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1. SARS‐CoV‐2 superinfection and reinfection with three different strains

Author

Pilar Catalán, Luis Alcalá, Rubén Francisco Flores-García, Cristina Rodríguez-Grande, Darío García de Viedma, Sergio Buenestado-Serrano, Laura Pérez-Lago, Martha Kestler, Pedro J Sola-Campoy, Patricia Muñoz, Marta Herranz, Julia Suárez-González, and Carolina Martínez-Laperche

Subjects
2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Short Communication, viruses, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Virus diseases, medicine.disease_cause, SARS‐CoV‐2, Disease Outbreaks, COVID‐19, genomics, medicine, Animals, Nosocomial outbreak, General Veterinary, General Immunology and Microbiology, SARS-CoV-2, business.industry, COVID-19, virus diseases, General Medicine, After discharge, Virology, Reinfection, Superinfection, business
Abstract

We report a corona virus disease (COVID‐19) case with unprecedented viral complexity. In the first severe episode, two different severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) strains (superinfection) were identified within a week. Three months after discharge, the patient was readmitted and was infected in a nosocomial outbreak with a different strain, suffering a second milder COVID‐19 episode.

Published
2021
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2. Prevention, Diagnosis and Management of Post-Surgical Mediastinitis in Adults Consensus Guidelines of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES)

Author

Javier Hortal, Arístides de Alarcón, Dolores Sousa, Miguel Ángel Goenaga, Marta Rodríguez-Créixems, José M. Miró, Mercedes Nieto, María Carmen Fariñas, Carlos A. Mestres, Enrique Pérez de la Sota, Francisco Gutiérrez-Díez, Jorge Rodríguez-Roda, J.M. Lasso, Enrique Navas, Carlos Velasco García de Sierra, Hugo Rodríguez-Abella, Gemma Sánchez Espín, Emilio Bouza, Martha Kestler, Antonio Parra, Patricia Muñoz, Juan Gálvez, and Universidad de Cantabria

Subjects
medicine.medical_specialty, Cardiovascular infection, business.industry, Surgical wound infection, Sternal wound infections, Workload, General Medicine, Review, Cardiac surgery, medicine.disease, Mediastinitis, Surgery, Harm, Multidisciplinary approach, Intensive care, Health care, Post-surgical mediastinitis, medicine, Medicine, business, Infection
Abstract

This is a consensus document of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES). These three entities have brought together a multidisciplinary group of experts that includes anaesthesiologists, cardiac and cardiothoracic surgeons, clinical microbiologists, infectious diseases and intensive care specialists, internal medicine doctors and radiologists. Despite the clinical and economic consequences of sternal wound infections, to date, there are no specific guidelines for the prevention, diagnosis and management of mediastinitis based on a multidisciplinary consensus. The purpose of the present document is to provide evidence-based guidance on the most effective diagnosis and management of patients who have experienced or are at risk of developing a post-surgical mediastinitis infection in order to optimise patient outcomes and the process of care. The intended users of the document are health care providers who help patients make decisions regarding their treatment, aiming to optimise the benefits and minimise any harm as well as the workload.

Published
2021

3. A Contemporary Picture of Enterococcal Endocarditis

Author

Juan M. Pericàs, Jaume Llopis, Patricia Muñoz, Juan Gálvez-Acebal, Martha Kestler, Maricela Valerio, Marta Hernández-Meneses, Miguel Á. Goenaga, Manuel Cobo-Belaustegui, Miguel Montejo, Guillermo Ojeda-Burgos, M. Dolores Sousa-Regueiro, Arístides de Alarcón, Antonio Ramos-Martínez, José M. Miró, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre Lima, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Josune Goikoetxea, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, 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, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, Ma del Mar Alonso, Beatriz Castro, Dácil García Rosado, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, 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, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Jaume Llopis Pérez, Francesc Marco, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Daniel Celemín, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Ana García Mansilla, Ma Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Mercedes Marín, Manuel Martínez-Sellés, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Alberto Fortaleza, Pablo García Pavía, Jesús González, Ana Fernández Cruz, Elena Múñez, Antonio Ramos, 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, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Antonio Cabrera Villegas, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, García-Domínguez Gloria, Sánchez-Porto Antonio, José Ma Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, 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, Nazaret Cobos Trigueros, María Jesús Del Amor Espín, José Antonio Giner Caro, Roberto Jiménez Sánchez, Amaya Jimeno Almazán, Alejandro Ortín Freire, Monserrat Viqueira González, Pere Pericás Ramis, Ma Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Ma Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars, Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego, Héctor Marrero Santiago, Isabel de Miguel Martínez, Elena Pisos Álamo, Carmen Díaz Pedroche, Fernando Chaves, Santiago de Cossío, Francisco López Medrano, Ma Jesús López, Javier Solera, Jorge Solís, Carmen Ardanuy, Guillermo Cuervo Requena, Sara Grillo, and Alejandro Ruiz Majoral

Subjects
Aortic valve, Male, medicine.medical_specialty, relapses, Enterococci, Epidemiology, medicine.medical_treatment, heart failure, Heart failure, 030204 cardiovascular system & hematology, Logistic regression, Prosthesis, prosthetic valves, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, enterococci, Internal medicine, Post-hoc analysis, medicine, Enterococcus faecalis, Endocarditis, Humans, 030212 general & internal medicine, Gram-Positive Bacterial Infections, Aged, Bacteria, business.industry, infective endocarditis, ComputingMilieux_PERSONALCOMPUTING, Endocarditis, Bacterial, Middle Aged, Prosthetic valves, medicine.disease, medicine.anatomical_structure, Spain, Infective endocarditis, Cohort, epidemiology, Female, Cardiology and Cardiovascular Medicine, business, Relapses
Abstract

GAMES Investigators., [Background] Enterococcal endocarditis (EE) is a growing entity in Western countries. However, quality data from large studies is lacking., [Objectives] The purpose of this study was to describe the characteristics and analyze the prognostic factors of EE in the GAMES cohort., [Methods] This was a post hoc analysis of a prospectively collected cohort of patients from 35 Spanish centers from 2008 to 2016. Characteristics and outcomes of 516 cases of EE were compared with those of 3,308 cases of nonenterococcal endocarditis (NEE). Logistic regression and Cox proportional hazards regression analysis were performed to investigate risk factors for in-hospital and 1-year mortality, as well as relapses., [Results] Patients with EE were significantly older; more frequently presented chronic lung disease, chronic heart failure, prior endocarditis, and degenerative valve disease; and had higher median age-adjusted Charlson score. EE more frequently involved the aortic valve and prosthesis (64.3% vs. 46.7%; p < 0.001; and 35.9% vs. 28.9%; p = 0.002, respectively) but less frequently pacemakers/defibrillators (1.5% vs. 10.5%; p < 0.001), and showed higher rates of acute heart failure (45% vs. 38.3%; p = 0.005). Cardiac surgery was less frequently performed in EE (40.7% vs. 45.9%; p = 0.024). No differences in in-hospital and 1-year mortality were found, whereas relapses were significantly higher in EE (3.5% vs. 1.7%; p = 0.035). Increasing Charlson score, LogEuroSCORE, acute heart failure, septic shock, and paravalvular complications were risk factors for mortality, whereas prior endocarditis was protective and persistent bacteremia constituted the sole risk factor for relapse., [Conclusions] Besides other baseline and clinical differences, EE more frequently affects prosthetic valves and less frequently pacemakers/defibrillators. EE presents higher rates of relapse than NEE.

Published
2020

5. Clinical Factors Associated with Reinfection versus Relapse in Infective Endocarditis: Prospective Cohort Study

Author

Antonio Ramos-Martínez, Patricia Muñoz, David Vinuesa, Rafael Luque, Jorge Calderón-Parra, Emilio Bouza, Martha Kestler, Juan M. Pericàs, Guillermo Ojeda-Burgos, Antonio Plata, Mª Carmen Fariñas, Miguel Ángel Goenaga, Tomás Echeverría, Arístides de Alarcón, Ana Fernández-Cruz, Maricela Valerio, UAM. Departamento de Medicina, GAMES Investigators, [Calderón-Parra,J, Ramos-Martínez,A, Fernández-Cruz,A] Unidad de Enfermedades Infecciosas, Hospital Universitario Puerta de Hierro- Majadahonda (IDIPHSA), Madrid, Spain. [Kestler,M, Bouza,E, Valerio,M, Muñoz,P] Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain. [Bouza,E, Muñoz,P] Enfermedades Respiratorias-CIBERES (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain. [de Alarcón,A, Luque,R] Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine Infectious Diseases Research Group, University of Seville/CSIC/University Virgen del Rocío and Virgen Macarena (IBIS), Sevilla, Spain. [Goenaga,MÁ] Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián, Spain. [Echeverría,T] Servicio de Cardiología, Hospital Donosti, San Sebastián, Spain. [Fariñas,MC] Infectious Diseases Unit, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain. [Pericàs,JM] Infectious Disease Department, Hospital Clínic de Barcelona (IDIBAPS), Barcelona, Spain. [Ojeda-Burgos,G] Unidad de Gestión Clínica de Enfermedades Infecciosas, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Plata,A] Servicio de Enfermedades Infecciosas, Hospital Regional de Málaga, Málaga, Spain. [Vinuesa,D] Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Clínico San Cecilio, Granada, Spain., and Universidad de Cantabria

Subjects
Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection [Medical Subject Headings], lcsh:Medicine, Bacteremia, Cirrosis hepática, 030204 cardiovascular system & hematology, Chronic liver disease, Enterococcus, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Liver disease, 0302 clinical medicine, Recurrence, Diseases::Cardiovascular Diseases::Heart Diseases::Endocarditis [Medical Subject Headings], 030212 general & internal medicine, Prospective cohort study, Reinfección, First episode, Endocarditis, biology, Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia [Medical Subject Headings], Bacterial, General Medicine, Diseases::Digestive System Diseases::Liver Diseases [Medical Subject Headings], Infective endocarditis, endocarditis, Organisms::Bacteria::Gram-Positive Bacteria::Lactobacillales::Enterococcaceae::Enterococcus [Medical Subject Headings], Hepatopatía, liver disease, medicine.medical_specialty, recurrence, Medicina, Recurrencia, Diseases::Digestive System Diseases::Liver Diseases::Liver Cirrhosis [Medical Subject Headings], Enfermedades infecciosas, Cardiología, Article, 03 medical and health sciences, Internal medicine, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies [Medical Subject Headings], medicine, bacterial, Procedimientos quirúrgicos cardíacos, bacteremia, cardiac surgical procedures, Cardiac surgical procedures, business.industry, lcsh:R, medicine.disease, biology.organism_classification, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Hospitalization::Patient Discharge [Medical Subject Headings], Reinfection, Bacteriemia, business
Abstract

We aimed to identify clinical factors associated with recurrent infective endocarditis (IE) episodes. The clinical characteristics of 2816 consecutive patients with definite IE (January 2008–2018) were compared according to the development of a second episode of IE. A total of 2152 out of 2282 (94.3%) patients, who were discharged alive and followed-up for at least the first year, presented a single episode of IE, whereas 130 patients (5.7%) presented a recurrence, 70 cases (53.8%) were due to other microorganisms (reinfection), and 60 cases (46.2%) were due to the same microorganism causing the first episode. Thirty-eight patients (29.2%), whose recurrence was due to the same microorganism, were diagnosed during the first 6 months of follow-up and were considered relapses. Relapses were associated with nosocomial endocarditis (OR: 2.67 (95% CI: 1.37–5.29)), enterococci (OR: 3.01 (95% CI: 1.51–6.01)), persistent bacteremia (OR: 2.37 (95% CI: 1.05–5.36)), and surgical treatment (OR: 0.23 (0.1–0.53)). On the other hand, episodes of reinfection were more common in patients with chronic liver disease (OR: 3.1 (95% CI: 1.65–5.83)) and prosthetic endocarditis (OR: 1.71 (95% CI: 1.04–2.82)). The clinical factors associated with reinfection and relapse in patients with IE appear to be different. A better understanding of these factors would allow the development of more effective therapeutic strategies.

Published
2021
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6. Prevalence of Colorectal Neoplasms Among Patients With Enterococcus faecalis Endocarditis in the GAMES Cohort (2008-2017)

Author

Juan M. Pericàs, Juan Ambrosioni, Patricia Muñoz, Arístides de Alarcón, Martha Kestler, Amaia Mari-Hualde, Asunción Moreno, Miguel Á. Goenaga, M. Carmen Fariñas, Regino Rodríguez-Álvarez, Guillermo Ojeda-Burgos, Juan Gálvez-Acebal, Carmen Hidalgo-Tenorio, Mariam Noureddine, José M. Miró, Fernando Fernández Sánchez, Gabriel Rosas, Javier de la Torre Lima, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Josune Goikoetxea, 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, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, Ma del Mar Alonso, Beatriz Castro, Dácil García Rosado, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, 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, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Daniel Celemín, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Ana García Mansilla, Ma Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Mercedes Marín, Manuel Martínez-Sellés, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Alberto Fortaleza, Pablo García Pavía, Jesús González, Ana Fernández Cruz, Elena Múñez, Antonio Ramos, 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, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Antonio Cabrera Villegas, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, García-Domínguez Gloria, Sánchez-Porto Antonio, José Ma Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, 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, Nazaret Cobos Trigueros, María Jesús Del Amor Espín, José Antonio Giner Caro, Roberto Jiménez Sánchez, Amaya Jimeno Almazán, Alejandro Ortín Freire, Monserrat Viqueira González, Pere Pericás Ramis, Ma Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Ma Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars. Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego Héctor Marrero Santiago, Isabel de Miguel Martínez, and Elena Pisos Álamo

Subjects
Male, medicine.medical_specialty, Colorectal cancer, Population, Colonoscopy, Enterococcus faecalis, Risk Factors, Internal medicine, medicine, Prevalence, Endocarditis, Humans, education, Gram-Positive Bacterial Infections, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, medicine.diagnostic_test, biology, business.industry, Retrospective cohort study, General Medicine, Endocarditis, Bacterial, Middle Aged, medicine.disease, biology.organism_classification, Infective endocarditis, Cohort, Female, business, Colorectal Neoplasms
Abstract

Objective: To investigate the rate of colorectal neoplasms (CRNs) in patients who have Enterococcus faecalis infective endocarditis (EFIE) with available colonoscopies and to assess whether this is associated with the identification of a focus the infection. Patients and Methods: Retrospective analysis of data from a prospective multicenter study involving 35 centers who are members of the Grupo de Apoyo para el Manejo de la Endocarditis en Espana [Support Group for the Management of Infective Endocarditis in Spain] cohort. A specific set of queries regarding information on colonoscopy and histopathology of colorectal diseases was sent to each participating center. Four-hundred sixty-seven patients with EFIE were included from January 1, 2008, to December 31, 2017, from whom data on colonoscopy performance and results were available in 411 patients. Results: One hundred forty-two (34.5%) patients had a colonoscopy close to the EFIE episode. The overall rate of colorectal diseases was 70.4% (100 of 142), whereas the prevalence of CRN (advanced adenomas and colorectal carcinoma) was 14.8% (21 of 142), with no significant differences between the group of EFIE of unknown focus and that with an identified focus. Conclusion: Our study adds to prior evidence suggesting a much higher rate of CRN among patients with EFIE than in the general population of the same age and sex. In addition, our findings suggest that this phenomenon might take place both in EFIE with an unknown and an identified source of infection.

Published
2019

7. Gentamicin may have no effect on mortality of staphylococcal prosthetic valve endocarditis

Author

Antonio Ramos-Martínez, Alejandro Muñoz Serrano, Arístides de Alarcón González, Patricia Muñoz, Ana Fernández-Cruz, Maricela Valerio, María Carmen Fariñas, Manuel Gutiérrez-Cuadra, José Ma Miró, Josefa Ruiz-Morales, Dolores Sousa-Regueiro, José Miguel Montejo, Juan Gálvez-Acebal, Carmen HidalgoTenorio, Fernando Domínguez, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre Lima, José Aramendi, Elena Bereciartua, Roberto Blanco, María Victoria Boado, Itxasne Cabezón Estébanez, Marta Campaña Lázaro, Josune Goikoetxea, Juan José Goiti, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodríguez, Regino Rodríguez, Roberto Voces, Ma Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, Ma del Mar Alonso, Beatriz Castro, Dácil García Rosado, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, 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, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, 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, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Gregorio Cuerpo Caballero, Ana Fernández Cruz, Ma Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Mercedes Marín, Manuel Martínez-Sellés, Ma Cruz Menárguez, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Pablo García Pavíaz, Jesús Gonzálezz, Beatriz Ordenz, Antonio Ramosz, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Arístides de Alarcón, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, Gloria García Domínguez, Antonio Sánchez-Porto, José Ma Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, 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, Pilar Egea Serrano, José Joaquín Hernández Roca, Ivan Keituqwa Yañez, Ana Peláez Ballesta, Víctor Soriano, 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, and Juan Carlos Porres

Subjects
Male, 0301 basic medicine, Microbiology (medical), Staphylococcus aureus, medicine.medical_specialty, Prosthesis-Related Infections, 030106 microbiology, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Cloxacillin, Vancomycin, Internal medicine, medicine, Humans, Endocarditis, Pharmacology (medical), Prospective Studies, Renal Insufficiency, 030212 general & internal medicine, Aged, Heart Failure, business.industry, Endocarditis, Bacterial, Middle Aged, Staphylococcal Infections, medicine.disease, Anti-Bacterial Agents, Regimen, Infectious Diseases, Heart Valve Prosthesis, Multivariate Analysis, Female, Gentamicin, Gentamicins, Rifampin, business, Complication, Rifampicin, medicine.drug
Abstract

Purpose: To analyze the influence of adding gentamicin to a regimen consisting of β-lactam or vancomycin plus rifampicin on survival in patients suffering from Staphylococcal prosthetic valve endocarditis (SPVE). Methods: From January 2008 to September 2016, 334 patients with definite SPVE were attended in the participating hospitals. Ninety-four patients (28.1%) received treatment based on β-lactam or vancomycin plus rifampicin and were included in the study. Variables were analyzed which related to patient survival during admission, including having received treatment with gentamicin. Results: Seventy-seven (81.9%) were treated with cloxacillin (or vancomycin) plus rifampicin plus gentamicin, and 17 patients (18.1%) received the same regimen without gentamicin. The causative microorganism was Staphylococcus aureus in 40 cases (42.6%) and coagulase-negative staphylococci in 54 cases (57.4%). Overall, 40 patients (42.6%) died during hospital admission, 33 patients (42.9%) in the group receiving gentamicin and 7 patients in the group that did not (41.2%, P = 0.899). Worsening renal function was observed in 42 patients (54.5%) who received gentamicin and in 9 patients (52.9%) who did not (p = 0.904). Heart failure as a complication of endocarditis (OR: 4.58; CI 95%: 1.84–11.42) and not performing surgery when indicated (OR: 2.68; CI 95%: 1.03–6.94) increased mortality. Gentamicin administration remained unrelated to mortality (OR: 1.001; CI 95%: 0.29–3.38) in the multivariable analysis. Conclusions: The addition of gentamicin to a regimen containing vancomycin or cloxacillin plus rifampicin in SPVE was not associated to better outcome.

Published
2018
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8. Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study

Author

Dolores Sousa, Ana Fernández-Cruz, Maricela Valerio, Antonio Ramos-Martínez, Laura Vidal, Patricia Muñoz, José M. Miró, Martha Kestler, M. Carmen Fariñas, Juan M. Pericàs, Guillermo Ojeda-Burgos, Miguel Montejo, Fernando Domínguez, Antonio Plata, Universidad de Cantabria, and UAM. Departamento de Medicina

Subjects
Male, Time Factors, humanos, gentamicinas, ampicilina, 030204 cardiovascular system & hematology, Pathology and Laboratory Medicine, Cohort Studies, 0302 clinical medicine, Antibiotics, estudios prospectivos, Medicine and Health Sciences, Enterococcus faecalis, Prospective Studies, 030212 general & internal medicine, estudios de cohortes, Prospective cohort study, Aged, 80 and over, anciano, Multidisciplinary, Endocarditis, biology, Antimicrobials, Pharmaceutics, farmacoterapia, Ceftriaxone, Drugs, Vàlvules, infecciones por bacterias grampositivas, Prognosis, Hospitals, Bacterial Pathogens, Anti-Bacterial Agents, Medical Microbiology, Four-week course, Infective endocarditis, Medicine, Drug Therapy, Combination, Female, Pathogens, antibacterianos, Research Article, Cohort study, medicine.drug, medicine.medical_specialty, Efficacy, Medicina, Science, Cardiology, Surgical and Invasive Medical Procedures, Iinternational guidelines, Enterococcus Faecalis, Microbiology, 03 medical and health sciences, factores de tiempo, Signs and Symptoms, Drug Therapy, Diagnostic Medicine, Microbial Control, Internal medicine, Mortalitat, medicine, Humans, Mortality, Microbial Pathogens, Gram-Positive Bacterial Infections, Aged, Pharmacology, Native Valve Endocarditis, Bacteria, business.industry, Organisms, Biology and Life Sciences, Endocarditis, Bacterial, medicine.disease, biology.organism_classification, Valves, Treatment, Health Care, Abscesses, Regimen, ceftriaxona, Health Care Facilities, Ampicillin, Clinical Medicine, Gentamicins, business, Enterococcus
Abstract

Enterococcus faecalis infective endocarditis (EFIE) is a severe disease of increasing incidence. The objective was to analyze whether the outcome of patients with native valve EFIE (NVEFIE) treated with a short course of ampicillin plus ceftriaxone (4wAC) was similar to patients treated according to international guidelines (6wAC). Between January 2008 and June 2018, 1,978 consecutive patients with definite native valve IE were prospectively included in a national registry. Outcomes of patients with NVEFIE treated with 4wAC were compared to those of patients who received 6wAC. Three hundred and twenty-two patients (16.3%) had NVEFIE. One hundred and eighty-three (56.8%) received AC. Thirty-nine patients (21.3%) were treated with 4wAC for four weeks and 70 patients (38.3%) with 6wAC. There were no differences in age or comorbidity. Patients treated 6wAC presented a longer duration of symptoms before diagnosis (21 days, IQR 7-60 days vs. 7 days, IQR 1-22 days; p = 0.002). Six patients presented perivalvular abscess and all of these received 6wAC. Surgery was performed on 14 patients (35.9%) 4wAC and 34 patients (48.6%) 6wAC (p = 0.201). In-hospital mortality, one-year mortality and relapses among 4wAC and 6wAC patients were 10.3% vs. 11.4% (p = 0.851); 17.9% vs. 21.4% (p = 0.682) and 5.1% vs. 4.3% (p = 0.833), respectively. In conclusion, a four-week course of AC may be considered as an alternative regimen in NVEFIE, notably in patients with shorter duration of symptoms and those without perivalvular abscess. These results support the performance of a randomized clinical trial to evaluate the efficacy of this short regimen., This work was supported in part by the “Fondo de Investigaciones Sanitarias” (FIS) grant 17/01251 from the “Instituto de Salud Carlos III”, Madrid, Spain awarded to JMM. JMM received a personal 80:20 research grant from the Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain, during 2017–19. JMP was member of the Endocarditis Team of the Hospital Clinic of Barcelona, Spain when this project was approved by the GAMES Steering Committee.’

Published
2020
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9. Assessment of the anti-biofilm effect of micafungin in an animal model of catheter-related candidemia

Author

María Guembe, Lorena Cussó, Beatriz Salinas, Patricia Muñoz, Manuel Desco, Jesús Guinea, Emilio Bouza, and Martha Kestler

Subjects
medicine.medical_specialty, Antifungal Agents, Catheters, Femoral vein, Gastroenterology, Group B, Persistence (computer science), 03 medical and health sciences, In vivo, Weight loss, Internal medicine, Candida albicans, medicine, Animals, Rats, Wistar, 030304 developmental biology, 0303 health sciences, biology, 030306 microbiology, business.industry, Micafungin, Animal Structures, Candidemia, General Medicine, biology.organism_classification, Survival Analysis, Catheter, Disease Models, Animal, Infectious Diseases, Treatment Outcome, Biofilms, Catheter-Related Infections, Luminescent Measurements, Female, medicine.symptom, business, medicine.drug
Abstract

In cases where catheter-related candidemia (CRC) must be managed without catheter withdrawal, antifungal lock therapy using highly active anti-biofilm (HAAB) agents is combined with systemic treatment. However, the activity of HAAB agents has never been studied in in vivo models using bioluminescence. We assessed the efficacy of micafungin using a bioluminescent Candida albicans SKCA23-ACTgLuc strain in an animal model of CRC. We divided 33 female Wistar rats into five groups: sham (A), infected nontreated (B), treated with lock therapy (0.16 mg/ml) (C), systemically treated only (1 mg/kg) (D), and systemically treated+lock (E). Catheters were colonized 24 h before insertion into the femoral vein (day 0). Treatment started on day 1 and lasted 7 days, followed by 7 days of surveillance. Bioluminescence assays were carried out on days 1, 3, 5, and 14, together with daily monitoring of clinical variables. Postmortem microbiological cultures from the catheter and several tissue samples were also obtained. Overall, 28 rats (84.8%) completed the study. Group B animals showed significant weight loss at days 2, 4, and 5 compared with groups C and D (P < .05). In group B, no animals survived after day 7, 75% had CRC, and bioluminescence remained constant 5 days after catheter implantation. Positive catheter culture rates in groups C, D, and E were, respectively, 83.3%, 62.5%, and 25.0% (P = .15). Micafungin proved to be a HAAB agent when administered both systemically and in lock therapy in an animal model of CRC, although the bioluminescence signal persists after treatment. This persistence should be further analyzed.

Published
2018

10. Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis—The ESCAPE Study

Author

Rivoisy, Claire, Vena, Antonio, Schaeffer, Laura, Charlier, Caroline, Fontanet, Arnaud, Delahaye, François, Bouza, Emilio, Lortholary, Olivier, Lefort, Agnès, Yazdanpanah, Yazdan, Wolff, Michel, Houze, Sandrine, Ferry, Tristan, Wallon, Martine, Strady, Christophe, Toubas, Dominique, Bréchot, Nicolas, Henry, Benoit, Fekkar, Arnaud, Fourme, Thierry, Amouroux, Isabelle, Mainardi, Jean-Luc, Dannaoui, Eric, Rogeaux, Olivier, Levast, Marion, Chirouze, Catherine, Million, Laurence, Bastides, Frédéric, Chandenier, Jacques, Lançon, Jean-Pierre, Ovize, Anne, Abgueguen, Pierre, Bouchara, Jean-Philippe, Tric, Laurent, Habib, Gilbert, Gourriet, Frederic, Aaron, Laurent, Bougnoux, Marie Elisabeth, Camou, Fabrice, Accoceberry, Isabelle, Sánchez, Fernando Fernández, Noureddine, Mariam, Rosas, Gabriel, de la Torre Lima, Javier, Aramendi, José, Bereciartua, Elena, Victoria Boado, María, Campaña Lázaro, Marta, Goikoetxea, Josune, José Goiti, Juan, Hernández, José Luis, Iruretagoyena, José Ramón, Zuazabal, Josu Irurzun, López-Soria, Leire, Montejo, Miguel, Pérez, Pedro María, Rodríguez, Regino, Voces, Roberto, López, Mª Victoria García, Georgieva, Radka Ivanova, Solero, Manuel Márquez, Bailón, Isabel Rodríguez, Morales, Josefa Ruiz, Cuende, Ana María, Echeverría, Tomás, Fuerte, Ana, Gaminde, Eduardo, Goenaga, Miguel Ángel, Idígoras, Pedro, Iribarren, José Antonio, Yarza, Alberto Izaguirre, Urkola, Xabier Kortajarena, Reviejo, Carlos, Carrasco, Rafael, Climent, Vicente, Llamas, Patricio, Merino, Esperanza, Plazas, Joaquín, Reus, Sergio, Álvarez, Nemesio, Bravo-Ferrer, Jose María, Castelo, Laura, Cuenca, José, Llinares, Pedro, Rey, Enrique Miguez, Mayo, María Rodríguez, Sánchez, Efrén, Regueiro, Dolores Sousa, Martinez, Francisco Javier, del Mar Alonso, Mª, Castro, Beatriz, Marrero, Dácil García, Durán, Mª del Carmen, Gómez, Mª Antonia Miguel, Calzada, Juan La, Nassar, Ibrahim, Ciezar, Antonio Plata, Iglesias, José Mª Reguera, Asensio, Víctor, Costas, Carlos, de la Hera, Jesús, Suárez, Jonnathan Fernández, Fraile, Lisardo Iglesias, Arguero, Víctor León, Menéndez, José López, MenciaBajo, Pilar, Morales, Carlos, Torrico, Alfonso Moreno, Palomo, Carmen, Martínez, Begoña Paya, Esteban, Ángeles Rodríguez, García, Raquel Rodríguez, Asensio, Mauricio Telenti, Almela, Manuel, Armero, Yolanda, Azqueta, Manuel, Brunet, Merce, Cartañá, Ramón, Cervera, Carlos, Falces, Carlos, Fita, Guillermina, Fuster, David, de la Maria, Cristina García, Gatell, José, Pérez, Jaume Llopis, Marco, Francesc, Mestres, Carlos, Miró, José Mª, Moreno, Asunción, Ninot, Salvador, Quintana, Eduardo, Paré, Carlos, Pericás, Juan Manuel, Pomar, José, Ramírez, José, Rovira, Irene, Sitges, Marta, Soy, Dolors, Téllez, Adrián, Vila, Jordi, Bermejo, Javier, Cuerpo, Gregorio, de Egea, Viviana, Eworo, Alia, Cruz, Ana Fernández, Leoni, Mª Eugenia García, del Vecchio, Marcela González, Ramallo, Víctor González, Hernández, Martha Kestler, Marín, Mercedes, Martínez-Sellés, Manuel, Menárguez, Mª Cruz, Muñoz, Patricia, Rincón, Cristina, Rodríguez-Abella, Hugo, Rodríguez-Créixems, Marta, Pinilla, Blanca, Pinto, Ángel, Valerio, Maricela, Moreno, Eduardo Verde, Antorrena, Isabel, Loeches, Belén, Moreno, Mar, Ramírez, Ulises, Bastón, Verónica Rial, Romero, María, Saldaña, Araceli, Castillo, Carlos Armiñanzas, Arnaiz, Ana, Berrazueta, José, Bellisco, Sara, Belaustegui, Manuel Cobo, Durán, Raquel, Fariñas, MªCarmen, Fariñas-Álvarez, Concepción, Mazarrasa, Carlos Fernández, Izquierdo, Rubén Gómez, Rico, Claudia González, Díez, José Gutiérrez, Durán, Rafael Martín, Pajarón, Marcos, Parra, José Antonio, Teira, Ramón, Zarauza, Jesús, Pavía, Pablo García, González, Jesús, Orden, Beatriz, RAMOS, Antonio, González, Elena Rodríguez, Centella, Tomasa, Hermida, José Manuel, Luis Moya, José, Martín-Dávila, Pilar, Navas, Enrique, Oliva, Enrique, del Río, Alejandro, Ruiz, Soledad, Tenorio, Carmen Hidalgo, de Castro, Antonio, de Cueto, Marina, Gallego, Pastora, Acebal, Juan Gálvez, Baño, Jesús Rodríguez, de Alarcón, Arístides, García, Emilio, Haro, Juan Luis, Lepe, José Antonio, López, Francisco, Luque, Rafael, Alonso, Luis Javier, Gutiérrez, José Manuel Azcona, Blanco, José Ramón, García, Lara, Oteo, José Antonio, de Benito, Natividad, Gurguí, Mercé, Pacho, Cristina, Pericas, Roser, Pons, Guillem, Alvarez, M., Fernández, A, Prieto, A., Regueiro, Benito, Tijeira, E, Vega, Marino, Blasco, Andrés Canut, Mollar, José Cordo, Arana, Juan Carlos Gainzarain, Uriarte, Oscar García, López, Alejandro Martín, de Zárate, Zuriñe Ortiz, Matos, José Antonio Urturi, Nacle, Mª Belén, Sánchez-Porto, Antonio, Vallejo, Luis, ArribasLeal, José Mª, Vázquez, Elisa García, Torres, Alicia Hernández, Blázquez, Ana, de la Morena Valenzuela, Gonzalo, Alonso, Ángel, Aramburu, Javier, Calvo, Felicitas Elena, Rodríguez, Anai Moreno, Tarabini-Castellani, Paola, Gálvez, Eva Heredero, Bellido, Carolina Maicas, Pau, José Largo, Sepúlveda, Mª Antonia, Sierra, Pilar Toledano, Iqbal-Mirza, Sadaf Zafar, Alcolea, Eva Cascales, Serrano, Pilar Egea, Hernández Roca, José Joaquín, Service des Maladies infectieuses et tropicales [CHU Necker], Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP]-Institut des Maladies Génétiques Imagine [Paris], Hospital General Universitario 'Gregorio Marañón' [Madrid], Epidémiologie des Maladies Emergentes, Pasteur-Cnam risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre d'infectiologie Necker-Pasteur [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Mère et enfant face aux infections tropicales (MERIT - UMR_D 216), Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5), Service de Parasitologie, Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Matrice extracellulaire et dynamique cellulaire - UMR 7369 (MEDyC), SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Centre National de la Recherche Scientifique (CNRS), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP], Institut Élie Cartan de Lorraine (IECL), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [APHP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Mycologie moléculaire, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Service des Maladies Infectieuses, CHR Chambéry, Laboratoire de Bactériologie, Centre Hospitalier Régional de Chambéry, Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de Médecine Interne et Maladies Infectieuses [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Tours, Service de Parasitologie - Mycologie - Médecine Tropicale, Eurofins Biomnis [Lyon, France], Service des maladies infectieuses et tropicales [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Groupe d’Etude des Interactions Hôte-Pathogène, Université d'Angers (UA), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Biologie et Pathogénicité fongiques, Institut National de la Recherche Agronomique (INRA)-Institut Pasteur [Paris], Hôpital St-André, Réanimation, CHU Bordeaux [Bordeaux], Microbiologie cellulaire et moléculaire et pathogénicité (MCMP), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Universitad Politecnica de Alicante (UPA), Departamento de Lenguajes y Sistemas Informaticos, Instituto Tecnologico de Aragon (ITA), Instituto Tecnológico de Aragón, Department of Anatomy and Cell Biology [Montréal], McGill University, Universitat de Barcelona (UB), AIDS Research Group [Barcelona, Spain], August Pi i Sunyer Biomedical Research Institute - IDIBAPS [Barcelona, Spain]-Hospital Clinic [Barcelona, Spain], Instituto Tecnológico de Tláhuac, Cardiology Department, Thorax Clinic Institute, Hospital Cliınic, Institut d'Investigacions Biomèdiques [Barcelona], Clinical Microbiology and Infectious Diseases Department, Universidad Complutense de Madrid [Madrid] (UCM), Universidade de Aveiro, Departamento de Quimica Organica [Universidad de Cordoba], Universidad de Córdoba [Cordoba], Department of Microbiology, Hospital de la Santa Creu i Sant Pau, University Rovirai Virgili de Tarragona (URV), Chercheur indépendant, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Mère et enfant en milieu tropical : pathogènes, système de santé et transition épidémiologique (MERIT - UMR_D 216), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA)-Centre National de la Recherche Scientifique (CNRS), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Eurofins Biomnis, Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP), Biologie et Pathogénicité fongiques (BPF), Institut National de la Recherche Agronomique (INRA)-Institut Pasteur [Paris] (IP), Microbiologie Fondamentale et Pathogénicité (MFP), Instituto Tecnológico de Aragón (ITAINNOVA), McGill University = Université McGill [Montréal, Canada], Universidad de Córdoba = University of Córdoba [Córdoba], This work was supported by the Programa Multidisciplinar para la Gestión de Antifúngicos y la Reducción de Candidiasis Invasora (PROMULGA) II Project, Instituto de Salud Carlos III, partially financed by the European Regional Development Fund (grant PI13/01148). A. V. is supported by a Rio Hortega contract from the Instituto de Salud Carlos III, also partially financed by the European Regional Development Fund (grant CM15/00181)., Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Beaujon-Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut Pasteur [Paris]-Institut National de la Recherche Agronomique (INRA), Hospital Clinic [Barcelona, Spain]-August Pi i Sunyer Biomedical Research Institute - IDIBAPS [Barcelona, Spain], and Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Antifungal Agents, Prosthesis-Related Infections, Echinocandin, 030106 microbiology, 03 medical and health sciences, Candida, endocarditis, prosthetic valve, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Amphotericin B, Internal medicine, Humans, Medicine, Endocarditis, Prospective Studies, Registries, Adverse effect, Prospective cohort study, Fluconazole, Survival rate, ComputingMilieux_MISCELLANEOUS, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Aged, Retrospective Studies, business.industry, Candidiasis, Disease Management, Retrospective cohort study, Odds ratio, Middle Aged, Prognosis, medicine.disease, 3. Good health, Infectious Diseases, Spain, Heart Valve Prosthesis, Female, France, business, medicine.drug
Abstract

International audience; Background: Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment.Methods: We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.Results: Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients

Published
2018
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11. Infective Endocarditis in Patients With Bicuspid Aortic Valve or Mitral Valve Prolapse

Author

Isabel Zegri-Reiriz, Arístides de Alarcón, Patricia Muñoz, Manuel Martínez Sellés, Victor González-Ramallo, Jose M. Miro, Carles Falces, Claudia Gonzalez Rico, Xabier Kortajarena Urkola, José Antonio Lepe, Regino Rodriguez Alvarez, Jose Maria Reguera Iglesias, Enrique Navas, Fernando Dominguez, Pablo Garcia-Pavia, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre Lima, José Aramendi, Elena Bereciartua, María José Blanco, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Josune Goikoetxea, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodrigo, David Rodríguez, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, María Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, María del Mar Alonso, Beatriz Castro, Dácil García Rosado, Mª del Carmen Durán, Mª Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, 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, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, José María Miró, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan Manuel Pericás, José Luis Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Daniel Celemín, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Ana Fernández Cruz, Ana García Mansilla, María Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Mercedes Marín, Manuel Martínez-Sellés, María Cruz Menárguez, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Fernando Domínguez, Pablo García-Pavía, Jesús González Mirelis, Beatriz Orden, Antonio Ramos, Marta Cobo-Marcos, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Oliva, Alejandro del Río, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Emilio García, Juan Luis Haro, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, Ángel Luis Fernández, Amparo Martínez, Arturo Prieto, Benito Regueiro, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, Gloria García Domínguez, Antonio Sánchez-Porto, José Mª Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, María Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Pilar Egea Serrano, José Joaquín Hernández Roca, Ivan Keituqwa Yañez, Ana Peláez Ballesta, Víctor Soriano, 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, Nazaret Cobos Trigueros, María Jesús Del Amor Espín, José Antonio Giner Caro, Roberto Jiménez Sánchez, Amaya Jimeno Almazán, Alejandro Ortín Freire, Monserrat Viqueira González, Pere Pericás Ramis, Mª Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Mª Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, and Juan Carlos Segura Luque

Subjects
Adult, Male, medicine.medical_specialty, bicuspid aortic valve, Enfermedad cardiovascular, Heart Valve Diseases, 030204 cardiovascular system & hematology, Intracardiac injection, 03 medical and health sciences, Tratamiento médico, 0302 clinical medicine, Bicuspid aortic valve, Bicuspid Aortic Valve Disease, medicine, Mitral valve prolapse, Endocarditis, Humans, In patient, 030212 general & internal medicine, Registries, Antibiotic prophylaxis, Antibióticos, Aged, Endocarditis infecciosa, Mitral Valve Prolapse, antibiotic prophylaxis, business.industry, Incidence (epidemiology), Antibiotic Prophylaxis, Middle Aged, medicine.disease, Surgery, Infective endocarditis, Aortic Valve, Válvulas cardíacas, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background: There is little information concerning infective endocarditis (IE) in patients with bicuspid aortic valve (BAV) or mitral valve prolapse (MVP). Currently, IE antibiotic prophylaxis (IEAP) is not recommended for these conditions. Objectives: This study sought to describe the clinical and microbiological features of IE in patients with BAV and MVP and compare them with those of IE patients with and without IEAP indication, to determine the potential benefit of IEAP in these conditions. Methods: This analysis involved 3,208 consecutive IE patients prospectively included in the GAMES (Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España) registry at 31 Spanish hospitals. Patients were classified as high-risk IE with IEAP indication (high-risk group; n = 1,226), low- and moderate-risk IE without IEAP indication (low/moderate-risk group; n = 1,839), and IE with BAV (n = 54) or MVP (n = 89). Results: BAV and MVP patients had a higher incidence of viridans group streptococci IE than did high-risk group and low/moderate-risk group patients (35.2% and 39.3% vs. 12.1% and 15.0%, respectively; all p < 0.01). A similar pattern was seen for IE from suspected odontologic origin (14.8% and 18.0% vs. 5.8% and 6.0%; all p < 0.01). BAV and MVP patients had more intracardiac complications than did low/moderate-risk group (50% and 47.2% vs. 30.6%, both p < 0.01) patients and were similar to high-risk group patients. Conclusions: IE in patients with BAV and MVP have higher rates of viridans group streptococci IE and IE from suspected odontologic origin than in other IE patients, with a clinical profile similar to that of high-risk IE patients. Our findings suggest that BAV and MVP should be classified as high-risk IE conditions and the case for IEAP should be reconsidered. Sin financiación 18.639 JCR (2018) Q1, 3/136 Cardiac & Cardiovascular Systems 9.280 SJR (2018) Q1, 1/365 Cardiology and Cardiovascular Medicine No data IDR 2018 UEM

Published
2018

12. Los «Endocarditis Team» de la Sociedad Española de Infecciones Cardiovasculares (SEICAV) alcanzan los 4.500 casos recogidos prospectivamente

Author

Manuel Martínez-Sellés, Miguel Montejo-Baranda, Miguel Ángel Goenaga, Juan Gálvez-Acebal, C.A. Mestres, Francisco Gutiérrez-Díez, M.C. Fariñas, Emilio Bouza, Martha Kestler, A. de Alarcón, Patricia Muñoz, D. Sousa-Regueiro, Miró Jm, and Eduard Quintana

Subjects
business.industry, Medicine, Surgery, Cardiology and Cardiovascular Medicine, business, Humanities
Published
2019
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14. Left-sided infective endocarditis in patients with liver cirrhosis

Author

J. Ruiz-Morales, R. Ivanova-Georgieva, N. Fernández-Hidalgo, E. García-Cabrera, Jose M. Miró, P. Muñoz, B. Almirante, A. Plata-Ciézar, V. González-Ramallo, J. Gálvez-Acebal, M.C. Fariñas, J.M. Bravo-Ferrer, M.A. Goenaga-Sánchez, C. Hidalgo-Tenorio, J. Goikoetxea-Agirre, A. de Alarcón-González, Fernando Fernández Sánchez, Marian Noureddine, Gabriel Rosas, Javier de la Torre Lima, José Aramendi, Elena Bereciartua, María Victoria Boado, Marta Campaña Lázaro, Juan José Goiti, José Luis Hernández, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Pedro María Pérez, Regino Rodríguez, Roberto Voces, Mª Victoria García López, Manuel Márquez Solero, Isabel Rodríguez Bailón, Gemma Sanchez Espín, Juan Otero, Ana María Cuende, Eduardo Gaminde, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Carlos Reviejo, Tomás Echeverría, Ana Fuertes, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, María del Mar Carmona, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Dolores Sousa, Mª Carmen Zúñiga, Francisco Javier Martínez-Marcos, J.M. Lomas Cabezas, Mª del Mar Alonso, Beatriz Castro, Dácil García Marrero, Mª del Carmen Durán, Mª Antonia Miguel Gómez, Juan La Calzada, Ibrahim Nassar, José Mª Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, José Manuel García Ruiz, Lisardo Iglesias Fraile, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez, Raquel Rodríguez García, Mauricio Telenti, Manuel Almela, Yolanda Armero, Manuel Azqueta, Ximena Castañeda, Carlos Cervera, Carlos Falces, Cristina García-de-la-Maria, José M. Gatell, Jaume Llopis, Francesc Marco, Carlos A. Mestres, Asunción Moreno, Salvador Ninot, José Ramírez, Marta Sitges, Carlos Paré, Juan M. Pericás, Javier Bermejo, Emilio Bouza, Viviana de Egea, Alia Eworo, Ana Fernández Cruz, Mª Eugenia García Leoni, Marcela González del Vecchio, Víctor González Ramallo, Martha Kestler Hernández, Mercedes Marín, Manuel Martínez-Sellés, Mª Cruz Menárguez, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Jorge Rodríguez Roda, Blanca Pinilla, Ángel Pinto, Maricela Valerio, Eduardo Verde Moreno, Isabel Antorrena, Mar Moreno, José Ramón Paño, Sandra Rosillo, María Romero, Araceli Saldaña, Carlos Armiñanzas Castillo, Ana Arnaiz, José Berrazueta, Sara Bellisco, Manuel Cobo Belaustegui, Raquel Durán, Concepción Fariñas-Álvarez, Carlos Fernández Mazarrasa, Rubén Gómez Izquierdo, Claudia González Rico, José Gutiérrez Díez, Rafael Martín Durán, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Pablo García Pavía, Jesús González, Beatriz Orden, Antonio Ramos, Elena Rodríguez González, Tomasa Centella, José Hermida, José Moya, Pilar Martínez, Enrique Navas, Enrique Oliva, Alejandro del Río, Soledad Ruiz, Antonio de Castro, Marina de Cueto, Pastora Gallego, Jesús Rodríguez Baño, José Antonio Lepe, Rafael Luque Márquez, Encarnación Gutiérrez-Carretero, Julia Eslava Galán, Luis Javier Alonso, José Manuel Azcona Gutiérrez, José Ramón Blanco, Lara García, José Antonio Oteo, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, Mª Belén Nacle, Antonio Sánchez, Luis Vallejo, José Mª Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Joaquín Ruiz Gómez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, Mª Antonia Sepúlveda, Eva Cascales Alcolea, Pilar Egea Serrano, and José Joaquín Hernández Roca

Subjects
Liver Cirrhosis, Male, Microbiology (medical), medicine.medical_specialty, Cirrhosis, medicine.disease_cause, Gastroenterology, Cohort Studies, Risk Factors, Internal medicine, medicine, Humans, In patient, Prospective Studies, Cardiac Surgical Procedures, Stage (cooking), Prospective cohort study, Aged, Ejection fraction, business.industry, Endocarditis, Bacterial, Middle Aged, Prognosis, medicine.disease, Surgery, Infectious Diseases, Spain, Staphylococcus aureus, Infective endocarditis, Female, business, Cohort study
Abstract

To evaluate the course of left-sided infective endocarditis (LsIE) in patients with liver cirrhosis (LC) analyzing its influence on mortality and the impact of surgery.Prospective cohort study, conducted from 1984 to 2013 in 26 Spanish hospitals.A total of 3.136 patients with LsIE were enrolled and 308 had LC: 151 Child-Pugh A, 103 B, 34 C and 20 were excluded because of unknown stage. Mortality was significantly higher in the patients with LsIE and LC (42.5% vs. 28.4%; p0.01) and this condition was in general an independent worse factor for outcome (HR 1.51, 95% CI: 1.23-1.85; p0.001). However, patients in stage A had similar mortality to patients without cirrhosis (31.8% vs. 28.4% p = NS) and in this stage heart surgery had a protective effect (28% in operated patients vs. 60% in non-operated when it was indicated). Mortality was significantly higher in stages B (52.4%) and C (52.9%) and the prognosis was better for patients in stage B who underwent surgery immediately (mortality 50%) compared to those where surgery was delayed (58%) or not performed (74%). Only one patient in stage C underwent surgery.Patients with liver cirrhosis and infective endocarditis have a poorer prognosis only in stages B and C. Early surgery must be performed in stages A and although in selected patients in stage B when indicated.

Published
2015
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15. Respiratory syncytial virus burden among adults during flu season: an underestimated pathology

Author

Patricia Muñoz, Miriam Mateos, D. Adrados, Emilio Bouza, and Martha Kestler

Subjects
0301 basic medicine, Microbiology (medical), Adult, Male, medicine.medical_specialty, 030106 microbiology, Disease, Respiratory Syncytial Virus Infections, Virus, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, medicine, Flu season, Humans, 030212 general & internal medicine, Prospective Studies, Respiratory system, Prospective cohort study, Respiratory Tract Infections, Aged, Aged, 80 and over, Cross Infection, business.industry, virus diseases, Respiratory infection, General Medicine, Middle Aged, medicine.disease, Hospitals, Community-Acquired Infections, Infectious Diseases, Molecular Diagnostic Techniques, Spain, Viral pneumonia, Respiratory Syncytial Virus, Human, Population study, Female, Seasons, business
Abstract

Information on the role of respiratory syncytial virus (RSV) in adult patients with influenza-like syndrome is scarce.To assess the clinical characteristics of RSV in adult patients with respiratory manifestations during a regular influenza season.Prospective study in a tertiary Spanish hospital from December 2015 to February 2016. The study population included only adult patients with either community-acquired or hospital/healthcare-associated influenza-like illness, according to the European Centre for Disease Prevention and Control criteria. Samples were analysed using a rapid molecular assay (XpertTwelve hundred patients with influenza-like respiratory infection were included. Overall, 114 of the samples (9%) were positive for influenza and 95 (8%) were positive for RSV. When RSV-positive and influenza-positive patients were compared, RSV-positive patients were older (57.7 vs 48.9 years; P = 0.03), and their disease was more frequently healthcare-related (26/95, 27.3% vs 5/114, 1.7%; P 0.001). They also had significantly more antibiotics prescribed (77/95, 81.0% vs 70/114, 61.4%; P 0.001) and more frequently needed hospital admission (93/95, 97.8% vs 69/114, 60.5%; P 0.001). Mortality was also significantly higher in RSV-positive patients (14/95, 14.7% vs 7/114, 6.1%; P = 0.04).RSV is a major cause of moderate-to-severe respiratory infection during the influenza season; acquisition is frequently nosocomial or healthcare-related; and mortality is significantly higher than with influenza virus infection. The use of a rapid molecular test as a first-step diagnostic technique is necessary to ensure that isolation measures are implemented and that spread is prevented.

Published
2018

16. Evaluation of GeneXpert MTB/RIF for the detection of Mycobacterium tuberculosis and resistance to rifampin in clinical specimens

Author

Darío García de Viedma, Eleonora Bunsow, Emilio Bouza, Martha Kestler, María Jesús Ruiz-Serrano, and Paula López Roa

Subjects
Microbiology (medical), Susceptibility testing, Tuberculosis, Antitubercular Agents, Real-Time Polymerase Chain Reaction, law.invention, Mycobacterium tuberculosis, law, Drug Resistance, Bacterial, Tuberculosis, Multidrug-Resistant, medicine, Humans, Respiratory samples, Polymerase chain reaction, Bacteriological Techniques, GeneXpert MTB/RIF, biology, business.industry, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Virology, Rapid identification, Infectious Diseases, Molecular Diagnostic Techniques, Spain, Rifampin, business
Abstract

Summary Objectives GeneXpert (GX) is a novel real-time polymerase chain reaction assay for the simultaneous detection of Mycobacterium tuberculosis (MTB) and resistance to rifampin (RIF). We evaluated the performance of GX for direct detection of MTB in respiratory and non-respiratory specimens and assessed the ability of the assay to detect resistance to RIF in non-tuberculosis (TB) endemic country. Methods We analyzed 595 clinical samples in a 1550-bed tertiary hospital in Madrid, Spain. Specimens were processed using GX, auramine smear, conventional culture, and drug phenotypic susceptibility testing (DST) with MGIT SIRE (BD). Results Of the 595 clinical samples, 305 (51.3%) were non-respiratory and 290 (48.7%) were respiratory. In total, MTB was isolated in 81 specimens, 71 of which were positive with GX. The sensitivity, specificity, PPV, and NPV of the GX were: 97.1%, 98.6%, 95.7% and 99.1% for respiratory samples and 33.3%, 99.7%, 80.0% and 97.3% for non-respiratory. GX detected 8 RIF-resistant samples, but only 5 were confirmed by DST. Conclusions GX is an accurate, easy-to-apply and rapid test to detect MTB, especially in smear-positive respiratory samples. Although is a useful tool for the rapid identification of RIF-resistant MTB strains, the rifampin resistant results should be confirmed by DST.

Published
2014
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17. Efficacy of daptomycin in the treatment of enterococcal endocarditis: a 5 year comparison with conventional therapy

Author

Pablo Muñoz, Ana F. Cruz, Eva Tizón Bouza, Blanca Pinilla, M. L. Marin, Manuel Ruiz, J. M. Roda, Manuel Martínez Sellés, Ines Cerón, Marta Rodríguez-Créixems, Marcela González-Del Vecchio, Hugo Rodriguez, Jose Antonio García Robles, Alia Eworo, Victor González Ramallo, Patricia Muñoz, Ana Gonzalez Mansilla, Eduardo Verde, M. Valerio, Mª Cruz Menárguez, Ángel González Pinto, Mercedes Marín, Antonio Segado, Pilar Vázquez, Gregorio Cuerpo, Marisol Salas, Jorge R. Roda, Emilio Bouza, Martha Kestler, A. Segado, Javier Bermejo, Esther Pérez, and Maricela Valerio

Subjects
Male, Microbiology (medical), medicine.medical_specialty, Comorbidity, Daptomycin, Risk Factors, Internal medicine, Ampicillin, polycyclic compounds, medicine, Humans, Pharmacology (medical), Gram-Positive Bacterial Infections, Aged, Retrospective Studies, Aged, 80 and over, Pharmacology, Cross Infection, biology, Drug Substitution, business.industry, Endocarditis, Bacterial, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Anti-Bacterial Agents, Treatment Outcome, Infectious Diseases, Infective endocarditis, Bacteremia, Ceftriaxone, Vancomycin, Drug Therapy, Combination, Female, lipids (amino acids, peptides, and proteins), Gentamicin, business, Enterococcus, medicine.drug, Enterococcus faecium
Abstract

OBJECTIVES Enterococcus spp. account for 10% of infective endocarditis (IE). Although daptomycin is a bactericidal drug with in vitro activity against Enterococcus, there is little experience of its use in IE. We analysed the effectiveness of daptomycin in the treatment of enterococcal IE (EIE). METHODS This was a retrospective descriptive study comparing the efficacy of daptomycin versus ampicillin/ceftriaxone versus conventional antibiotic regimens (ampicillin or vancomycin ± gentamicin) in EIE. RESULTS From January 2007 to December 2011, 6 patients with EIE treated with daptomycin monotherapy were compared with 21 patients treated with ampicillin/ceftriaxone and 5 patients treated with ampicillin or vancomycin ± gentamicin. The three groups had similar epidemiological and clinical characteristics. Daptomycin indications were allergy to β-lactams (n = 3), therapy simplification (n = 2), renal failure (n = 2) and Enterococcus faecium resistant to ampicillin/gentamicin (n = 1). Daptomycin MICs ranged from 1 to 2 mg/L and the doses were 6-10 mg/kg/day intravenously. Daptomycin patients had longer duration of bacteraemia (6 versus 1 day, P

Published
2014
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18. Reply to Tubiana et al

Author

Patricia Muñoz, Emilio Bouza, Martha Kestler, and Javier Bermejo

Subjects
Male, Microbiology (medical), medicine.medical_specialty, business.industry, General surgery, MEDLINE, Bacteremia, Endocarditis, Bacterial, medicine.disease, Infectious Diseases, Enterococcus faecalis, medicine, Humans, Endocarditis, Female, business, Echocardiography, Transesophageal, Enterococcus, Gram-Positive Bacterial Infections
Published
2015
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19. 2016 Expert consensus document on prevention, diagnosis and treatment of short-term peripheral venous catheter-related infections in adult

Author

Francisco Gutiérrez, Marta Rodríguez-Créixems, Josep A. Capdevila, J. Gálvez, José M. Miró, José Barberán, Miguel Ángel Goenaga, Emilio Bouza, Martha Kestler, Arístides de Alarcón, Carlos-A. Mestres, María Guembe, José Cuenca, Dolores Sousa, Patricia Muñoz, M. Carmen Fariñas, Pedro Llinares, Miguel Montejo, and Universitat de Barcelona

Subjects
0301 basic medicine, Peripheral venous catheter, Cardiovascular infection, lcsh:Medicine, Diagnóstico de la infección de catéter, Cirurgia cardiovascular, Cardiovascular surgery, Routine practice, Tertiary care, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Evidence-Based Medicine, Peripheral catheter, Catèters, Infeccions, Catheter, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Consensus, Catheters, Vascular catheter, Catheter infection, Intravenous catheterization, 030106 microbiology, lcsh:Surgery, Catéter venoso periférico, Infección de catéter, Tratamiento de la infección de catèter, Infections, Treatment of catheter infection, 03 medical and health sciences, Catheterization, Peripheral, Humans, Diagnosis of catheter infection, Intensive care medicine, Device Removal, Prevention of catheter infection, business.industry, lcsh:R, Expert consensus, lcsh:RD1-811, Catheter-Related Infections, Prevención de la infección de catéter, Equipment Contamination, Surgery, business, Cateterisme intravascular
Abstract

Aquest document també està publicat a: 'Cirugía Cardiovascular' http://dx.doi.org/10.1016/j.circv.2016.06.001, The use of endovascular catheters is a routine practice in secondary and tertiary care level hospitals. Short peripheral catheters have been found to be associated with the risk of nosocomial bacteremia resulting in morbidity and mortality. Staphyloccus aureus is mostly associated with peripheral catheter insertion. This Consensus Document has been elaborated by a panel of experts of the Spanish Society of Cardiovascular Infections in cooperation with experts from the Spanish Society of Internal Medicine, Spanish Society of Chemotherapy and Spanish Society of Thoracic-Cardiovascular Surgery and aims at define and establish the norm for management of short duration peripheral vascular catheters. The document addresses the indications for insertion, catheter maintenance and registry, diagnosis and treatment of infection, indications for removal and stresses on continuous education as a driver for quality. Implementation of this norm will allow uniformity in usage thus minimizing the risk of infection and its complications.

Published
2016

20. Usefulness of Simultaneous Performance of an Interferon-Gamma Relay Assay and Tuberculin Skin Test for Latent Tuberculosis Screening in Rheumatology Patients: Influence of Disease and Treatment

Author

Oihane Aldecoa-Otarola, María Jesús Ruiz-Serrano, María Montoro, Emilio Bouza, Martha Kestler, Paloma Gijón, and Patricia Muñoz

Subjects
medicine.medical_specialty, Pathology, Interferon type II, Latent tuberculosis, business.industry, Tuberculin, Skin test, Disease, medicine.disease, Dermatology, Rheumatology, Infectious Diseases, Oncology, Internal medicine, medicine, Interferon gamma, business, Tuberculin test, medicine.drug
Published
2016
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21. Current Epidemiology and Outcome of Infective Endocarditis: A Multicenter, Prospective, Cohort Study

Author

Emilio Bouza, Javier Bermejo, Víctor José González Ramallo, Jesús Rodríguez-Baño, Víctor Asensi Álvarez, Claudia González-Rico, Vicente Climent, Angel L. Fernández, Francesc Marco, Antonio Ramos-Martinez, Ana Fernández-Cruz, Gonzalo De la Morena, Carlos Cervera, Lara García-Álvarez, José Ignacio Aramendi, José A. Oteo, Jose Maria Arribas Leal, Marina Cueto-López, Natividad Benito, Jose A. Lepe, Patricia Carmen Muñoz García, Martha Kestler, Juan M Pericas, Javier De La Torre-Lima, Jonathan Fernández-Suárez, and Benito Regueiro

Subjects
Male, medicine.medical_specialty, Epidemiology, Heart Valve Diseases, Observational Study, Communicable diseases, Risk Factors, Interquartile range, Internal medicine, Humans, Medicine, Endocarditis, Prospective Studies, Prospective cohort study, Epidemiologia, Aged, business.industry, General Medicine, Odds ratio, Middle Aged, Malalties infeccioses, medicine.disease, Surgery, Spain, Heart Valve Prosthesis, Infective endocarditis, Cohort, Etiology, Female, business, Research Article
Abstract

This study was partially financed by the CIBER de Enfermedades Respiratorias (CIBERES) from the ISCIII (CB06/06/0058) and by Fundación BBVA-FundacioóCarolina (research fellowship of Maricela Valerio)., Muñoz, P; Kestler, M; De Alarcon, A; Miro, JM; Bermejo, J; Rodriguez-Abella, H; Farinas, MC; Belaustegui, MC; Mestres, C; Llinares, P; Goenaga, M; Navas, E; Oteo, JA; Tarabini, P; Bouza, E.

Published
2015

22. Influenza vaccination during the first 6 months after solid organ transplantation is efficacious and safe

Author

Patricia Muñoz, J.L. Montero, M.A. Gentil-Govantes, Diego Rincón, José María Aguado, Jordi Carratalà, P. Diez, Julián Torre-Cisneros, Marino Blanes, Angel Bulnes-Ramos, Joan Gavaldà, Manuel Rodríguez, S. Fernández-Rozas, C. Berasategui, I. Morales-Barroso, R. Durán, M.C. Fariñas, Paula López-Roa, Marta Bodro, F. Anaya, Cristina Roca, Elisa Vidal, Magda Campins, A. Gasch, Manuel López-Meseguer, F. Zurbano-Goñi, Miguel Montejo, M. Cobo-Beláustegy, Magdalena Salcedo, Alia Eworo, Elisa Cordero, S. Oriol, J. Fortún, Sylvana Melo dos Santos, M. Valerio, A. Rodríguez, C. Rosso, Francisco López-Medrano, Pilar Pérez-Romero, Rosario Lara, Julia Origüen, Juliana Martinez-Atienza, M.L. Agüera, Jordi Niubó, Emilio Bouza, Martha Kestler, E. Fábrega-García, Josune Goikoetxea, Teresa Aydillo, A. Páez, J.M. Alamo, Fernando Casafont, Sara Cantisán, M. Peghin, N. Sabé, M. A. Marcos, E. Lage, Claudia González-Rico, Y. Sousa, F.J. Molina-Ortega, J.L. Barranco, G. Sanclemente, N. Diez, A. Moreno, M. Sánchez, Pilar Catalán, Berta Sáez, J.M. Arizón, and Alejandro Suárez-Benjumea

Subjects
Adult, Microbiology (medical), medicine.medical_specialty, Adolescent, Drug-Related Side Effects and Adverse Reactions, Influenza vaccine, Disease, Antibodies, Viral, seroprotection, immune response, Young Adult, Influenza A Virus, H1N1 Subtype, Internal medicine, Influenza, Human, medicine, Humans, Prospective Studies, Adverse effect, Prospective cohort study, solid organ transplantation, Immunization Schedule, Aged, Early vaccination, Aged, 80 and over, business.industry, Influenza A Virus, H3N2 Subtype, Immunogenicity, Organ Transplantation, General Medicine, Middle Aged, Transplant Recipients, Confidence interval, Surgery, Vaccination, Transplantation, Influenza B virus, Treatment Outcome, Infectious Diseases, Influenza Vaccines, influenza vaccine, business
Abstract

Preventing influenza infection early after transplantation is essential, given the disease's high mortality. A multicentre prospective cohort study in adult solid organ transplant recipients (SOTR) receiving the influenza vaccine during four consecutive influenza seasons (2009–2013) was performed to assess the immunogenicity and safety of influenza vaccination in SOTR before and 6 months after transplantation. A total of 798 SOTR, 130 of them vaccinated within 6 months of transplantation and 668 of them vaccinated more than 6 months since transplantation. Seroprotection was similar in both groups: 73.1% vs. 76.5% for A/(H1N1)pdm (p 0.49), 67.5% vs. 74.1% for A/H3N2 (p 0.17) and 84.2% vs. 85.2% for influenza B (p 0.80), respectively. Geometric mean titres after vaccination did not differ among groups: 117.32 (95% confidence interval (CI) 81.52, 168.83) vs. 87.43 (95% CI 72.87, 104.91) for A/(H1N1)pdm, 120.45 (95% CI 82.17, 176.57) vs. 97.86 (95% CI 81.34, 117.44) for A/H3N2 and 143.32 (95% CI 103.46, 198.53) vs. 145.54 (95% CI 122.35, 174.24) for influenza B, respectively. After adjusting for confounding factors, time since transplantation was not associated with response to vaccination. No cases of rejection or severe adverse events were detected in patients vaccinated within the first 6 months after transplantation. In conclusion, influenza vaccination within the first 6 months after transplantation is as safe and immunogenic as vaccination thereafter. Thus, administration of the influenza vaccine can be recommended as soon as 1 month after transplantation.

Published
2015

23. The NOVA score: a proposal to reduce the need for transesophageal echocardiography in patients with enterococcal bacteremia

Author

Marta Rodríguez-Créixems, Teresa Beca, Francisco Fernández-Avilés, Patricia Muñoz, Javier Bermejo, Emilio Bouza, Martha Kestler, Gabriel Mariscal, and Ana Fernández-Cruz

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, Adolescent, Heart Valve Diseases, Bacteremia, Cohort Studies, Young Adult, Risk Factors, Internal medicine, medicine, Enterococcus faecalis, Endocarditis, Humans, Blood culture, Heart valve, Prospective Studies, Prospective cohort study, Gram-Positive Bacterial Infections, Aged, medicine.diagnostic_test, Heart Murmurs, business.industry, Auscultation, Endocarditis, Bacterial, Middle Aged, bacterial infections and mycoses, medicine.disease, Infectious Diseases, medicine.anatomical_structure, Blood, Logistic Models, Spain, Infective endocarditis, Case-Control Studies, Heart murmur, Cardiology, Female, medicine.symptom, business, human activities, Echocardiography, Transesophageal, Enterococcus
Abstract

Background: Frequency of enterococcal bloodstream infection (E-BSI) is increasing, and the number of episodes complicated by infective endocarditis (IE) varies. Performing transesophageal echocardiography (TEE) in all patients with E-BSI is costly and time-consuming. Our objectives were to identify patients with E-BSI who are at very low risk of enterococcal IE (and therefore do not require TEE) and to compare the outcome of E-BSI in patients with/without IE. Methods: Between September 2003 and October 2012, we performed a prospective cohort study (all patients with E-BSI) and a case-control study (patients with/without enterococcal IE) in our center. Results: We detected 1515 patients with E-BSI and 65 with enterococcal IE (4.29% of all episodes of E-BSI, 16.7% of patients with E-BSI who underwent transthoracic echocardiography, and 35.5% of all patients with E-BSI who underwent TEE). We developed a bedside predictive score for enterococcal IE-Number of positive blood cultures, Origin of the bacteremia, previous Valve disease, Auscultation of heart murmur (NOVA) score-based on the following variables: Number of positive blood cultures (3/3 blood cultures or the majority if more than 3), 5 points; unknown Origin of bacteremia, 4 points; prior heart Valve disease, 2 points; Auscultation of a heart murmur, 1 point (receiver operating characteristic = 0.83). The best cutoff corresponded to a score ≥4 (sensitivity, 100%; specificity, 29%). A score

Published
2014

24. Role of (18)F-FDG PET in Patients with Infectious Endocarditis

Author

Felisa Jimenez-Requena, Juan Carlos Alonso, Marta Rodríguez-Créixems, Amanda Rotger, Luis Hernández, Javier Orcajo, Amaia Mari, Emilio Bouza, Martha Kestler, and Patricia Muñoz

Subjects
Male, medicine.medical_specialty, Embolism, Lesion, Cohort Studies, Fluorodeoxyglucose F18, Sepsis, medicine, Endocarditis, Humans, Radiology, Nuclear Medicine and imaging, In patient, Prospective cohort study, Septic embolism, business.industry, Middle Aged, medicine.disease, Predictive value, Case-Control Studies, Positron-Emission Tomography, Cohort, Female, Radiology, medicine.symptom, Nuclear medicine, business, Complication, Tomography, X-Ray Computed
Abstract

It was our purpose to evaluate the clinical impact of systematic PET/CT for the diagnosis of infectious embolisms in patients with infectious endocarditis (IE) in comparison with a historic cohort of IE patients managed without this technique. Detection of extracardiac lesions is an essential component of the management and outcome of IE. Studies using PET/CT for the evaluation of patients with IE are scarce, lack a control group, evaluate a small number of patients, or consist of case reports.We performed a prospective cohort study (47 patients with definite IE undergoing PET/CT) with matched controls (94 patients with definite IE not undergoing PET/CT) from January 2012 to July 2013 in a tertiary hospital. The results were compared with those of conventional diagnostic techniques and clinical follow-up.PET/CT revealed at least 1 lesion in 35 patients (74.5%): 18 showed an embolic complication, 8 showed pathologic uptake on the valves or cardiac devices, 1 showed both, 5 had incidental noninfectious findings, and the findings for 3 were considered false-positive. The validity values for the efficacy of PET/CT in the diagnosis of septic lesions were as follows: sensitivity, 100%; specificity, 80%; positive predictive value, 90%; and negative predictive value, 100%. PET/CT was the only initially positive imaging technique in 15 true-positive cases (55.5%). The systematic use of PET/CT was associated with a 2-fold reduction in the number of relapses (9.6% vs. 4.2%, P = 0.25) and enabled significantly more infectious complications to be diagnosed (18% vs. 57.4%, P = 0.0001).PET/CT enables the extent of IE to be assessed using a single test. It is fast (2 h) and comfortable for the patient, gathers whole-body data, and detects significantly more infectious complications.

Published
2013

25. Long-term outcome of high-urgency heart transplant patients with and without temporary ventricular assist device support

Author

M. Cardona, Manuel Castellá, María Ángeles Castel, Martha Kestler Hernández, Félix Pérez-Villa, Daniel Pereda, Elena Sandoval, and Ramón Cartañá

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Waiting Lists, medicine.medical_treatment, Kaplan-Meier Estimate, Prosthesis Design, Ventricular Function, Left, Risk Factors, parasitic diseases, medicine, Extracorporeal membrane oxygenation, Humans, cardiovascular diseases, Registries, Renal Insufficiency, Survival rate, Proportional Hazards Models, Retrospective Studies, Heart transplantation, Heart Failure, Transplantation, business.industry, Proportional hazards model, Cardiogenic shock, Retrospective cohort study, Middle Aged, medicine.disease, Surgery, Survival Rate, Treatment Outcome, Spain, Ventricular assist device, Heart Transplantation, Transplant patient, Female, Heart-Assist Devices, biological phenomena, cell phenomena, and immunity, business
Abstract

Background. The use of short-term ventricular assist devices (VAD) in patients awaiting high-urgency (HU) heart transplantation (HTx) in Spain has steadily increased due to longer waiting times and the new heart allocation system. It is unknown whether the use of short-term VAD support in patients with cardiogenic shock affects HTx outcome. We sought to investigate long-term outcomes of HU transplanted patients with VAD compared with HU transplanted patients without device support. Methods. We retrospectively evaluated all HTx patients transplanted between 1999 and 2011 in our institution. Patients were categorized by urgency: elective HTx, HU-HTx with VAD (status 0), and HU-HTx without VAD (status 1). Actuarial survival rates were compared. Results. Of 237 transplanted patients, 55 (23%) were HU-HTx, including 16 on VAD support and 39 without VAD. Mean time in the HU waiting list was 6.5 6 days and mean VAD support was 8.4 8 days (range, 1 to 31 days). Assist devices used were Levitronix Centrimag (6), Abiomed (9), and extracorporeal membrane oxygenation (ECMO) (1). After a mean follow-up of 4.6 4.1 years (range 0 to 13 years), 22 patients had died: 5 VAD and 17 non-VAD. The 1- and 5-year survival rates were 73% and 61% for the VAD and 74% and 62% for the non-VAD group, respectively (P ns). Kaplan-Meier and Cox regression analyses did not show survival differences, HR 1.11 (95% CI 0.41-3.02), P 0.84. The presence of renal failure was associated with increased mortality risk, HR 1.9 (95% CI 1.1-3.2), P 0.02. The presence of renal failure was associated with increased mortality risk [HR 1.9 (95% CI 1.1–3.2), P .02.). Conclusions. In our experience, the long-term outcome of patients receiving HU-HTx under short-term VAD support is comparable to that of patients undergoing HU-HTx without VAD support. Patients with renal failure had an increased risk for overall mortality in this set of patients.

Published
2012

26. Bloodstream infections in patients with kidney disease: risk factors for poor outcome and mortality

Author

Patricia Muñoz, Marta Rodríguez-Créixems, Loreto Rojas, Emilio Bouza, Martha Kestler, Eduardo Verde, María Guembe, and David Arroyo

Subjects
Microbiology (medical), Nephrology, Male, medicine.medical_specialty, medicine.medical_treatment, Bacteremia, Peritoneal dialysis, Cohort Studies, Risk Factors, Internal medicine, medicine, Humans, Intensive care medicine, Hospitals, Teaching, Dialysis, Aged, Retrospective Studies, Bacteria, Septic shock, business.industry, Incidence (epidemiology), Mortality rate, Incidence, Fungi, Retrospective cohort study, General Medicine, Middle Aged, bacterial infections and mycoses, medicine.disease, Survival Analysis, Infectious Diseases, Treatment Outcome, Female, Kidney Diseases, business, human activities, Fungemia, Peritoneal Dialysis, Kidney disease
Abstract

Summary Background Information regarding bloodstream infections (BSIs) in patients with kidney diseases is scarce and mainly derived from selected groups of patients. Aim To assess the characteristics of BSI in an unselected population of patients with kidney disease, including renal transplant recipients and patients with chronic kidney failure who were receiving or not receiving dialysis. Methods A retrospective cohort study of all patients who presented with BSI in the nephrology department of a large teaching hospital. Clinical records were reviewed according to a pre-established protocol. Standard definitions were used. Findings In all, 155 episodes of BSI were recorded in 108 patients. The incidence of BSI was 77.3 episodes per 1000 admissions, and 4.5 episodes per 100 patient-years. Haemodialysis patients had the highest incidence of BSI. The distribution of micro-organisms was as follows: Gram-negative, 52.3%; Gram-positive, 46.5%; fungi, 1.2%. Escherichia coli was the most frequently isolated micro-organism (27%). The BSI was classed as bacteraemia of unknown source (29.7%), urinary tract infection (23.2%), vascular access infection (17.4%), and other (29.7%). Eighteen patients (11.6%) developed septic shock or multi-organ failure, and the same proportion had persistent bacteraemia. The crude mortality rate was 14.6%. The risk factors for mortality were high Charlson index, persistent bacteraemia, and absence of fever. Conclusion Nephrology patients have a high incidence of BSI, particularly patients undergoing haemodialysis. The predominant micro-organisms causing BSI episodes were Gram-negative bacilli. Patients with kidney disease have high BSI-related morbidity and mortality. Risk factors for mortality were high Charlson comorbidity index and persistent BSI. The presence of fever during the BSI episodes was found to be a protective factor.

Published
2012

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