christina, Pagano, Livio, Pagliuca, Antonio, Penack, Olaf, Pettrikos, George, Racil, Zdenek, Ribaud, Patricia, Rizzi-Puechal, Valérie, Roilides, Emmanuel, Sinko, Janos, Skiada, Anna, Slavin, Monica, Styczynski, Jan, Tissot, Frederic, Tweddle, Lorraine, van Boemmel, Florian, von Lilienfeld-Toal, Marie, Viscoli, Claudio, Ward, Katherine, and Wood, Craig

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, HIV Infections, Pneumocystis carinii, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Hematologic Neoplasms, Humans, Pneumonia, Pneumocystis, Stem Cell Transplantation, Pharmacology, Pharmacology (medical), Infectious Diseases, Medicine, In patient, Intensive care medicine, hematopoietic stem cell transplant, business.industry, Pneumocystis, PNEUMOCYSTIS JIROVECI, Pneumocystis jiroveci, infection, hematopoietic stem cell transplant, Pneumocystis jirovecii Pneumonia, Pneumocystis jiroveci, Pneumonia, medicine.disease, infection, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], Stem cell, business, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5]
Abstract

Contains fulltext : 169784.pdf (Publisher’s version ) (Closed access)

Published
2017

3. Détection d’un disaccharide (MSDS) par spectrométrie de masse. Analyse multicentrique de son intérêt pour le diagnostic des infections fongiques invasives

Author

Alexandre Mery, Pierre-Yves Bochud, Boualem Sendid, Mikulska Malgorzata, Alexandre Alanio, Damonti Lauro, Marjorie Cornu, Helena De Carolis, Nadine François, Claudio Viscoli, Daniel Poulain, Valérie Letscher-Bru, Raoul Herbrecht, Frédéric Dalle, Yann Guerarde, and Maurizio Sanguinetti

Subjects
Infectious Diseases
Abstract

Introduction Nous avons recemment decrit une methode utilisant la spectrometrie de masse MALDI-TOF pour detecter, identifier et quantifier un disaccharide (MSDS) dont la presence dans le serum est associee aux infections fongiques invasives (IFI). Nos premieres investigations, portant sur des cas de candidoses et d’aspergilloses invasives (IC et IA) recrutes dans notre CHU, ont montre que les performances diagnostiques de cette methode etaient comparables a celles des tests Platelia™ et Fungitell ® et qu’en outre elle permettait de diagnostiquer les mucormycoses (MM) pour lesquelles ces tests serologiques sont en defaut. Cette etude a comme objectif de confirmer ces resultats de maniere multicentrique. Patients et methodes Les patients ont ete selectionnes, par divers centres specialises dans la prise en charge d’IFI, sur base de la disponibilite de serums durant des episodes infectieux documentes. Les patients atteints de CI, provenaient des centres de Genes et de Rome (26 patients, 57 serums). Les patients atteints d’AI provenaient de Strasbourg (19 patients, 52 serums). Les patients atteints de mucormycoses provenaient de deux centres Paris et Dijon (23 patients, 72 serums). Des temoins hospitalises presentant les memes facteurs de risque que les patients atteints d’IFI ont egalement ete selectionnes par des centres exterieurs et testes a l’aveugle parallelement a ces derniers. Il s’agissait de 20 patients neutropeniques (Genes) et de 20 patients de reanimation ayant presente une bacteriemie (Lausanne). Pour chaque type d’IFI, les tests preconises pour leur diagnostic visant a detecter le Mannane (Mnn), le Galactomannane (GM), les b-glucanes (BDG) ou la q-PCR ont ete realises parallelement a la detection du MSDS. Resultats L’etablissement de courbes ROC pour les IC et les IA a permis de definir un cutoff optimal du MSDS a 290 permettant de differencier au mieux les patients atteints d’IFI des temoins. Les resultats correspondants en termes de sensibilite et de specificite sont resumes dans le tableau ci-dessous par comparaison aux tests de detection des glycannes actuellement disponibles ( Tableau 1 ). Pour les MM, un certain nombre de resultats en cours d’acquisition seront integres a notre communication. Il ressort des resultats preliminaires une cinetique de circulation differente de l’ADN et du MSDS. Bien que la sensibilite de ce dernier soit inferieure a celle de la q-PCR, il permet de diagnostiquer isolement des cas de MM et se revele complementaire dans l’evolution de leur suivi. Conclusion Cette etude confirme l’interet diagnostique du MSDS, sa precocite, sensibilite et sa specificite sont comparables a celles de tests recommandes par l’EORTC et l’IDSA. Le caractere panfongique du MSDS permet de le proposer en test de depistage pour les patients a haut risque. Sa contribution au diagnostic apparait complementaire de celle des tests actuels dont aucun n’est adapte, a lui seul, a la detection de l’ensemble des IFI.

Published
2017

4. Risk factors for severe complications of the novel influenza A (H1N1): analysis of patients hospitalized in Italy

Author

Bassetti, M., Parisini, A., Calzi, A., Pallavicini, F. M., Cassola, G., Artioli, S., Anselmo, M., Pagano, G., Rezza, G., Viscoli, Claudio, Ligurian H1N1 Collaborative Group, Mikulska, MALGORZATA KAROLINA, and Ansaldi, Filippo

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Pediatrics, Complications, Adolescent, Critical Care, medicine.disease_cause, law.invention, Lung Disorder, Young Adult, Influenza A Virus, H1N1 Subtype, Pregnancy, law, Influenza, Human, Prevalence, medicine, Influenza A virus, Humans, pneumonia, risk factors, Young adult, Risk factor, Child, Intensive care medicine, Aged, Asthma, Aged, 80 and over, business.industry, H1N1, Respiratory disease, Infant, General Medicine, Middle Aged, medicine.disease, Intensive care unit, respiratory tract diseases, Pneumonia, Infectious Diseases, Italy, Child, Preschool, Female, business
Abstract

Eighty-one patients affected by the novel influenza A (H1N1), hospitalized in North-western Italy, were studied. The median age was 32 years (range 1–81 years). Fifty-six (69%) had an underlying medical condition, including lung disorders (asthma or chronic obstructive pulmonary disease) in 34% and obesity in 25%. Fifty percent of them had pneumonia, 12% were admitted to the intensive care unit and 3% died. Antiviral treatment was initiated in 75% of patients started within 48 h. Older age and lung and neurocognitive disorders were associated with severe disease and death.

Published
2011

5. Pre-engraftment and post-engraftment Gram=negative rods bacteremia in HSCT patients: Risk factors and association with mortality

Author

Averbuch, Diana, Tridello, Gloria, Hoek, Jennifer, Mikulska, Malgorzata, Pabst, Thomas, Yanez San Segundo, Lucrecia, Akan, Hamdi, Ozcelik, Tulay, Donnini, Irene, Klyasova, Galina, Sousa, Aida Botelho, Zuckerman, Tsila, Wu, Depei, Tecchio, Cristina, La Camara, Rafael, Sahika Zeynep Aki, Ljungman, Per, Gulbas, Zafer, Nicolas, Emmanuelle, Calore, Elisabetta, Perruccio, Katia, Ram, Ron, Annaloro, Claudio, Martino, Rodrigo, Avni, Batia, Shaw, Peter, Gil, Lidia, Iacobelli, Simona, Styczynski, Jan, Engelhard, Dan, and Cesaro, Simone

6. The Prognostic Impact of the Donor/Recipient CMV Serostatus in Patients with Different Chronic Hematological Disorders after Allogeneic Hematopoietic Stem Cell Transplantation: A Report from the Infectious Diseases Working Party of EBMT

Author

Schmidt-Hieber, Martin, Tridello, Gloria, Mikulska, Malgorzata, Knelange, Nina, Blaise, Didier, Socie, Gerard, Volin, Liisa, Nicolaas Schaap, Fegueux, Nathalie, Ljungman, Per, Yakoub-Agha, Ibrahim, Milpied, Noel, Maertens, Johan, Chevallier, Patrice, Passweg, Jakob R., Cornelissen, Jan J., Russell, Nigel H., Craddock, Charles, Bourhis, Jean-Henri, Lamy, Thierry, Remenyi, Peter, Cahn, Jean-Yves, Michallet, Mauricette, Montoto, Silvia, Kroger, Nicolaus, Glass, Bertram, and Styczynski, Jan

7. Upper and/or Lower Respiratory Tract Infection Caused by Human Coronavirus After Allogeneic Stem Cell Transplantation

Author

Luis Pinana, Jose, Tridello, Gloria, Kozjin, Anne, Xhaard, Alienor, Passweg, Jakob, Polverelli, Nicola, Heras, Inmaculada, Perez, Ariadna, Sanz, Jaime, Berghuis, Dagmar, Vazquez, Lourdes, Suarez-Lledo, Maria, Itala-Remes, Maija, Arat, Mutlu, Iturrate Basaran, Isabel, Musa Karakukcu, Al Zahrani, Mohsen, Choi, Goda, Cuesta Casas, Marian Angeles, Batlle Massana, Montserrat, Viviana, Amato, Blijlevens, Nicole, Ganser, Arnold, Uckan-Cetinkaya, Duygu, Labussiere-Wallet, Helene, Shaw, Peter J., Yegin, Zeynep Arzu, Gonzalez-Vicent, Marta, Rocha, Vanderson, Ferster, Alina, Knelange, Nina, Navarro, David, Mikulska, Malgorzata, La Camara, Rafael, and Styczynski, Jan

8. Impact of early candidemia on the long-term outcome of allogeneic hematopoietic stem cell transplant in non leukemic patients: An outcome analysis on behalf of IDWP

Author

Cesaro, Simone, Tridello, Gloria, Knelange, Nina Simone, Schaap, Nicolaas, Martin, Murray, Snowden, John, Malladi, Ram, Ljungman, Per, Deconinck, Eric, Gedde-Dahl, Tobias, Russell, N. H., Socie, Gerard, Chevallier, Patrice, Maertens, Johan, Zuckerman, Tsila, Lioure, Bruno, Abayomi, Akin, Petersen, Eefke, Cornelissen, J. J., Arcese, William, Didier Blaise, Milpied, Noel, Cahn, Jean Yves, Aljurf, Mahmoud, Wreede, Liesbeth, Cordonnier, Catherineherine, La Camara, Rafael, Averbuch, Dina, Mikulska, Malgorzata, and Styczynski, Jan

9. Molecular Analysis With 16S rRNA PCR/Sanger Sequencing and Molecular Antibiogram Performed on DNA Extracted From Valve Improve Diagnosis and Targeted Therapy of Infective Endocarditis: A Prospective Study

Author

Alessandra Mularoni, Malgorzata Mikulska, Floriana Barbera, Elena Graziano, Alice Annalisa Medaglia, Daniele Di Carlo, Francesco Monaco, Diego Bellavia, Antonio Cascio, Giuseppe Raffa, Sergio Sciacca, Angelo Luca, Michele Pilato, Pier Giulio Conaldi, Mularoni, Alessandra, Mikulska, Malgorzata, Barbera, Floriana, Graziano, Elena, Medaglia, Alice Annalisa, Di Carlo, Daniele, Monaco, Francesco, Bellavia, Diego, Cascio, Antonio, Raffa, Giuseppe, Sciacca, Sergio, Luca, Angelo, Pilato, Michele, and Conaldi, Pier Giulio

Subjects
16 s and 18 s rRNA, Microbiology (medical), blood culture negative endocarditi, Infectious Diseases, molecular antibiogram, molecular analysi
Abstract

Background Molecular analysis (MA) on heart valve (HV) improves the microbiologic diagnosis of infectious endocarditis (IE). The main drawback of MA is the lack of antimicrobial susceptibility information. Methods We conducted a prospective cohort observational study of consecutive adult patients from April 2012 to May 2021 who underwent valve surgery at our hospital. The performance of MA, blood cultures (BC) and valve cultures (VC), and the diagnostic and therapeutic impact of MA were evaluated. Molecular antibiogram results were compared to culture-based antimicrobial susceptibility testing (AST). Results A total of 137 patients with definite IE and 52 patients with no IE were enrolled in the study. Among IE cases BC, VC, and MA were positive in 75 (55%), 30 (22%), and 120 (88%) of IE cases, respectively. Among 62 cases of BC-negative IE (BCNE), 57 achieved diagnosis with MA. MA led to a change of antimicrobial therapy in 92% of BCNE. MA was negative in 100% of patients with no IE. Molecular antibiogram performed on 17 valve specimens that resulted positive for pathogens potential carrier of genes encoding for multidrug resistant mechanisms showed 100% concordance with AST. Conclusions MA showed a high specificity and sensitivity in etiological diagnosis of IE. Molecular antibiogram could overcome the major limitation of MA that is the lack of susceptibility testing. We advocate for the inclusion of MA among diagnostic criteria for IE and for a more extensive use of molecular antibiogram when the culture result is negative, and MA is the only positive test.

Published
2022

10. Prospective Study on Incidence, Risk Factors and Outcome of Recurrent

Author

Erica Franceschini, Malgorzata Mikulska, Andrea Lombardi, Gregorio Basile, Laura Isabella Lupo, Giambattista Lobreglio, Daniele Roberto Giacobbe, Giancarlo Ceccarelli, Maria Adriana Cataldo, Anna Maria De Luca, Mario Venditti, Stefano Di Bella, Emanuela Caraffa, Michele Bartoletti, Enrica Giacometti, Nicola Petrosillo, Matteo Bassetti, Alessandra Oliva, Guido Granata, Ivan Gentile, Pierluigi Viale, Cristina Mussini, Alessandro Pandolfo, Paolo Bonfanti, Raffaella Borromeo, Sara Fossati, Alessandra Mularoni, Lucia Adamoli, Fabrizio Ingrassia, Filippo Lagi, Alberto Enrico Maraolo, Carlotta Rogati, Filippo Trapani, Roberto Luzzati, Alessandro Bartoloni, Mario U. Mondelli, Granata, G, Petrosillo, N, Adamoli, L, Bartoletti, M, Bartoloni, A, Basile, G, Bassetti, M, Bonfanti, P, Borromeo, R, Ceccarelli, G, De Luca, A, Di Bella, S, Fossati, S, Franceschini, E, Gentile, I, Giacobbe, D, Giacometti, E, Ingrassia, F, Lagi, F, Lobreglio, G, Lombardi, A, Lupo, L, Luzzati, R, Maraolo, A, Mikulska, M, Mondelli, M, Mularoni, A, Mussini, C, Oliva, A, Pandolfo, A, Rogati, C, Trapani, F, Venditti, M, Viale, P, Caraffa, E, Cataldo, M, Granata, Guido, Petrosillo, Nicola, Adamoli, Lucia, Bartoletti, Michele, Bartoloni, Alessandro, Basile, Gregorio, Bassetti, Matteo, Bonfanti, Paolo, Borromeo, Raffaella, Ceccarelli, Giancarlo, De Luca, Anna Maria, Di Bella, Stefano, Fossati, Sara, Franceschini, Erica, Gentile, Ivan, Giacobbe, Daniele Roberto, Giacometti, Enrica, Ingrassia, Fabrizio, Lagi, Filippo, Lobreglio, Giambattista, Lombardi, Andrea, Lupo, Laura Isabella, Luzzati, Roberto, Maraolo, Alberto Enrico, Mikulska, Malgorzata, Mondelli, Mario Umberto, Mularoni, Alessandra, Mussini, Cristina, Oliva, Alessandra, Pandolfo, Alessandro, Rogati, Carlotta, Trapani, Filippo Fabio, Venditti, Mario, Viale, Pierluigi, Caraffa, Emanuela, Cataldo, Maria Adriana, Granata G., Petrosillo N., Adamoli L., Bartoletti M., Bartoloni A., Basile G., Bassetti M., Bonfanti P., Borromeo R., Ceccarelli G., De Luca A.M., Di Bella S., Fossati S., Franceschini E., Gentile I., Giacobbe D.R., Giacometti E., Ingrassia F., Lagi F., Lobreglio G., Lombardi A., Lupo L.I., Luzzati R., Maraolo A.E., Mikulska M., Mondelli M.U., Mularoni A., Mussini C., Oliva A., Pandolfo A., Rogati C., Trapani F.F., Venditti M., Viale P., Caraffa E., and Cataldo M.A.

Subjects
medicine.medical_specialty, recurrence, genetic structures, lcsh:Medicine, Logistic regression, Clostridioides difficile, Article, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, risk factors, 030212 general & internal medicine, Risk factor, Prospective cohort study, 0303 health sciences, Adult patients, 030306 microbiology, business.industry, Incidence (epidemiology), Mortality rate, lcsh:R, General Medicine, risk factor, outcome, incidence, business, Clostridioides, Cohort study
Abstract

Background: Limited and wide-ranging data are available on the recurrent Clostridioides difficile infection (rCDI) incidence rate. Methods: We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case–control study was performed to identify risk factors associated with 30-day onset rCDI. Results: Three hundred nine patients with a first CDI were included in the study, 32% of the CDI episodes (99/309) were severe/complicated, complete follow-up was available for 288 patients (19 died during the first CDI episode, and 2 were lost during follow-up). At the end of the study, the crude all-cause mortality rate was 10.7% (33 deaths/309 patients). Two hundred seventy-one patients completed the follow-up, rCDI occurred in 21% of patients (56/271) with an incidence rate of 72/10,000 patient-days. Logistic regression analysis identified exposure to cephalosporin as an independent risk factor associated with rCDI (RR: 1.7, 95% CI: 1.1–2.7, p = 0.03). Conclusion: Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.

Published
2020

11. Improved outcome of patients with graft-versus-host disease after allogeneic hematopoietic cell transplantation for hematologic malignancies over time: an EBMT mega-file study

Author

Ibrahim Yakoub-Agha, Dirk-Jan Eikema, Silvia Montoto, Hildegard Greinix, Arnon Nagler, Mohamad Mohty, Marie Robin, Yves Chalandon, Stephen D. Robinson, Christian Chabannon, Nicolaus Kröger, Liesbeth C. de Wreede, Francesco Lanza, Stefan Schönland, Malgorzata Mikulska, Zinaida Peric, Olaf Penack, Linda Koster, Annalisa Ruggeri, Grzegorz W. Basak, Jan Styczyński, Greinix, Hildegard T, Eikema, Dirk-Jan, Koster, Linda, Penack, Olaf, Yakoub-Agha, Ibrahim, Montoto, Silvia, Chabannon, Christian, Styczynski, Jan, Nagler, Arnon, Robin, Marie, Robinson, Stephen, Chalandon, Yve, Mikulska, Malgorzata, Schönland, Stefan, Peric, Zinaida, Ruggeri, Annalisa, Lanza, Francesco, De Wreede, Liesbeth C, Mohty, Mohamad, Basak, Grzegorz W, and Kröger, Nicolaus

Subjects
Male, medicine.medical_specialty, Graft vs Host Disease, Disease, survival, Graft vs Host Disease* / prevention & control, prevention, Unrelated Donor, Internal medicine, medicine, Humans, Sibling, Alemtuzumab, ddc:616, Hematopoietic Stem Cell Transplantation* / adverse effects, Hematopoietic cell, business.industry, Incidence (epidemiology), Hematologic Neoplasms* / complications, Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, medicine.disease, mortality, Graft vs Host Disease* / etiology, Transplantation, stem cell, diagnosi, Graft-versus-host disease, surgical procedures, operative, haploidentical bone marrow, Hematologic Neoplasms, Female, business, Unrelated Donors, Calendar time
Abstract

Acute graft-versus-host disease (aGvHD) remains a major threat to successful outcome following allogeneic hematopoietic cell transplantation though advances in prophylaxis and supportive care have been made. The aim of this study is to test whether the incidence and mortality of aGvHD have decreased over time. 102,557 patients with a median age of 47.6 years and with malignancies after first allogeneic sibling or unrelated donor (URD) transplant were studied in the following periods: 1990-1995, 1996-2000, 2001-2005, 2006-2010 and 2011-2015. Findings: 100-day incidences of aGvHD grades II-IV decreased from 40% to 38%, 32%, 29% and 28%, respectively, over calendar time (P

Published
2020

12. Fluoroquinolone prophylaxis in haematological cancer patients with neutropenia: ECIL critical appraisal of previous guidelines

Author

Malgorzata Mikulska, Diana Averbuch, Frederic Tissot, Catherine Cordonnier, Murat Akova, Thierry Calandra, Marcello Ceppi, Paolo Bruzzi, Claudio Viscoli, Mahmoud Aljurf, Dina Averbuch, Rosemary Barnes, Ola Blennow, Pierre-Yves Bochud, Emilio Bouza, Stephane Bretagne, Roger Brüggemann, Jordi Carratala, Simone Cesaro, Oliver Cornely, Tina Dalianis, Rafael De La Camara, Peter Donnelly, Lubos Drgona, Rafael Duarte, Hermann Einsele, Dan Engelhard, Christopher Fox, Corrado Girmenia, Andreas Groll, Dag Heldal, Jannick Helweg Larsen, Raoul Herbrecht, Hans Hirsch, Elisabeth Johnson, Galina Klyasova, Minna Koskuenvo, Katrien Lagrou, Russel E. Lewis, Per Ljungman, Johan Maertens, Georg Maschmeyer, Marcio Nucci, Christophe Padoin, Livio Pagano, Antonio Pagliuca, Zdenek Racil, Patricia Ribaud, Christine Rinaldo, Valérie Rizzi Puechal, Emmanuel Roilides, Christine Robin, Montserrat Rovira, Markus Rupp, Sonia Sanchez, Peter Schellongowski, Peter Sedlacek, Janos Sinko, Monica Slavin, Isabella Sousa Ferreira, Jan Styczynski, Katherine Ward, Anne-Therese Witschi, Mikulska, Malgorzata, Averbuch, Diana, Tissot, Frederic, Cordonnier, Catherine, Akova, Murat, Calandra, Thierry, Ceppi, Marcello, Bruzzi, Paolo, Viscoli, Claudio, Aljurf, Mahmoud, Averbuch, Dina, Barnes, Rosemary, Blennow, Ola, Bochud, Pierre-Yve, Bouza, Emilio, Bretagne, Stephane, Brüggemann, Roger, Carratala, Jordi, Cesaro, Simone, Cornely, Oliver, Dalianis, Tina, De La Camara, Rafael, Donnelly, Peter, Drgona, Lubo, Duarte, Rafael, Einsele, Hermann, Engelhard, Dan, Fox, Christopher, Girmenia, Corrado, Groll, Andrea, Heldal, Dag, Larsen, Jannick Helweg, Herbrecht, Raoul, Hirsch, Han, Johnson, Elisabeth, Klyasova, Galina, Koskuenvo, Minna, Lagrou, Katrien, Lewis, Russel E., Ljungman, Per, Maertens, Johan, Maschmeyer, Georg, Nucci, Marcio, Padoin, Christophe, Pagano, Livio, Pagliuca, Antonio, Racil, Zdenek, Ribaud, Patricia, Rinaldo, Christine, Puechal, Valérie Rizzi, Roilides, Emmanuel, Robin, Christine, Rovira, Montserrat, Rupp, Marku, Sanchez, Sonia, Schellongowski, Peter, Sedlacek, Peter, Sinko, Jano, Slavin, Monica, Ferreira, Isabella Sousa, Styczynski, Jan, Ward, Katherine, and Witschi, Anne-Therese

Subjects
Neutropenic, Microbiology (medical), Ciprofloxacin, Febrile neutropenia, Infection, Levofloxacin, Multidrug resistance (MDR), Prevention, Quinolone, medicine.medical_specialty, Neutropenia, Guidelines as Topic, Infections, law.invention, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Randomized controlled trial, law, Internal medicine, medicine, Humans, Ciprofloxacin, Febrile neutropenia, Infection, Levofloxacin, Multidrug resistance (MDR), Neutropenic, Prevention, Quinolone, Microbiology (medical), Infectious Diseases, 030212 general & internal medicine, Intensive care medicine, Infection Control, business.industry, Antibiotic Prophylaxis, medicine.disease, Anti-Bacterial Agents, Settore MED/15 - MALATTIE DEL SANGUE, Resistant bacteria, Critical appraisal, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Infectious Diseases, Hematologic Neoplasms, 030220 oncology & carcinogenesis, Haematological cancer, Observational study, business, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5], Fluoroquinolones
Abstract

Contains fulltext : 190513.pdf (Publisher’s version ) (Closed access) OBJECTIVES: Fluoroquinolone (FQ) prophylaxis was recommended in 2005 by European Conference on Infections in Leukemia (ECIL) for patients with prolonged neutropenia. In consideration of a worldwide increase in antibiotic resistance, the issue of FQ prophylaxis during neutropenia was re-evaluated. METHODS: Literature review of randomised controlled trials (RCT) and observational studies published in years 2006-2014 was performed. Their results were analysed in meta-analysis. Meta-regression model was applied to evaluate whether the rates of FQ resistance in community and hospital settings influenced the efficacy of FQ prophylaxis. The impact of FQ prophylaxis on colonisation and infection with resistant bacteria was reviewed. RESULTS: Two RCTs and 12 observational studies were identified. FQ prophylaxis did not have effect on mortality (pooled OR 1.01, 95%CI 0.73-1.41), but was associated with lower rate of bloodstream infections (BSI) (pooled OR 0.57, 95%CI 0.43-0.74) and episodes of fever during neutropenia (pooled OR 0.32, 95%CI 0.20-0.50). No effect of the background rate of FQ resistance on the efficacy of FQ prophylaxis was observed. In few studies, FQ prophylaxis resulted in an increased colonisation or infection with FQ- or multi-drug resistant strains. CONCLUSIONS: The possible benefits of FQ prophylaxis on BSI rate, but not on overall mortality, should be weighed against its impact in terms of toxicity and changes in local ecology in single centres.

Published
2018

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