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5 results on '"Calvo Montes, Jorge"'

1. Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain.

Author

Fernández-Martínez M, González-Rico C, Gozalo-Margüello M, Marco F, Gracia-Ahufinger I, Aranzamendi M, Sánchez-Díaz AM, Vicente-Rangel T, Chaves F, Calvo Montes J, Martínez-Martínez L, and Fariñas MC

Subjects
Anti-Bacterial Agents pharmacology, Citrobacter freundii genetics, Enterobacter cloacae genetics, Enterobacteriaceae isolation & purification, Escherichia coli genetics, Humans, Kidney Transplantation adverse effects, Klebsiella pneumoniae genetics, Klebsiella pneumoniae isolation & purification, Liver Transplantation adverse effects, Microbial Sensitivity Tests, Pancreas Transplantation adverse effects, Prevalence, Prospective Studies, Spain epidemiology, Bacterial Infections complications, Bacterial Infections drug therapy, Carbapenems pharmacology, Citrobacter freundii drug effects, Drug Resistance, Multiple, Bacterial drug effects, Enterobacter cloacae drug effects, Enterobacteriaceae drug effects, Escherichia coli drug effects, Klebsiella pneumoniae drug effects, Transplant Recipients
Abstract

The objective of this study was to analyse the mechanisms of resistance to carbapenems and other extended-spectrum-β-lactams and to determine the genetic relatedness of multidrug-resistant Enterobacterales (MDR-E) causing colonization or infection in solid-organ transplantation (SOT) recipients. Prospective cohort study in kidney (n = 142), liver (n = 98) or kidney/pancreas (n = 7) transplant recipients between 2014 and 2018 in seven Spanish hospitals. We included 531 MDR-E isolates from rectal swabs obtained before transplantation and weekly for 4-6 weeks after the procedure and 10 MDR-E from clinical samples related to an infection. Overall, 46.2% Escherichia coli, 35.3% Klebsiella pneumoniae, 6.5% Enterobacter cloacae, 6.3% Citrobacter freundii and 5.7% other species were isolated. The number of patients with MDR-E colonization post-transplantation (176; 71.3%) was 2.5-fold the number of patients colonized pre-transplantation (71; 28.7%). Extended-spectrum β-lactamases (ESBLs) and carbapenemases were detected in 78.0% and 21.1% of MDR-E isolates respectively. In nine of the 247 (3.6%) transplant patients, the microorganism causing an infection was the same strain previously cultured from surveillance rectal swabs. In our study we have observed a low rate of MDR-E infection in colonized patients 4-6 weeks post-transplantation. E. coli producing bla CTX-M-G1 and K. pneumoniae harbouring bla OXA-48 alone or with bla CTX-M-G1 were the most prevalent MDR-E colonization strains in SOT recipients.

Published
2021
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2. Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain

Author

Fernandez-Martinez, Marta, Gonzalez-Rico, Claudia, Gozalo-Marguello, Monica, Marco, Francesc, Gracia-Ahufinger, Irene, Aranzamendi, Maitane, Sanchez-Diaz, Ana M., Vicente-Rangel, Teresa, Chaves, Fernando, Calvo Montes, Jorge, Martinez-Martinez, Luis, Carmen Farinas, Maria, ENTHERE Study Grp, Spanish Soc Infect Dis Clinical Mi, Spanish Network Res Infect Dis REI, Universidad de Cantabria, [Fernandez-Martinez, Marta] Hosp Univ Marques de Valdecilla, Serv Microbiol, Santander, Spain, [Gozalo-Marguello, Monica] Hosp Univ Marques de Valdecilla, Serv Microbiol, Santander, Spain, [Calvo Montes, Jorge] Hosp Univ Marques de Valdecilla, Serv Microbiol, Santander, Spain, [Fernandez-Martinez, Marta] Inst Invest Valdecilla IDIVAL, Santander, Spain, [Gonzalez-Rico, Claudia] Inst Invest Valdecilla IDIVAL, Santander, Spain, [Gozalo-Marguello, Monica] Inst Invest Valdecilla IDIVAL, Santander, Spain, [Calvo Montes, Jorge] Inst Invest Valdecilla IDIVAL, Santander, Spain, [Carmen Farinas, Maria] Inst Invest Valdecilla IDIVAL, Santander, Spain, [Gonzalez-Rico, Claudia] Hosp Univ Marques Valdecilla, Serv Enfermedades Infecciosas, Santander, Spain, [Carmen Farinas, Maria] Hosp Univ Marques Valdecilla, Serv Enfermedades Infecciosas, Santander, Spain, [Marco, Francesc] Univ Barcelona, Hosp Clin ISGlobal, Ctr Diagnost Biomed, Serv Microbiol, Barcelona, Spain, [Gracia-Ahufinger, Irene] Hosp Univ Reina Sofia, Unidad Microbiol, Cordoba, Spain, [Martinez-Martinez, Luis] Hosp Univ Reina Sofia, Unidad Microbiol, Cordoba, Spain, [Gracia-Ahufinger, Irene] Inst Maimonides Invest Biomed Cordoba IMIBIC, Cordoba, Spain, [Martinez-Martinez, Luis] Inst Maimonides Invest Biomed Cordoba IMIBIC, Cordoba, Spain, [Aranzamendi, Maitane] Hosp Univ Cruces, Serv Microbiol, Baracaldo, Vizcaya, Spain, [Aranzamendi, Maitane] Inst Invest Sanitaria Biocruces, Vizcaya, Spain, [Sanchez-Diaz, Ana M.] Hosp Univ Ramon y Cajal, Serv Microbiol, Madrid, Spain, [Vicente-Rangel, Teresa] Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, Madrid, Spain, [Chaves, Fernando] Hosp Univ 12 Octubre, Serv Microbiol, Madrid, Spain, [Martinez-Martinez, Luis] Univ Cordoba, Hosp Univ Reina Sofia, IMIBIC, Dept Microbiol,Unidad Microbiol, Cordoba, Spain, Plan Nacional de I+D+i and Instituto de Salud Carlos III, Spanish Network for Research in Infectious Diseases, European Development Regional Fund 'A way to achieve Europe', Operative Program Intelligent Growth, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Ciencia, Innovacion y Universidades, ENTHERE Study Group, the Group for Study of Infection in Transplantation of the Spanish Society of Infectious Diseases and Clinical Microbiology (GESITRA-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI), [Fernández-Martínez,M, Gozalo-Margüello,M, Calvo Montes,J] Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain. [Fernández-Martínez,M, González-Rico,C, Calvo Montes,J, Fariñas,MC] Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain. [González-Rico,C, Fariñas,MC] Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, Santander, Spain. [Marco,F] Servicio de Microbiología, Centro Diagnóstico Biomédico, Hospital Clínic. ISGlobal, Universidad de Barcelona, Barcelona, Spain. [Gracia-Ahufinger,I, Martínez-Martínez,L] Unidad de Microbiología, Hospital Universitario Reina Sofía, Córdoba, Spain. [Gracia-Ahufinger,I, Martínez-Martínez,L] Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain. [Aranzamendi,M] Servicio de Microbiología, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain. [Aranzamendi,M] Instituto de Investigación Sanitaria Biocruces, Vizcaya, Spain. [Sánchez-Díaz,AM] Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain. [Vicente-Rangel,T] Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain. [Chaves,F] Servicio de Microbiología, Hospital Universitario 12 de Octubre, Madrid, Spain. [Martínez-Martínez,L] Departamento of Microbiología, Unidad de Microbiología, Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, Córdoba, Spain., and Te study was co-fnanced by the Euro pean Development Regional Fund 'A way to achieve Europe' and the Operative Program Intelligent Growth 2014‐2020.

Subjects
0301 basic medicine, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Transplantation::Organ Transplantation::Pancreas Transplantation [Medical Subject Headings], Klebsiella pneumoniae, Epidemiology, España, Riñón, medicine.disease_cause, Kidney, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Lactamase-producing enterobacteriaceae, Resistencia a múltiples medicamentos, Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial::Drug Resistance, Bacterial::Drug Resistance, Multiple, Bacterial [Medical Subject Headings], 0302 clinical medicine, Enterobacterales, Drug Resistance, Multiple, Bacterial, Prevalence, Colonization, Multidrug-resistant, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings], Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae [Medical Subject Headings], High-risk clones, Multidisciplinary, Surveillance, biology, Antimicrobials, Bacterial Infections, Hospitals, Citrobacter freundii, Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Escherichia::Escherichia coli [Medical Subject Headings], Anti-Bacterial Agents, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Microbiological Techniques::Microbial Sensitivity Tests [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Transplantation::Organ Transplantation::Kidney Transplantation [Medical Subject Headings], Medicine, Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Klebsiella::Klebsiella pneumoniae [Medical Subject Headings], Pancreas Transplantation, Infection, Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Carbapenems [Medical Subject Headings], Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Transplantation::Organ Transplantation::Liver Transplantation [Medical Subject Headings], Science, 030106 microbiology, Microbial Sensitivity Tests, Infections, Microbiology, Article, Diseases::Bacterial Infections and Mycoses::Bacterial Infections [Medical Subject Headings], 03 medical and health sciences, Enterobacteriaceae, Enterobacter cloacae, medicine, Escherichia coli, Infección, Humans, Clinical microbiology, Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings], Transplantation, business.industry, biology.organism_classification, Kidney Transplantation, Transplant Recipients, Liver Transplantation, Multiple drug resistance, Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Citrobacter::Citrobacter freundii [Medical Subject Headings], Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Enterobacter::Enterobacter cloacae [Medical Subject Headings], Carbapenems, Spain, Trasplante, business
Abstract

The objective of this study was to analyse the mechanisms of resistance to carbapenems and other extended-spectrum-?-lactams and to determine the genetic relatedness of multidrug-resistant Enterobacterales (MDR-E) causing colonization or infection in solid-organ transplantation (SOT) recipients. Prospective cohort study in kidney (n= 142), liver (n= 98) or kidney/pancreas (n= 7) transplant recipients between 2014 and 2018 in seven Spanish hospitals. We included 531 MDR-E isolates from rectal swabs obtained before transplantation and weekly for 4?6 weeks after the procedure and 10 MDR-E from clinical samples related to an infection. Overall, 46.2% Escherichia coli, 35.3% Klebsiella pneumoniae, 6.5% Enterobacter cloacae, 6.3% Citrobacter freundii and 5.7% other species were isolated. The number of patients with MDR-E colonization post-transplantation (176; 71.3%) was 2.5-fold the number of patients colonized pre-transplantation (71; 28.7%). Extended spectrum ?-lactamases (ESBLs) and carbapenemases were detected in 78.0% and 21.1% of MDR-E isolates respectively. In nine of the 247 (3.6%) transplant patients, the microorganism causing an infection was the same strain previously cultured from surveillance rectal swabs. In our study we have observed a low rate of MDR-E infection in colonized patients 4?6 weeks post-transplantation. E. coli producing blaCTX-M-G1 and K. pneumoniae harbouring blaOXA-48 alone or with blaCTX-M-G1 were the most prevalent MDR-E colonization strains in SOT recipients. Acknowledgements The authors thank Mª Jesús Lecea and Laura Álvarez for technical assistance. Tis research was supported by ‘Plan Nacional de I+D+i and Instituto de Salud Carlos III (Fondo de Investigaciones Sanitarias 13/01191), Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, and the Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0007, RD16/0016/0010, RD16/0016/0012, RD16/0016/0011, RD16/0016/0008, RD16/0016/0002). Te study was co-fnanced by the European Development Regional Fund “A way to achieve Europe” and the Operative Program Intelligent Growth 2014‐2020.

Published
2021

3. Clinical characteristics and outcome of bacteraemia caused by Enterobacter cloacae and Klebsiella aerogenes: more similarities than differences

Author

Álvarez-Marín, Rocío, Lepe Jiménez, José Antonio, Gasch-Blasi, Oriol, Rodríguez Martínez, José Manuel, Calvo-Montes, Jorge, Lara-Contreras, Rosario, Rodríguez-Baño, Jesús, Pascual Hernández, Álvaro, Jiménez-Mejías, Manuel E., Universidad de Sevilla. Departamento de Microbiología, Universidad de Sevilla. Departamento de Medicina, European Regional Development Fund 'A way to achieve Europe', Operative program Intelligent Growth 2014-2020, Instituto Carlos III , PS09/00916, Ministerio de Ciencia e Innovación, Ministerio de Ciencia, Innovación y Universidades (MICINN). España, Plan Nacional I + D +i 2013-2016, Spanish Network for Research in Infectious Diseases [REIPI] RD16/0016/0007, RD16/0016/0005, RD16/0016/0009, RD16/0016/0008, RD16/0016/0001, and Subdirección General de Redes y Centros de Investigación Cooperativa

Subjects
Quinolone resistance mechanism, Case–control study, Enterobacter cloacae, Klebsiella aerogenes, Bacteraemia, Enterobacter aerogenes
Abstract

Objectives The genus Enterobacter is a common cause of nosocomial infections. Historically, the most frequent Enterobacter species were those of Enterobacter cloacae complex and Enterobacter aerogenes. In 2019, E. aerogenes was re-classified as Klebsiella aerogenes owing to its higher genotypic similarity with the genus Klebsiella. Our objective was to characterise and compare the clinical profiles of bacteraemia caused by E. cloacae and K. aerogenes. Methods This 3-year multicentre, prospective cohort study enrolled consecutive patients with bacteraemia by E. cloacae or K. aerogenes. Baseline characteristics, bacteraemia features (source, severity, treatment), antibiotic susceptibility, resistance mechanisms and mortality were analysed. Results The study included 285 patients with bacteraemia [196 (68.8%) E. cloacae and 89 (31.2%) K. aerogenes]. The groups showed no differences in age, sex, previous use of invasive devices, place of acquisition, sources or severity at onset. The Charlson score was higher among patients with E. cloacae bacteraemia [2 (1–4) vs. 1 (0.5–3); P = 0.018], and previous antibiotic therapy was more common in patients with K. aerogenes bacteraemia (57.3% vs. 41.3%; P = 0.01). Mortality was 19.4% for E. cloacae and 20.2% for K. aerogenes (P = 0.869). Antibiotic susceptibility was similar for both species, and the incidence of multidrug resistance or ESBL production was low (6% and 5.3%, respectively), with no differences between species. Conclusion Bacteraemias caused by E. cloacae and K. aerogenes share similar patient profiles, presentation and prognosis. Patients with E. cloacae bacteraemia had more co-morbidities and those with K. aerogenes bacteraemia had received more antibiotics.

Published
2021

4. A prospective, multicenter case control study of risk factors for acquisition and mortality in Enterobacter species bacteremia.

Author

Álvarez-Marín, Rocío, Navarro-Amuedo, Dolores, Gasch-Blasi, Oriol, Rodríguez-Martínez, José Manuel, Calvo-Montes, Jorge, Lara-Contreras, Rosario, Lepe-Jiménez, José Antonio, Tubau-Quintano, Fe, Cano-García, María Eliecer, Rodríguez-López, Fernando, Rodríguez-Baño, Jesús, Pujol-Rojo, Miquel, Torre-Cisneros, Julián, Martínez-Martínez, Luis, Pascual-Hernández, Álvaro, and Jiménez-Mejías, Manuel Enrique

Abstract

• Invasive devices, antibiotics and ICU stay predispose to acquire an Enterobacter bacteremia. • Enterobacter bacteremia increased mortality in patients with comorbidities or a severe infection. • The outcome was not affected by antibiotic resistances of the isolates or the antibiotic therapy. Enterobacter is among the main etiologies of hospital-acquired infections. This study aims to identify the risk factors of acquisition and attributable mortality of Enterobacter bacteremia. Observational, case-control study for risk factors and prospective cohort for outcomes of consecutive cases with Enterobacter bacteremia. This study was conducted in five hospitals in Spain over a three-year period. Matched controls were patients with negative blood cultures and same sex, age, and hospitalization area. The study included 285 cases and 570 controls. E. cloacae was isolated in 198(68.8%) cases and E. aerogenes in 89(31.2%). Invasive procedures (hemodialysis, nasogastric tube, mechanical ventilation, surgical drainage tube) and previous antibiotics or corticosteroids were independently associated with Enterobacter bacteremia. Its attributable mortality was 7.8%(CI95%2.7–13.4%), being dissimilar according to a McCabe index: non-fatal=3.2%, ultimately fatal=12.9% and rapidly fatal=0.12%. Enterobacter bacteremia remained an independent risk factor for mortality among cases with severe sepsis or septic shock (OR 5.75 [CI95%2.57–12.87], p <0.001), with an attributable mortality of 40.3%(CI95%25.7–53.3). Empiric therapy or antibiotic resistances were not related to the outcome among patients with bacteremia. Invasive procedures, previous antibiotics and corticosteroids predispose to acquire Enterobacter bacteremia. This entity increases mortality among fragile patients and those with severe infections. Antibiotic resistances did not affect the outcome. [ABSTRACT FROM AUTHOR]

Published
2020
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5. A prospective, multicenter case control study of risk factors for acquisition and mortality in Enterobacter species bacteremia.

Author

Álvarez-Marín, Rocío, Navarro-Amuedo, Dolores, Gasch-Blasi, Oriol, Rodríguez-Martínez, José Manuel, Calvo-Montes, Jorge, Lara-Contreras, Rosario, Lepe-Jiménez, José Antonio, Tubau-Quintano, Fe, Cano-García, María Eliecer, Rodríguez-López, Fernando, Rodríguez-Baño, Jesús, Pujol-Rojo, Miquel, Torre-Cisneros, Julián, Martínez-Martínez, Luis, Pascual-Hernández, Álvaro, Mejías, Manuel Enrique Jiménez, Spanish Network for Research in Infectious Diseases/Enterobacter spp. Bacteriemia Project group, and Jiménez-Mejías, Manuel Enrique

Abstract

Background: Enterobacter is among the main etiologies of hospital-acquired infections. This study aims to identify the risk factors of acquisition and attributable mortality of Enterobacter bacteremia.Methods: Observational, case-control study for risk factors and prospective cohort for outcomes of consecutive cases with Enterobacter bacteremia. This study was conducted in five hospitals in Spain over a three-year period. Matched controls were patients with negative blood cultures and same sex, age, and hospitalization area.Results: The study included 285 cases and 570 controls. E. cloacae was isolated in 198(68.8%) cases and E. aerogenes in 89(31.2%). Invasive procedures (hemodialysis, nasogastric tube, mechanical ventilation, surgical drainage tube) and previous antibiotics or corticosteroids were independently associated with Enterobacter bacteremia. Its attributable mortality was 7.8%(CI95%2.7-13.4%), being dissimilar according to a McCabe index: non-fatal=3.2%, ultimately fatal=12.9% and rapidly fatal=0.12%. Enterobacter bacteremia remained an independent risk factor for mortality among cases with severe sepsis or septic shock (OR 5.75 [CI95%2.57-12.87], p<0.001), with an attributable mortality of 40.3%(CI95%25.7-53.3). Empiric therapy or antibiotic resistances were not related to the outcome among patients with bacteremia.Conclusions: Invasive procedures, previous antibiotics and corticosteroids predispose to acquire Enterobacter bacteremia. This entity increases mortality among fragile patients and those with severe infections. Antibiotic resistances did not affect the outcome. [ABSTRACT FROM AUTHOR]

Published
2019
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