282 results on '"Calbo, E"'
Search Results
2. Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infections
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Sánchez-Diener, I., Zamorano, L., Peña, C., Ocampo-Sosa, A., Cabot, G., Gómez-Zorrilla, S., Almirante, B., Aguilar, M., Granados, A., Calbo, E., Rodriguez-Baño, J., Rodríguez-López, F., Tubau, F., Martínez-Martínez, L., Navas, A., and Oliver, A. more...
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- 2020
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Catalog
3. Interhospital sepsis code in Catalonia (Spain): territorial model for initial care of patients with sepsis
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Yébenes, J.C., Lorencio, C., Esteban, E., Espinosa, L., Badia, J.M., Capdevila, J.A., Cisteró, B., Moreno, S., Calbo, E., Jiménez-Fábrega, X., Clèries, M., Faixedas, M.T., Ferrer, R., Vela, E., Medina, C., Rodríguez, A., Netto, C., Armero, E., Solsona, M., Lopez, R., Granes, A., Perez-Claveria, V., Artigas, A., and Estany, J more...
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- 2020
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4. Código Sepsis Interhospitalario en Catalunya: modelo organizativo territorial para la atención inicial al paciente con sepsis
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Yébenes, J.C., Lorencio, C., Esteban, E., Espinosa, L., Badia, J.M., Capdevila, J.A., Cisteró, B., Moreno, S., Calbo, E., Jiménez-Fábrega, X., Clèries, M., Faixedas, M.T., Ferrer, R., Vela, E., Medina, C., Rodríguez, A., Netto, C., Armero, E., Solsona, M., Lopez, R., Granes, A., Perez-Claveria, V., Artigas, A., and Estany, J. more...
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- 2020
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5. Predictors of outcome in patients with severe sepsis or septic shock due to extended-spectrum β-lactamase-producing Enterobacteriaceae
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Russo, A., Falcone, M., Gutiérrez-Gutiérrez, B., Calbo, E., Almirante, B., Viale, P.L., Oliver, A., Ruiz-Garbajosa, P., Gasch, O., Gozalo, M., Pitout, J., Akova, M., Peña, C., Cisneros, J.M., Hernández-Torres, A., Farcomeni, A., Prim, N., Origüen, J., Bou, G., Tacconelli, E., Tumbarello, M., Hamprecht, A., Karaiskos, I., de la Calle, C., Pérez, F., Schwaber, M.J., Bermejo, J., Lowman, W., Hsueh, P.-R., Mora-Rillo, M., Rodriguez-Gomez, J., Souli, M., Bonomo, R.A., Paterson, D.L., Carmeli, Y., Pascual, A., Rodríguez-Baño, J., and Venditti, M. more...
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- 2018
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6. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study
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del Toro, M D, Gálvez, J, Falcone, M, Russo, A, Giamarellou, H, Trecarichi, E M, Losito, A R, García-Vázquez, E, Hernández, A, Gómez, J, Bou, G, Iosifidis, E, Prim, N, Navarro, F, Mirelis, B, Skiada, A, Origüen, J, Juan, R San, Fernández-Ruiz, M, Larrosa, N, Puig-Asensio, M, Cisneros, J M, Molina, J, González, V, Rucci, V, de Gopegui, E Ruiz, Marinescu, C I, Martínez-Martínez, L, Fariñas, M C, Cano, M E, Gozalo, M, Mora-Rillo, M, Francisco, C Navarro-San, Peña, C, Gómez-Zorrilla, S, Tubau, F, Tsakris, A, Zarkotou, O, Antoniadou, A, Poulakou, G, Pitout, J, Virmani, D, Torre-Cisneros, J, Guzmán-Puche, J, Helvaci, Ö, Sahin, A O, Pintado, V, Ruiz, P, Bartoletti, M, Giannella, M, Tacconelli, E, Riemenschneider, F, Calbo, E, Badia, C, Xercavins, M, Gasch, O, Fontanals, D, Jové, E, Gutiérrez-Gutiérrez, Belén, Salamanca, Elena, de Cueto, Marina, Hsueh, Po-Ren, Viale, Pierluigi, Paño-Pardo, José Ramón, Venditti, Mario, Tumbarello, Mario, Daikos, George, Cantón, Rafael, Doi, Yohei, Tuon, Felipe Francisco, Karaiskos, Ilias, Pérez-Nadales, Elena, Schwaber, Mitchell J, Azap, Özlem Kurt, Souli, Maria, Roilides, Emmanuel, Pournaras, Spyros, Akova, Murat, Pérez, Federico, Bermejo, Joaquín, Oliver, Antonio, Almela, Manel, Lowman, Warren, Almirante, Benito, Bonomo, Robert A, Carmeli, Yehuda, Paterson, David L, Pascual, Alvaro, and Rodríguez-Baño, Jesús more...
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- 2017
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7. A Predictive Model of Mortality in Patients With Bloodstream Infections due to Carbapenemase-Producing Enterobacteriaceae
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Gálvez, J., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, E.M., Losito, A.R., García-Vázquez, E., Hernández, A., Gómez, J., Iosifidis, E., Prim, N., Navarro, F., Mirelis, B., Origüen, J., San Juan, R., Fernández-Ruiz, M., Larrosa, N., Puig-Asensio, M., Cisneros, J.M., Molina, J., González, V., Rucci, V., Ruiz de Gopegui, E., Marinescu, C.I., Martínez-Martínez, L., Fariñas, M.C., Cano, M.E., Gozalo, M., Mora-Rillo, M., Navarro-San Francisco, C., Peña, C., Gómez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Azap, Ö.K., Pitout, J., Virmani, D., Torre-Cisneros, J., Natera, C., Helvaci, Ö., Sahin, A.O., Cantón, R., Ruiz, P., Bartoletti, M., Giannella, M., Taconelli, E., Riemenschneider, F., Calbo, E., Badia, C., Xercavins, M., Gasch, E., Fontanals, D., Jové, E., Gutiérrez-Gutiérrez, Belén, Salamanca, Elena, de Cueto, Marina, Hsueh, Po-Ren, Viale, Pierluigi, Paño-Pardo, José Ramón, Venditti, Mario, Tumbarello, Mario, Daikos, George, Pintado, Vicente, Doi, Yohei, Tuon, Felipe Francisco, Karaiskos, Ilias, Machuca, Isabel, Schwaber, Mitchell J., Azap, Özlem Kurt, Souli, Maria, Roilides, Emmanuel, Pournaras, Spyros, Akova, Murat, Pérez, Federico, Bermejo, Joaquín, Oliver, Antonio, Almela, Manel, Lowman, Warren, Almirante, Benito, Bonomo, Robert A., Carmeli, Yehuda, Paterson, David L., Pascual, Alvaro, and Rodríguez-Baño, Jesús more...
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- 2016
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8. Clinical characteristics, treatment and outcomes of MRSA bacteraemia in the elderly
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Jover, A., Barcenilla, F., Garcia, M., Pujol, M., Gasch, O., Domínguez, M.A., Camoez, M., Dueñas, C., Ojeda, E., Martinez, J.A., Marco, F., Chaves, F., Lagarde, M., López-Medrano, F., Montejo, J.M., Bereciartua, E., Hernández, J.L., Von Wichmann, M.A., Goenaga, M.A., García-Arenzana, J.M., Padilla, B., Padilla, C., Cercenado, E., García-Pardo, G., Tapiol, J., Horcajada, J.P., Montero, M., Salvado, M., Arnáiz, A., Fernandez, C., Calbo, E., Xercavins, M., Granados, A., Fontanals, D., Pintado, V., Loza, E., Torre-Cisneros, J., Lara, R., Rodríguez-López, F., Rodríguez, M., Natera, C., Gracia-Ahufinger, I., Blanco, J.R., Olarte, I., Benito, N., Mirelis, B., Murillas, J., Ruiz de Gopegui, E., Espejo, E., Morera, M.A., Rodríguez-Baño, J., López-Cortés, L.E., Pascual, A., Martín, C., Lepe, J.A., Molina, J., Sordé, R., Almirante, B., Larrosa, N., Cuervo, Guillermo, Gasch, Oriol, Shaw, Evelyn, Camoez, Mariana, Domínguez, María Ángeles, Padilla, Belén, Pintado, Vicente, Almirante, Benito, Lepe, José A., López-Medrano, Francisco, Ruiz de Gopegui, Enrique, Martínez, José A., Montejo, José Miguel, Perez-Nadales, Elena, Arnáiz, Ana, Goenaga, Miguel Ángel, Benito, Natividad, Horcajada, Juan Pablo, Rodríguez-Baño, Jesús, and Pujol, Miquel more...
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- 2016
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9. Desescalada desde antipseudomónicos en pacientes con bacteriemia por Enterobacterales: Ensayo aleatorizado SIMPLIFY. Resultados preliminares
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Cortés, LE López, primary, Mellado, E Moreno, additional, Delgado-Valverde, M, additional, Goikoetxea-Agirre, J, additional, Soria, LM López, additional, Rodríguez, MT Pérez, additional, Lamas, L Martínez, additional, Fariñas, C, additional, Puig, C Ruiz de Alegría, additional, Palacios, A Romero, additional, Rubio, MC Martínez, additional, Bejar, C Sáez, additional, Cuevas, C de las, additional, Aspas, A Martín, additional, Galán, F, additional, Yuste, JR, additional, Leiva-León, J, additional, Bou, G, additional, Beceiro, I Torres, additional, Calbo, E, additional, Xercavins-Valls, M, additional, Goenaga-Sánchez, MÁ, additional, Anza, DV, additional, Castón, JJ, additional, Recio, M, additional, Merino, E, additional, Rodríguez, JC, additional, Rosso-Fernández, C, additional, Retamar-Gentil, P, additional, and Baño, J Rodríguez, additional more...
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- 2023
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10. Low resilience as risk factor of mental disorders during COVID-19 pandemic: A cohort study
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Castellvi, P, primary, Llistosella, M, additional, Miranda-Mendizabal, A, additional, Recoder, S, additional, Calbo, E, additional, Casajuana-Closas, M, additional, Leiva, D, additional, Manolov, R, additional, Matilla-Santander, N, additional, and Garcia-Forero, C, additional more...
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- 2022
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11. Lack of association between genotypes and haematogenous seeding infections in a large cohort of patients with methicillin-resistant Staphylococcus aureus bacteraemia from 21 Spanish hospitals
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Gasch, O., Camoez, M., Dominguez, M.A., Padilla, B., Pintado, V., Almirante, B., Martín-Gandul, C., López-Medrano, F., de Gopegui, E. Ruiz, Ramón Blanco, J., García-Pardo, G., Calbo, E., Horcajada, J.P., Granados, A., Jover-Sáenz, A., Dueñas, C., and Pujol, M. more...
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- 2014
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12. Bloodstream infections caused by Escherichia coli producing AmpC β-lactamases: epidemiology and clinical features
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Pascual, V., Alonso, N., Simó, M., Ortiz, G., Garcia, M. C., Xercavins, M., Rivera, A., Morera, M. A., Miró, E., Espejo, E., Navarro, F., Gurguí, M., Pérez, J., Rodríguez-Carballeira, M., Garau, J., and Calbo, E. more...
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- 2016
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13. Healthcare-associated, community-acquired and hospital-acquired bacteraemic urinary tract infections in hospitalized patients: a prospective multicentre cohort study in the era of antimicrobial resistance
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Horcajada, J.P., Shaw, E., Padilla, B., Pintado, V., Calbo, E., Benito, N., Gamallo, R., Gozalo, M., and Rodríguez-Baño, J.
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- 2013
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14. A prospective multicentre study of the epidemiology and outcomes of bloodstream infection in cirrhotic patients
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Campoli, C., Siccardi, G., Ambretti, S., Stallmach, A., Venditti, M., Lucidi, C., Ludovisi, S., De Cueto, M., Navarro, M.D., Lopez Cortes, E., Bouza, E., Valerio, M., Eworo, A., Losito, R., Senzolo, M., Nadal, E., Ottobrelli, A., Varguvic, M., Badia, C., Borgia, G., Gentile, I., Buonomo, A.R., Boumis, E., Beteta-Lopez, A., Rianda, A., Taliani, G., Grieco, S., Bartoletti, M., Giannella, M., Lewis, R., Caraceni, P., Tedeschi, S., Paul, M., Schramm, C., Bruns, T., Merli, M., Cobos-Trigueros, N., Seminari, E., Retamar, P., Muñoz, P., Tumbarello, M., Burra, P., Torrani Cerenzia, M., Barsic, B., Calbo, E., Maraolo, A.E., Petrosillo, N., Galan-Ladero, M.A., D'Offizi, G., Bar Sinai, N., Rodríguez-Baño, J., Verucchi, G., Bernardi, M., and Viale, P. more...
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- 2018
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15. Decreased Mortality among Patients with Catheter-Related Bloodstream Infections at Catalan Hospitals (2010-2019)
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Medicina i Cirurgia, Universitat Rovira i Virgili, Badia-Cebada L; Peñafiel J; López-Contreras J; Pomar V; Martínez JA; Santana G; Cuquet J; Montero MM; Hidalgo-López C; Andrés M; Gimenez M; Quesada MD; Vaqué M; Iftimie S; Gudiol C; Pérez R; Coloma A; Marron A; Barrufet P; Marimon M; Lérida A; Clarós M; Ramírez-Hidalgo MF; Garcia Pardo G; Martinez MJ; Chamarro EL; Jiménez-Martínez E; Hornero A; Limón E; López M; Calbo E; Pujol M; Gasch O, Medicina i Cirurgia, Universitat Rovira i Virgili, and Badia-Cebada L; Peñafiel J; López-Contreras J; Pomar V; Martínez JA; Santana G; Cuquet J; Montero MM; Hidalgo-López C; Andrés M; Gimenez M; Quesada MD; Vaqué M; Iftimie S; Gudiol C; Pérez R; Coloma A; Marron A; Barrufet P; Marimon M; Lérida A; Clarós M; Ramírez-Hidalgo MF; Garcia Pardo G; Martinez MJ; Chamarro EL; Jiménez-Martínez E; Hornero A; Limón E; López M; Calbo E; Pujol M; Gasch O more...
- Abstract
The incidence of catheter-related bloodstream infections (CRBSI) has fallen over the last decade, especially in intensive care units (ICUs).To assess the existence of concomitant trends in outcomes and to analyse the current risk factors for mortality.A multicentre retrospective cohort study was conducted at 24 Catalan hospitals participating in the Surveillance of healthcare associated infections in Catalonia (VINCat). All hospital-acquired CRBSI episodes diagnosed from January 2010 to December 2019 were included. A common protocol including epidemiological, clinical and microbiological data was prospectively completed. Mortality at 30 days after bacteraemia onset was analysed using the Cox regression model.Over the study period, 4,795 episodes of CRBSI were diagnosed. Among them, 75% were acquired in conventional wards and central venous catheters were the most frequently involved (61%). The 30-day mortality rate was 13.8%, presenting a significant downward trend over the study period: from 17.9% in 2010 to 10.6% in 2019 (HR 0.95 [0.92-0.98]). The multivariate analysis identified age (HR 1.03 [1.02-1.04]), femoral catheter (HR 1.78 [1.33-2.38]), medical ward acquisition (HR 2.07 [1.62-2.65] and ICU acquisition (HR 3.45 [2.7-4.41]), S. aureus (HR 1.59 [1.27-1.99]) and Candida sp. (HR 2.19 [1.64-2.94]) as risk factors for mortality while the mortality rate associated with episodes originating in peripheral catheters was significantly lower (HR 0.69 [0.54-0.88]).Mortality associated with CRBSI has fallen in recent years but remains high. Intervention programs should focus especially on ICUs and medical wards, where incidence and mortality rates are highest.Copyright © 2022 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. more...
- Published
- 2022
16. Impact of a hand hygiene educational programme on hospital-acquired infections in medical wards
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Monistrol, O., Calbo, E., Riera, M., Nicolás, C., Font, R., Freixas, N., and Garau, J.
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- 2012
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17. Emergence of resistance to daptomycin in a cohort of patients with methicillin-resistant Staphylococcus aureus persistent bacteraemia treated with daptomycin
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Gasch, O., Camoez, M., Domínguez, M. A., Padilla, B., Pintado, V., Almirante, B., Martín, C., López-Medrano, F., de Gopegui, E. Ruiz, Blanco, J. R., García-Pardo, G., Calbo, E., Montero, M., Granados, A., Jover, A., Dueñas, C., Pujol, M., Jover, A., Barcenilla, F., García, M., Pujol, M., Gasch, O., Domínguez, M. A., Camoez, M., Dueñas, C., Ojeda, E., Martínez, J. A., Marco, F., Chaves, F., Lagarde, M., López-Medrano, F., Montejo, J. M., Bereciertua, E., Hernández, J. L., von Wichmann, M. Á., Goenaga, A., García-Arenzana, J. M., Padilla, B., Padilla, C., Cercenado, E., García-Prado, G., Tapiol, J., Horcajada, J. P., Montero, M., Salvadó, M., Arnáiz, A., Fernández, C., Calbo, E., Xercavins, M., Granados, A., Fontanals, D., Pintado, V., Loza, E., Torre-Cisneros, J., Lara, R., Rodríguez-López, F., Rodríguez, M., Natera, C., Blanco, J. R., Olarte, I., Benito, N., Mirelis, B., Murillas, J., Ruiz de Gopegui, E., Espejo, H., Morera, M. A., Rodríguez-Baño, J., López-Cortés, L. E., Pascual, A., Martín, C., Lepe, J. A., Molina, J., Sordé, R., Almirante, B., and Larrosa, N. more...
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- 2014
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18. Aetiology of community-acquired pneumonia among adults in an H1N1 pandemic year: the role of respiratory viruses
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Sangil, A., Calbo, E., Robles, A., Benet, S., Viladot, M. E., Pascual, V., Cuchí, E., Pérez, J., Barreiro, B., Sánchez, B., Torres, J., Canales, L., De Marcos, J. A., and Garau, J.
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- 2012
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19. Bloodstream infections in adults: Importance of healthcare-associated infections
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Vallés, J., Calbo, E., Anoro, E., Fontanals, D., Xercavins, M., Espejo, E., Serrate, G., Freixas, N., Morera, M.A., Font, B., Bella, F., Segura, F., and Garau, J.
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- 2008
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20. Bacteraemic pneumococcal pneumonia in COPD patients: better outcomes than expected
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Calbo, E., Valdés, E., Ochoa de Echagüen, A., Fleites, A., Molinos, L., Xercavins, M., Freixas, N., Rodríguez-Carballeira, M., and Garau, J.
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- 2009
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21. Interhospital Sepsis Code in Catalonia (Spain): Territorial model for initial care of patients with sepsis
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Yébenes JC, Lorencio C, Esteban-Torne E, Espinosa L, Badia JM, Capdevila JA, Cisteró B, Moreno S, Calbo E, Jiménez-Fábrega X, Clèries M, Faixedas MT, Ferrer R, Vela E, Medina C, Rodríguez A, Netto C, Armero E, Solsona M, Lopez R, Granes A, Perez-Claveria V, Artigas A, Estany J, and Comisión Asesora para la Atención al Paciente con Sepsis y Grup de Treball de Sè more...
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Código sepsis, Emergencia, Emergency, Riesgo vital, Sepsis, Sepsis code, Septic shock, Shock séptico, Vital risk - Abstract
Sepsis is a syndromic entity with high prevalence and mortality. The management of sepsis is standardized and exhibits time-dependent efficiency. However, the management of patients with sepsis is complex. The heterogeneity of the forms of presentation can make it difficult to detect and manage such cases, in the same way as differences in training, professional competences or the availability of health resources. The Advisory Commission for Patient Care with Sepsis (CAAPAS), comprising 7 scientific societies, the Emergency Medical System (SEM) and the Catalan Health Service (CatSalut), have developed the Interhospital Sepsis Code (CSI) in Catalonia (Spain). The general objective of the CSI is to increase awareness, promote early detection and facilitate initial care and interhospital coordination to attend septic patients in a homogeneous manner throughout Catalonia. more...
- Published
- 2020
22. Infection Control, Antimicrobial Consumption, and Hospital-Acquired Clostridioides difficile Infection in Acute-Care Hospitals in Catalonia
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Calbo, E, Castella, L, Hornero, A, Larrosa, N, Sopena, N, Grau, S, Hernandez, S, Gimenez, M, Ferrer, R, Melendo, S, Boix-Palop, L, and Horcajada, JP
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- 2020
23. Invasive pneumococcal disease among children in a health district of Barcelona: early impact of pneumococcal conjugate vaccine
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Calbo, E., Díaz, Á., Cañadell, E., Fábrega, J., Uriz, S., Xercavins, M., Morera, M.A., Cuchi, E., Rodríguez-Carballeira, M., and Garau, J.
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- 2006
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24. Healthcare-associated bacteraemic pneumonia: aetiology, severity of disease and outcomes: O26
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Salvado, M., Lozano, L., Calbo, E., Freixes, N., Riera, M., Xercavins, M., Rodriguez-Carballeira, M., and Garau, J.
- Published
- 2008
25. Impact of a training program on the surveillance of Clostridioiaes difficile infection
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Sopena, N, Freixas, N, Bella, F, Perez, J, Hornero, A, Limon, E, Gudiol, F, Pujol, M, Salgado, X, Lora, M, Martos, P, Niubo, J, Fernandez, G, Castella, L, Valls, S, Santana, G, Lopez, M, Calbo, E, Falgueras, L, Piriz, M, Horcajada, JP, Sorli, L, Lopez-Contreras, J, Cotura, MA, Jover-Saenz, A, Ramirez-Hidalgo, M, Garcia, G, Pico, E, Perez, MO, Domenech, MF, Mas, D, Perez, R, Coloma, A, Grau, L, Andres, M, Vilamala, A, Martinez, MJ, Cuquet, J, Vasquez, R, Castro, A, Iftimie, S, Sanchez, I, Claros, M, Vilaro, I, Jofre, M, Coll, R, Brugues, M, Marron, A, Sauca, G, Barrufet, MP, Marimon, M, Tortajada, S, Gallardo, M, Vaque, M, Meije, Y, Berbel, C, Garcia, I, Serrat, J, Palau, E, Garcia, A, Galles, C, Laborda, R, Martinez, A, Burgas, MC, Girbal, P, Sala, C, Moreno, MJ, Ros, MT, Angas, J, Smithson, A, Bastida, MT, de la Fuente, JC, Rovira, M, Martin-Urda, A, Aliu, T, Diaz-Brito, V, Moreno, E, Agusti, C, Pena, I, Grau, J, Benitez, RM, Blancas, D, Martinez, S, Ferrer, R, Capdevila, E, Sanfeliu, E, Blasco, MM, Monzon, H, Sancliment, S, Hernandez, S, Castander, D, Montardit, I, Sanz, M, Sabate, S, Gese, T, Hernandez, PJ, Tricas, JM, Redon, E, Panisello, M, Ferre, RM, Cusco, M, Gabarro, L, Farguell, J, Calaf, E, Fernandez, MC, Oviedo, E, Gudiol, C, Albasanz-Puig, A, Jimenez, M, and Rodrigues, G more...
- Subjects
Clostridioides difficile ,surveillance ,infection prevention ,Clostridium difficile ,medical education - Abstract
A high degree of vigilance and appropriate diagnostic methods are required to detect Clostridioides difficile infection (CDI). We studied the effectiveness of a multimodal training program for improving CDI surveillance and prevention. Between 2011 and 2016, this program was made available to healthcare staff of acute care hospitals in Catalonia. The program included an online course, two face-to-face workshops and dissemination of recommendations on prevention and diagnosis. Adherence to the recommendations was evaluated through surveys administered to the infection control teams at the 38 participating hospitals. The incidence of CDI increased from 2.20 cases/10 000 patient-days in 2011 to 3.41 in 2016 (P < 0.001). The number of hospitals that applied an optimal diagnostic algorithm rose from 32.0% to 71.1% (P = 0.002). Hospitals that applied an optimal diagnostic algorithm reported a higher overall incidence of CDI (3.62 vs. 1.92, P < 0.001), and hospitals that were more active in searching for cases reported higher rates of hospital-acquired CDI (1.76 vs. 0.84, P < 0.001). The results suggest that the application of a multimodal training strategy was associated with a significant rise in the reporting of CDI, as well as with an increase in the application of the optimal diagnostic algorithm. more...
- Published
- 2019
26. External validation of the INCREMENT-CPE mortality score in a carbapenem-resistant Klebsiella pneumoniae bacteraemia cohort: the prognostic significance of colistin resistance
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Machuca, I, Gutierrez-Gutierrez, B, Rivera-Espinar, F, Cano, A, Gracia-Ahufinger, I, Guzman-Puche, J, Marfil-Perez, E, Perez-Nadales, E, Caston, JJ, Bonomo, RA, Carmeli, Y, Paterson, D, Pascual, A, Martinez-Martinez, L, Rodriguez-Bano, J, Torre-Cisneros, J, Salamanca, E, de Cueto, M, Hsueh, PR, Viale, P, Bartoletti, M, Giannella, M, Pano-Pardo, JR, Mora-Rillo, M, Navarro-San Francisco, C, Venditti, M, Falcone, M, Russo, A, Tumbarello, M, Trecarichi, EM, Losito, AR, Daikos, G, Skiada, A, Canton, R, Pintado, V, Ruiz, P, Doi, Y, Tuon, FF, Karaiskos, I, Giamarellou, H, Schwaber, MJ, Azap, OK, Souli, M, Antoniadou, A, Poulakou, G, Roilides, E, Iosifidis, E, Pournaras, S, Tsakris, A, Zarkotou, O, Akova, M, Helvaci, O, Sahin, AO, Perez, F, Bermejo, J, Rucci, V, Oliver, A, de Gopegui, ER, Marinescu, CI, de la Calle, C, Martinez, JA, Morata, L, Soriano, A, Lowman, W, Almirante, B, Larrosa, N, Puig-Asensio, M, Garcia-Vazquez, E, Hernandez, A, Gomez, J, Bou, G, Prim, N, Navarro, F, Mirelis, B, Origuen, J, San Juan, R, Fernandez-Ruiz, M, Cisneros, JM, Molina, J, Gonzalez, V, Farinas, MC, Cano, ME, Gozalo, M, Pena, C, Gomez-Zorrilla, S, Tubau, F, Pitout, J, Virmani, D, Natera, C, Marfil, E, Tacconelli, E, Riemenschneider, F, Calbo, E, Badia, C, Xercavins, M, Gasch, O, Fontanals, D, and Jove, E more...
- Subjects
KPC ,Klebsiella pneumoniae ,Carbapenem resistance ,INCREMENT risk score ,Colistin resistance - Abstract
External validation of the INCREMENT-CPE risk score (ICS) for 30-day all-cause mortality is needed. There is also scarce information about whether colistin resistance influences the prognosis of carbapenem-resistant Klebsiella pneumoniae (CRKp) bacteraemia. In this study, the ability of ICS to predict all-cause mortality in the KAPECOR cohort was calculated using the area under the receiver operating characteristic (AUROC) curve. The association of colistin resistance with mortality was studied. The ICS showed an AUROC curve of 0.77 (95% CI 0.68-0.86). A cut-off of 8 points showed 96.8% sensitivity and 50.7% specificity. Mortality of low-risk patients was not different in those treated with monotherapy versus combination therapy. However, mortality of high-risk patients treated with combination therapy (37.8%) was significantly lower than in those treated with monotherapy (68.4%) (P = 0.008). To study the prognostic significance of colistin resistance, 83 selected cases of bacteraemia due to colistin-susceptible CRKp were obtained from the INCREMENT cohort for comparison. Colistin resistance could not be shown to be associated with higher mortality in either the high-risk ICS group [adjusted odds ratio (aOR) = 1.56, 95% CI 0.69-3.33; P = 0.29] or in 37 ICS-matched pairs (aOR = 1.38, 95% CI 0.55-3.42; P = 0.49), or in a sensitivity analysis including only KPC isolates (aOR = 1.81, 95% CI 0.73-4.57; P = 0.20), but the precision of estimates was low. These results validate ICS for all-cause mortality and to optimise targeted therapy for CRKp bacteraemia. Colistin resistance was not clearly associated with increased mortality. (C) 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. more...
- Published
- 2019
27. Significance of staphylococcal bacteruria in the course of S. aureus bacteraemia: P1696
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Monzón, H., Calbo, E., Cuadra, L., Xercavins, M., Garau, J., and Quintana, S.
- Published
- 2005
28. Streptococcus pneumoniae spinal infection: P1185
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Cuadra, L., Calbo, E., Pallarés, R., Aguado, J. M., Pérez-Trallero, E., Xercavins, M., and Garau, J.
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- 2005
29. Corticosteroids in patients with severe community-acquired pneumonia: impact on mortality: P881
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Vidal, C. Garcia, Calbo, E., Ferrer, C., Pascual, V., Quintana, S., and Garau, J.
- Published
- 2005
30. Impact of a training program on the surveillance of Clostridioiaes difficile infection
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Universitat Rovira i Virgili, Sopena, N; Freixas, N; Bella, F; Pérez, J; Hornero, A; Limon, E; Gudiol, F; Pujol, M; Salgado, X; Lora, M; Martos, P; Niubó, J; Fernández, G; Castellà, L; Valls, S; Santana, G; López, M; Calbo, E; Falgueras, L; Piriz, M; Horcajada, JP; Sorlí, L; López-Contreras, J; Cotura, MA; Jover-Sáenz, A; Ramírez-Hidalgo, M; García, G; Picó, E; Pérez, MO; Domenech, MF; Mas, D; Pérez, R; Coloma, A; Grau, L; Andrés, M; Vilamala, A; Martínez, MJ; Cuquet, J; Vásquez, R; Castro, A; Iftimie, S; Sánchez, I; Clarós, M; Vilaró, I; Jofre, M; Garcia, G; Coll, R; Brugués, M; Marrón, A; Sauca, G; Barrufet, MP; Marimón, M; Tortajada, S; Gallardo, M; Vaque, M; Meije, Y; Berbel, C; Garcia, I; Serrat, J; Palau, E; Garcia, A; Gallés, C; Laborda, R; Martínez, A; Burgas, MC; Girbal, P; Sala, C; Moreno, MJ; Ros, MT; Angas, J; Smithson, A; Bastida, MT; de la Fuente, JC; Rovira, M; Martin-Urda, A; Aliu, T; Diaz-Brito, V; Moreno, E; Agusti, C; Peña, I; Grau, J; Benítez, RM; Blancas, D; Moreno, E; Martínez, S; Ferrer, R; Capdevila, E; Sanfeliu, E; Blasco, MM; Monzón, H; Sancliment, S; Hernández, S; Castander, D; Montardit, I; Sanz, M; Sabaté, S; Gesé, T; Hernández, PJ; Tricas, JM; Redón, E; Panisello, M; Ferré, RM; Cuscó, M; Gabarró, L; Farguell, J; Calaf, E; Fernández, MC; Oviedo, E; Gudiol, C; Albasanz-Puig, A; Jiménez, M; Rodrigues, G, Universitat Rovira i Virgili, and Sopena, N; Freixas, N; Bella, F; Pérez, J; Hornero, A; Limon, E; Gudiol, F; Pujol, M; Salgado, X; Lora, M; Martos, P; Niubó, J; Fernández, G; Castellà, L; Valls, S; Santana, G; López, M; Calbo, E; Falgueras, L; Piriz, M; Horcajada, JP; Sorlí, L; López-Contreras, J; Cotura, MA; Jover-Sáenz, A; Ramírez-Hidalgo, M; García, G; Picó, E; Pérez, MO; Domenech, MF; Mas, D; Pérez, R; Coloma, A; Grau, L; Andrés, M; Vilamala, A; Martínez, MJ; Cuquet, J; Vásquez, R; Castro, A; Iftimie, S; Sánchez, I; Clarós, M; Vilaró, I; Jofre, M; Garcia, G; Coll, R; Brugués, M; Marrón, A; Sauca, G; Barrufet, MP; Marimón, M; Tortajada, S; Gallardo, M; Vaque, M; Meije, Y; Berbel, C; Garcia, I; Serrat, J; Palau, E; Garcia, A; Gallés, C; Laborda, R; Martínez, A; Burgas, MC; Girbal, P; Sala, C; Moreno, MJ; Ros, MT; Angas, J; Smithson, A; Bastida, MT; de la Fuente, JC; Rovira, M; Martin-Urda, A; Aliu, T; Diaz-Brito, V; Moreno, E; Agusti, C; Peña, I; Grau, J; Benítez, RM; Blancas, D; Moreno, E; Martínez, S; Ferrer, R; Capdevila, E; Sanfeliu, E; Blasco, MM; Monzón, H; Sancliment, S; Hernández, S; Castander, D; Montardit, I; Sanz, M; Sabaté, S; Gesé, T; Hernández, PJ; Tricas, JM; Redón, E; Panisello, M; Ferré, RM; Cuscó, M; Gabarró, L; Farguell, J; Calaf, E; Fernández, MC; Oviedo, E; Gudiol, C; Albasanz-Puig, A; Jiménez, M; Rodrigues, G more...
- Abstract
A high degree of vigilance and appropriate diagnostic methods are required to detect Clostridioides difficile infection (CDI). We studied the effectiveness of a multimodal training program for improving CDI surveillance and prevention. Between 2011 and 2016, this program was made available to healthcare staff of acute care hospitals in Catalonia. The program included an online course, two face-to-face workshops and dissemination of recommendations on prevention and diagnosis. Adherence to the recommendations was evaluated through surveys administered to the infection control teams at the 38 participating hospitals. The incidence of CDI increased from 2.20 cases/10 000 patient-days in 2011 to 3.41 in 2016 (P < 0.001). The number of hospitals that applied an optimal diagnostic algorithm rose from 32.0% to 71.1% (P = 0.002). Hospitals that applied an optimal diagnostic algorithm reported a higher overall incidence of CDI (3.62 vs. 1.92, P < 0.001), and hospitals that were more active in searching for cases reported higher rates of hospital-acquired CDI (1.76 vs. 0.84, P < 0.001). The results suggest that the application of a multimodal training strategy was associated with a significant rise in the reporting of CDI, as well as with an increase in the application of the optimal diagnostic algorithm. more...
- Published
- 2019
31. Risk factors for community-acquired infections due to Escherichia coli harbouring extended-spectrum-beta-lactamases
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Romani, V., Calbo, E., Garcia-Vidal, C., Gomez, L., Xercavins, M., Estrada, C., Lopez-Yeste, L., Quintana, S., and Garau, J.
- Published
- 2004
32. Programas de optimización de uso de antimicrobianos (PROA) en hospitales españoles: documento de consenso GEIH-SEIMC, SEFH y SEMPSPH
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Rodríguez-Baño, J., Paño-Pardo, J.R., Alvarez-Rocha, L., Asensio, Á., Calbo, E., Cercenado, E., Cisneros, J.M., Cobo, J., Delgado, O., Garnacho-Montero, J., Grau, S., Horcajada, J.P., Hornero, A., Murillas-Angoiti, J., Oliver, A., Padilla, B., Pasquau, J., Pujol, M., Ruiz-Garbajosa, P., San Juan, R., and Sierra, R. more...
- Published
- 2012
- Full Text
- View/download PDF
33. Predictors of outcome in patients with severe sepsis or septic shock due to extended-spectrum beta-lactamase-producing Enterobacteriaceae
- Author
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Russo, A, Falcone, M, Gutierrez-Gutierrez, B, Calbo, E, Almirante, B, Viale, PL, Oliver, A, Ruiz-Garbajosa, R, Gasch, O, Gozalo, M, Pitout, J, Akova, M, Pena, C, Cisneros, JM, Hernandez-Torres, A, Farcomeni, A, Prim, N, Origun, J, Bou, G, Tacconelli, E, Tumbarello, M, Hamprecht, A, Karaiskos, I, de la Calle, C, Perez, F, Schwaber, MJ, Bermejo, J, Lowman, W, Hsueh, RR, Mora-Rillo, M, Rodriguez-Gomez, J, Souli, M, Bonomo, RA, Paterson, DL, Carmeli, Y, Pascual, A, Rodriguez-Bano, J, and Venditti, M more...
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sepsis ,septic shock ,beta-lactam/beta-lactamase inhibitors ,carbapenems ,extended-spectrum beta-lactamases ,bacterial infections and mycoses - Abstract
Purpose: There are few data in the literature regarding sepsis or septic shock due to extended-spectrum fi-lactamases (ESBL)-producing Enterobacteriaceae (E). The aim of this study was to assess predictors of outcome in septic patients with bloodstream infection (BSI) caused by ESBL-E. Methods: Patients with severe sepsis or septic shock and BSI due to ESBL-E were selected from the INCREMENT database. The primary endpoint of the study was the evaluation of predictors of outcome after 30 days from development of severe sepsis or septic shock due to ESBL-E infection. Three cohorts were created for analysis: global, empirical-therapy and targeted-therapy cohorts. Results: 367 septic patients were analysed. Overall mortality was 43.9% at 30 days. Escherichia coli (62.4%) and Klebsiella pneumoniae (27.2%) were the most frequent isolates. fi-lactam/fi-lactamase inhibitor (BLBLI) combinations were the most empirically used drug (43.6%), followed by carbapenems (29.4%). Empirical therapy was active in vitro in 249 (67.8%) patients, and escalation of antibiotic therapy was reported in 287 (78.2%) patients. Cox regression analysis showed that age, Charlson Comorbidity Index, McCabe classification, Pitt bacteremia score, abdominal source of infection and escalation of antibiotic therapy were independently associated with 30-day mortality. No differences in survival were reported in patients treated with BLBLI combinations or carbapenems in empirical or definitive therapy. Conclusions: BSI due to ESBL-E in patients who developed severe sepsis or septic shock was associated with high 30-day mortality. Comorbidities, severity scores, source of infection and antibiotic therapy escalation were important determinants of unfavorable outcome. (C) 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. more...
- Published
- 2018
34. Rhodomyrtone decreases Staphylococcus aureus SigB activity during exponentially growing phase and inhibits haemolytic activity within membrane vesicles
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Mitsuwan, Watcharapong, primary, Jiménez-Munguía, Irene, additional, Visutthi, Monton, additional, Sianglum, Wipawadee, additional, Rodríguez-Ortega, Manuel J., additional, Voravuthikunchai, Supayang P., additional, Jover, A., additional, Barcenilla, F., additional, García, M., additional, Pujol, M., additional, Gasch, O., additional, Domínguez, M.A., additional, Camoez, M., additional, Dueñas, C., additional, Ojeda, E., additional, Martínez, J.A., additional, Marco, F., additional, Chaves, F., additional, Lagarde, M., additional, López-Medrano, F., additional, Montejo, J.M., additional, Bereciertua, E., additional, Hernández, J.L., additional, von Wichmann, M.Á., additional, Goenaga, A., additional, García-Arenzana, J.M., additional, Padilla, B., additional, Padilla, C., additional, Cercenado, E., additional, García-Prado, G., additional, Tapiol, J., additional, Horcajada, J.P., additional, Montero, M., additional, Salvadó, M., additional, Arnáiz, A., additional, Fernández, C., additional, Calbo, E., additional, Xercavins, M., additional, Granados, A., additional, Fontanals, D., additional, Pintado, V., additional, Loza, E., additional, Torre-Cisneros, J., additional, Lara, R., additional, Rodríguez-López, F., additional, Natera, C., additional, Blanco, J.R., additional, Olarte, I., additional, Benito, N., additional, Mirelis, B., additional, Murillas, J., additional, Ruiz de Gopegui, E., additional, Espejo, H., additional, Morera, M.A., additional, Rodríguez-Baño, J., additional, López-Cortés, L.E., additional, Pascual, A., additional, Martín, C., additional, Lepe, J.A., additional, Molina, J., additional, Sordé, R., additional, Almirante, B., additional, and Larrosa, N., additional more...
- Published
- 2019
- Full Text
- View/download PDF
35. Riesgo de infección de dispositivos intracardíacos en pacientes con bacteriemia
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Boix-Palop, L., primary, Dietl, B., additional, Calbo, E., additional, Xercavins, M., additional, Martínez Pérez-Crespo, P.M., additional, Lanz García, J., additional, Cantón, M.L., additional, Rodríguez Baño, J., additional, and López Cortés, L.E., additional more...
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- 2019
- Full Text
- View/download PDF
36. Bacillus species pseudo-outbreak: construction works and collateral damage
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Boix-Palop, L., Nicolás, C., Xercavins, M., Riera, M., Prim, N., Freixas, N., Pérez, J., and Calbo, E.
- Published
- 2017
- Full Text
- View/download PDF
37. A prospective multicentre study of the epidemiology and outcomes of bloodstream infection in cirrhotic patients
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Bartoletti, M., Giannella, M., Lewis, R., Caraceni, P., Tedeschi, S., Paul, M., Schramm, C., Bruns, T., Merli, M., Cobos-Trigueros, N., Seminari, E., Retamar, P., Munoz, P., Tumbarello, M., Burra, P., Cerenzia, M. Torrani, Barsic, B., Calbo, E., Maraolo, A. E., Petrosillo, N., Galan-Ladero, M. A., D'Offizi, G., Bar Sinai, N., Rodriguez-Bano, J., Verucchi, G., Bernardi, M., Viale, P., Bartoletti, M., Giannella, M., Lewis, R., Caraceni, P., Tedeschi, S., Paul, M., Schramm, C., Bruns, T., Merli, M., Cobos-Trigueros, N., Seminari, E., Retamar, P., Munoz, P., Tumbarello, M., Burra, P., Cerenzia, M. Torrani, Barsic, B., Calbo, E., Maraolo, A. E., Petrosillo, N., Galan-Ladero, M. A., D'Offizi, G., Bar Sinai, N., Rodriguez-Bano, J., Verucchi, G., Bernardi, M., and Viale, P. more...
- Abstract
Objectives: To describe the current epidemiology of bloodstream infection (BSI) in patients with cirrhosis; and to analyse predictors of 30-day mortality and risk factors for antibiotic resistance. Methods: Cirrhotic patients developing a BSI episode were prospectively included at 19 centres in five countries from September 2014 to December 2015. The discrimination of mortality risk scores for 30-day mortality were compared by area under the receiver operator risk and Cox regression models. Risk factors for multidrug-resistant organisms (MDRO) were assessed with a logistic regression model. Results: We enrolled 312 patients. Gram-negative bacteria, Gram-positive bacteria and Candida spp. were the cause of BSI episodes in 53%, 47% and 7% of cases, respectively. The 30-day mortality rate was 25% and was best predicted by the Sequential Organ Failure Assessment (SOFA) and Chronic Liver Failure-SOFA (CLIF-SOFA) score. In a Cox regression model, delayed (>24 hours) antibiotic treatment (hazard ratio (HR) 7.58; 95% confidence interval (CI) 3.29-18.67; p < 0.001), inadequate empirical therapy (HR 3.14; 95% CI 1.93-5.12; p < 0.001) and CLIF-SOFA score (HR 1.35; 95% CI 1.28-1.43; p < 0.001) were independently associated with 30-day mortality. Independent risk factors for MDRO (31% of BSIs) were previous antimicrobial exposure (odds ratio (OR) 2.91; 95% CI 1.73-4.88; p < 0.001) and previous invasive procedures (OR 2.51; 95% CI 1.48-4.24; p 0.001), whereas spontaneous bacterial peritonitis as BSI source was associated with a lower odds of MDRO (OR 0.30; 95% CI 0.12-0.73; p 0.008). Conclusions: MDRO account for nearly one-third of BSI in cirrhotic patients, often resulting in delayed or inadequate empirical antimicrobial therapy and increased mortality rates. Our data suggest that improved prevention and treatment strategies for MDRO are urgently needed in the liver cirrhosis patients. (C) 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Else more...
- Published
- 2018
38. Predictors of outcome in patients with severe sepsis or septic shock due to extended-spectrum beta-lactamase-producing Enterobacteriaceae
- Author
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Russo, A., Falcone, M., Gutierrez-Gutierrez, B., Calbo, E., Almirante, B., Viale, P. L., Oliver, A., Ruiz-Garbajosa, R., Gasch, O., Gozalo, M., Pitout, J., Akova, M., Pena, C., Cisneros, J. M., Hernandez-Torres, A., Farcomeni, A., Prim, N., Origun, J., Bou, G., Tacconelli, E., Tumbarello, M., Hamprecht, A., Karaiskos, I, de la Calle, C., Perez, F., Schwaber, M. J., Bermejo, J., Lowman, W., Hsueh, R-R, Mora-Rillo, M., Rodriguez-Gomez, J., Souli, M., Bonomo, R. A., Paterson, D. L., Carmeli, Y., Pascual, A., Rodriguez-Bano, J., Venditti, M., Russo, A., Falcone, M., Gutierrez-Gutierrez, B., Calbo, E., Almirante, B., Viale, P. L., Oliver, A., Ruiz-Garbajosa, R., Gasch, O., Gozalo, M., Pitout, J., Akova, M., Pena, C., Cisneros, J. M., Hernandez-Torres, A., Farcomeni, A., Prim, N., Origun, J., Bou, G., Tacconelli, E., Tumbarello, M., Hamprecht, A., Karaiskos, I, de la Calle, C., Perez, F., Schwaber, M. J., Bermejo, J., Lowman, W., Hsueh, R-R, Mora-Rillo, M., Rodriguez-Gomez, J., Souli, M., Bonomo, R. A., Paterson, D. L., Carmeli, Y., Pascual, A., Rodriguez-Bano, J., and Venditti, M. more...
- Abstract
Purpose: There are few data in the literature regarding sepsis or septic shock due to extended-spectrum fi-lactamases (ESBL)-producing Enterobacteriaceae (E). The aim of this study was to assess predictors of outcome in septic patients with bloodstream infection (BSI) caused by ESBL-E. Methods: Patients with severe sepsis or septic shock and BSI due to ESBL-E were selected from the INCREMENT database. The primary endpoint of the study was the evaluation of predictors of outcome after 30 days from development of severe sepsis or septic shock due to ESBL-E infection. Three cohorts were created for analysis: global, empirical-therapy and targeted-therapy cohorts. Results: 367 septic patients were analysed. Overall mortality was 43.9% at 30 days. Escherichia coli (62.4%) and Klebsiella pneumoniae (27.2%) were the most frequent isolates. fi-lactam/fi-lactamase inhibitor (BLBLI) combinations were the most empirically used drug (43.6%), followed by carbapenems (29.4%). Empirical therapy was active in vitro in 249 (67.8%) patients, and escalation of antibiotic therapy was reported in 287 (78.2%) patients. Cox regression analysis showed that age, Charlson Comorbidity Index, McCabe classification, Pitt bacteremia score, abdominal source of infection and escalation of antibiotic therapy were independently associated with 30-day mortality. No differences in survival were reported in patients treated with BLBLI combinations or carbapenems in empirical or definitive therapy. Conclusions: BSI due to ESBL-E in patients who developed severe sepsis or septic shock was associated with high 30-day mortality. Comorbidities, severity scores, source of infection and antibiotic therapy escalation were important determinants of unfavorable outcome. (C) 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. more...
- Published
- 2018
39. Geographical variation in therapy for bloodstream infections due to multidrug-resistant Enterobacteriaceae: a post-hoc analysis of the INCREMENT study
- Author
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Harris, P.N.A. Pezzani, M.D. Gutiérrez-Gutiérrez, B. Viale, P. Hsueh, P.-R. Ruiz-Garbajosa, P. Venditti, M. Tumbarello, M. Navarro-Francisco, C. Calbo, E. Akova, M. Giamarellou, H. Oliver, A. Almirante, B. Gasch, O. Martínez-Martínez, L. Schwaber, M.J. Daikos, G. Pitout, J. Peña, C. Hernández-Torres, A. Doi, Y. Pérez, F. Tuon, F.F. Tacconelli, E. Carmeli, Y. Bonomo, R.A. Pascual, Á. Paterson, D.L. Rodríguez-Baño, J. del Toro, M.D. Gálvez, J. Falcone, M. Russo, A. Karaiskos, I. Trecarichi, E.M. Losito, A.R. García-Vázquez, E. Gómez, J. Roilides, E. Iosifidis, E. Pournaras, S. Prim, N. Navarro, F. Mirelis, B. Origüen, J. Juan, R.S. Fernández-Ruiz, M. Almela, M. de la Calle, C. Martínez, J.A. Morata, L. Larrosa, N. Puig-Asensio, M. Bou, G. Molina, J. González, V. Bermejo, J. Rucci, V. de Gopegui, E.R. Marinescu, C.I. Fariñas, M.C. Cano, M.E. Gozalo, M. Paño-Pardo, J.R. Mora-Rillo, M. Gómez-Zorrilla, S. Tubau, F. Tsakris, A. Zarkotou, O. Antoniadou, A. Poulakou, G. Souli, M. Lowman, W. Virmani, D. Torre-Cisneros, J. Machuca, I. Gracia-Ahufinger, I. Azap, Ö.K. Helvaci, Ö. Sahin, A.O. Cantón, R. Pintado, V. Bartoletti, M. Giannella, M. Peter, S. Hamprecht, A. Badia, C. Xercavins, M. Fontanals, D. Jové, E. ESGBIS/REIPI/INCREMENT Group more...
- Abstract
We describe regional differences in therapy for bloodstream infection (BSI) caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE). Patients (n = 1482) in 12 countries from an observational study of BSI caused by ESBL-E or CPE were included. Multivariate logistic regression was used to calculate adjusted odds ratios (aORs) for the influence of country of recruitment on empirical use of β-lactam/β-lactamase inhibitors (BLBLIs) or carbapenems, targeted use of BLBLIs for ESBL-E and use of targeted combination therapy for CPE. Compared with Spain, BLBLI use for empirical therapy was least likely in sites from Israel (aOR 0.34, 95% CI 0.14–0.81), Greece (aOR 0.49, 95% CI 0.26–0.94) and Canada (aOR 0.31, 95% CI 0.11–0.88) but more likely in Italy (aOR 1.58, 95% CI 1.11–2.25) and Turkey (aOR 2.09, 95% CI 1.14–3.81). Empirical carbapenem use was more likely in sites from Taiwan (aOR 1.73, 95% CI 1.03–2.92) and USA (aOR 1.89, 95% CI 1.05–3.39) and less likely in Italy (aOR 0.44, 95% CI 0.28–0.69) and Canada (aOR 0.10, 95% CI 0.01–0.74). Targeted BLBLIs for ESBL-E was more likely in Italian sites. Treatment at sites within Israel, Taiwan, Turkey and Brazil was associated with less combination therapy for CPE. Although this study does not provide precise data on the relative prevalence of ESBL-E or CPE, significant variation in therapy exists across countries even after adjustment for patient factors. Better understanding of what influences therapeutic choices for these infections will aid antimicrobial stewardship efforts. © 2017 Elsevier B.V. and International Society of Chemotherapy more...
- Published
- 2017
40. Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection
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Wilcox, M. H., Gerding, D. N., Poxton, I. R., Kelly, C., Nathan, R., Birch, T., Cornely, O. A., Rahav, G., Bouza, E., Lee, C., Jenkin, G., Jensen, W., Kim, Y. -S., Yoshida, J., Gabryelski, L., Pedley, A., Eves, K., Tipping, R., Guris, D., Kartsonis, N., Playford G, Dorr M. -B., Mcgechie, D, Iredell, J, Allworth, A, Cheng, A, Choi, Nj, Thalhammer, F, Maieron, A, Wenisch, C, Meyer, B, Jacobs, F, Delmee, M, Peetermans, W, Giot, Jb, Munhoz, Al, Kallas, Eg, Ladeira, Jp, Bernstein, Cn, Grimard, D, Mcgeer, A, Poirier, A, Valiquette, L, Miller, M, Oughton, M, Trottier, S, Dolce, P, Smyth, D, Gambra, P, Palma, S, Rojas, L, Northland, R, Arellano, Mc, Perez, J, Barreto, Mf, Gomez, Jm, Ramirez, I, Correa, A, Onate, J, Rohacova, H, Stastnik, M, Zjevikova, A, Blazek, J, Kumpel, P, Petersen, Am, Gluud, Ll, Staugaard, Hm, Tvede, M, Glerup, H, Madsen, Sm, Helms, M, Naumann, R, Karthaus, M, Reinshagen, M, Raz, R, Giladi, M, Chowers, M, Bishara, J, Quirino, T, Castelli, F, Bassetti, M, Rizzardini, G, Vismara, E, Puoti, M, Viale, P, Menichetti, F, Cauda, R, Bonfanti, P, Franzetti, F, Gori, A, Minoli, L, Noriega, Er, Mills, Gd, Ritchie, S, Burns, A, Pithie, A, dos Santos RM, Aldomiro, F, Fernando, Pb, Rola, J, Reis, E, Van Zyl JH, Aboo, N, Richards, G, Hernandez, Mj, de Medrano VA, Prunonosa, Lm, Gonzalez, Jl, Reinoso, Jc, Martinez, Ar, Cisneros, Jd, Banos, Jr, Sheridan, R, Minton, J, Williams, J, Stanley, P, Guleri, A, Llewelyn, M, Todd, N, Barlow, G, Bacon, Ae, Baird, Im, Baxter, R, Zenilman, Jm, Beshay, M, Betts, Rf, Brettholz, Em, Buitrago, Mi, Carlson, Rw, Cook, Pp, Dupont, Hl, Foley, C, Freilich, B, Giron, Ja, Golan, Y, Green, S, Hall, Mc, Johnson, Dj, Jones, Rk, Graham, Dr, Kazimir, M, Keating, M, Brumble, Lm, Kumar, Pn, Liappis, Ap, Libke, R, Mehra, Pk, Overcash, Sj, Mullane, Km, Nguyen, Mh, Patel, Mc, Powers, Ck, Pullman, J, Keegan, J, Nepal, S, English, G, Ricci, Rl, Risi, Gf, Rodriguez, M, Schmitt, Cm, Sims, Md, Kamepalli, R, Tural, A, Vazquez, Ja, Alangaden, Gj, Weavind, Lm, Young, Ma, Chen, St, Liu, E, Nguyen, Hh, Alfonso, Tb, Muse, Dd, Orenstein, R, Yacyshyn, B, Gebhard, Re, Dinges, W, Bolton, M, Rubin, M, Kuemmerle, Jf, Limaye, Ap, Friedenberg, Ka, Hiemenz, Jw, Quadri, A, Martinez, Jv, Barcan, La, Cordova, E, Mykietiuk, A, Losso, M, Fedorak, Rn, Steiner, T, Gerson, M, Weiss, K, Dlouhy, P, Vitous, A, Benes, J, Husa, P, Knizek, P, Anttila, Vj, Broas, M, Camou, F, Postil, D, Launay, O, Corroyer-Simovic, B, Meynard, Jl, Schneider, S, Molina, Jm, Neau, D, Zalcman, G, Boutoille, D, Ostermann, H, Heinz, W, Reuter, S, Oren, I, Schiff, E, Umemoto, T, Masubuchi, T, Mukawa, K, Yasuda, K, Imokawa, S, Fukuda, K, Ohta, H, Harada, N, Fujii, S, Tamaki, S, Yasui, S, Furukawa, K, Takahashi, M, Uraoka, T, Watanabe, M, Ikehara, Y, Kodaira, M, Komatsu, H, Higashi, K, Taguchi, F, Ura, N, Serizawa, Y, Fukuchi, T, Ashikawa, T, Shabana, M, Okubo, M, Matsumoto, M, Kurihara, A, Miyasaka, E, Shimizu, M, Tominaga, H, Kubota, T, Kashiwazaki, M, Masuda, Y, Terasaki, S, Okafuji, H, Mieno, H, Urabe, T, Okamoto, E, Kajimura, M, Yamagishi, Y, Rydzewska, G, Mach, T, Ciechanowski, K, Podlasin, R, Tomasiewicz, K, Janczewska-Kazek, E, Czarnobilski, K, Halota, W, Gryglewska, B, Plesniak, R, Dabrowiecki, P, Lipowski, D, Simanenkov, V, Shcheglova, L, Uspenskiy, Y, Cheganov, A, Han, Ds, Kim, Js, Hong, Sp, Kim, Ti, Jang, Bi, Byeon, Js, Kim, E, Kim, Mj, Lee, J, Pai, H, Cheong, Hj, Lee, S, Loyarte, Ja, Gonzalez, Jc, Santiago, Eb, Lopez, Jr, Baranda, Jm, Viladomiu, As, Calbo, E, Lannergard, A, Falt, J, Gardlund, B, Andersson, Lm, Fraenkel, Cj, Rombo, L, Widmer, A, Chen, Yc, Sheng, Wh, Wang, Fd, Wang, Nc, Lee, Ch, Chen, Yh, Chuang, Yc, Unal, S, Ozaras, R, Esen, S, Ural, O, Ayaz, C, Sakarya, S, Celebi, A, Mistik, R, Bedimo, R, Bressler, A, Mckinley, Mj, Quirk, D, Talansky, Al, Agronin, Me, Akhrass, Fa, Ali, M, Alrabaa, Sf, Assi, Ma, Calfee, Dp, Carson, P, Mariani, Pg, Guerrero, D, Dubberke, Er, Hardi, R, Hazan-Steinberg, S, Itani, Km, Jauregui-Peredo, El, Kasabji, A, Hameed, M, Murillo, A, Odio, Aj, Shah, P, Braun, Ti, Slim, J, Sloan, L, Srinivasan, S, Tan, Mj, Clough, La, Herr, D, Miller, Lg, Dorfmeister, J, Khan, O, and Melik-Abrahamian, F. more...
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0301 basic medicine ,Male ,Adolescent ,Adult ,Aged ,Aged, 80 and over ,Anti-Bacterial Agents ,Antibodies, Monoclonal ,Antibodies, Neutralizing ,Clostridium Infections ,Double-Blind Method ,Drug Therapy, Combination ,Female ,Humans ,Infusions, Intravenous ,Intention to Treat Analysis ,Kaplan-Meier Estimate ,Middle Aged ,Secondary Prevention ,Young Adult ,Clostridium difficile ,Clinical Trial, Phase III ,Antibiotics ,0302 clinical medicine ,Monoclonal ,80 and over ,030212 general & internal medicine ,Medicine (all) ,Neutralizing ,education.field_of_study ,Research Support, Non-U.S. Gov't ,General Medicine ,Multicenter Study ,Randomized Controlled Trial ,Combination ,Broadly Neutralizing Antibodies ,Intravenous ,medicine.medical_specialty ,Infusions ,medicine.drug_class ,030106 microbiology ,Population ,Placebo ,Antibodies ,03 medical and health sciences ,Pharmacotherapy ,Drug Therapy ,Internal medicine ,Journal Article ,medicine ,education ,Intention-to-treat analysis ,Clostridioides difficile ,business.industry ,Interim analysis ,Surgery ,Bezlotoxumab ,business - Abstract
BACKGROUND: Clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients. Recurrences are common after antibiotic therapy. Actoxumab and bezlotoxumab are human monoclonal antibodies against C. difficile toxins A and B, respectively.METHODS: We conducted two double-blind, randomized, placebo-controlled, phase 3 trials, MODIFY I and MODIFY II, involving 2655 adults receiving oral standard-of-care antibiotics for primary or recurrent C. difficile infection. Participants received an infusion of bezlotoxumab (10 mg per kilogram of body weight), actoxumab plus bezlotoxumab (10 mg per kilogram each), or placebo; actoxumab alone (10 mg per kilogram) was given in MODIFY I but discontinued after a planned interim analysis. The primary end point was recurrent infection (new episode after initial clinical cure) within 12 weeks after infusion in the modified intention-to-treat population.RESULTS: In both trials, the rate of recurrent C. difficile infection was significantly lower with bezlotoxumab alone than with placebo (MODIFY I: 17% [67 of 386] vs. 28% [109 of 395]; adjusted difference, -10.1 percentage points; 95% confidence interval [CI], -15.9 to -4.3; PCONCLUSIONS: Among participants receiving antibiotic treatment for primary or recurrent C. difficile infection, bezlotoxumab was associated with a substantially lower rate of recurrent infection than placebo and had a safety profile similar to that of placebo. The addition of actoxumab did not improve efficacy. (Funded by Merck; MODIFY I and MODIFY II ClinicalTrials.gov numbers, NCT01241552 and NCT01513239 .). more...
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- 2017
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41. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study
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Gutiérrez-Gutiérrez, B. Salamanca, E. de Cueto, M. Hsueh, P.-R. Viale, P. Paño-Pardo, J.R. Venditti, M. Tumbarello, M. Daikos, G. Cantón, R. Doi, Y. Tuon, F.F. Karaiskos, I. Pérez-Nadales, E. Schwaber, M.J. Azap, Ö.K. Souli, M. Roilides, E. Pournaras, S. Akova, M. Pérez, F. Bermejo, J. Oliver, A. Almela, M. Lowman, W. Almirante, B. Bonomo, R.A. Carmeli, Y. Paterson, D.L. Pascual, A. Rodríguez-Baño, J. del Toro, M.D. Gálvez, J. Falcone, M. Russo, A. Giamarellou, H. Trecarichi, E.M. Losito, A.R. García-Vázquez, E. Hernández, A. Gómez, J. Bou, G. Iosifidis, E. Prim, N. Navarro, F. Mirelis, B. Skiada, A. Origüen, J. Juan, R.S. Fernández-Ruiz, M. Larrosa, N. Puig-Asensio, M. Cisneros, J.M. Molina, J. González, V. Rucci, V. de Gopegui, E.R. Marinescu, C.I. Martínez-Martínez, L. Fariñas, M.C. Cano, M.E. Gozalo, M. Mora-Rillo, M. Francisco, C.N.-S. Peña, C. Gómez-Zorrilla, S. Tubau, F. Tsakris, A. Zarkotou, O. Antoniadou, A. Poulakou, G. Pitout, J. Virmani, D. Torre-Cisneros, J. Guzmán-Puche, J. Helvaci, Ö. Sahin, A.O. Pintado, V. Ruiz, P. Bartoletti, M. Giannella, M. Tacconelli, E. Riemenschneider, F. Calbo, E. Badia, C. Xercavins, M. Gasch, O. Fontanals, D. Jové, E. REIPI/ESGBIS/INCREMENT Investigators REIPI/ESGBIS/INCREMENT Investigators more...
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Background The best available treatment against carbapenemase-producing Enterobacteriaceae (CPE) is unknown. The objective of this study was to investigate the effect of appropriate therapy and of appropriate combination therapy on mortality of patients with bloodstream infections (BSIs) due to CPE. Methods In this retrospective cohort study, we included patients with clinically significant monomicrobial BSIs due to CPE from the INCREMENT cohort, recruited from 26 tertiary hospitals in ten countries. Exclusion criteria were missing key data, death sooner than 24 h after the index date, therapy with an active antibiotic for at least 2 days when blood cultures were taken, and subsequent episodes in the same patient. We compared 30 day all-cause mortality between patients receiving appropriate (including an active drug against the blood isolate and started in the first 5 days after infection) or inappropriate therapy, and for patients receiving appropriate therapy, between those receiving active monotherapy (only one active drug) or combination therapy (more than one). We used a propensity score for receiving combination therapy and a validated mortality score (INCREMENT-CPE mortality score) to control for confounders in Cox regression analyses. We stratified analyses of combination therapy according to INCREMENT-CPE mortality score (0–7 [low mortality score] vs 8–15 [high mortality score]). INCREMENT is registered with ClinicalTrials.gov, number NCT01764490. Findings Between Jan 1, 2004, and Dec 31, 2013, 480 patients with BSIs due to CPE were enrolled in the INCREMENT cohort, of whom we included 437 (91%) in this study. 343 (78%) patients received appropriate therapy compared with 94 (22%) who received inappropriate therapy. The most frequent organism was Klebsiella pneumoniae (375 [86%] of 437; 291 [85%] of 343 patients receiving appropriate therapy vs 84 [89%] of 94 receiving inappropriate therapy) and the most frequent carbapenemase was K pneumoniae carbapenemase (329 [75%]; 253 [74%] vs 76 [81%]). Appropriate therapy was associated with lower mortality than was inappropriate therapy (132 [38·5%] of 343 patients died vs 57 [60·6%] of 94; absolute difference 22·1% [95% CI 11·0–33·3]; adjusted hazard ratio [HR] 0·45 [95% CI 0·33–0·62]; p more...
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- 2017
42. Empiric Therapy with Carbapenem-Sparing Regimens for Bloodstream Infections due to Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: Results from the INCREMENT Cohort
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Palacios-Baena, Z.R. Gutiérrez-Gutiérrez, B. Calbo, E. Almirante, B. Viale, P. Oliver, A. Pintado, V. Gasch, O. Martínez-Martínez, L. Pitout, J. Akova, M. Peña, C. Molina Gil-Bermejo, J. Hernández, A. Venditti, M. Prim, N. Bou, G. Tacconelli, E. Tumbarello, M. Hamprecht, A. Giamarellou, H. Almela, M. Pérez, F. Schwaber, M.J. Bermejo, J. Lowman, W. Hsueh, P.-R. Paño-Pardo, J.R. Torre-Cisneros, J. Souli, M. Bonomo, R.A. Carmeli, Y. Paterson, D.L. Pascual, Á. Rodríguez-Baño, J. Gálvez, J. Falcone, M. Russo, A. Daikos, G. Trecarichi, E.M. Losito, A.R. Gómez, J. Iosifidis, E. Roilides, E. Karaiskos, I. Doi, Y. Tuon, F.F. Navarro, F. Mirelis, B. Martínez, J.A. De La Calle, C. Morata, L. San Juan, R. Fernández-Ruiz, M. Larrosa, N. Puig, M. Molina, J. González, V. Rucci, V. Ruiz De Gopegui, E. Marinescu, C.I. Fariñas, M.C. Cano, M.E. Gozalo, M. Mora-Rillo, M. Gómez-Zorrilla, S. Tubau, F. Pournaras, S. Tsakris, A. Zarkotou, O. Azap, Ö.K. Antoniadou, A. Poulakou, G. Virmani, D. Cano, Á. Machuca, I. Helvaci, Ö. Sahin, A.O. Ruiz-Garbajosa, P. Bartoletti, M. Giannella, M. Peter, S. Badia, C. Xercavins, M. Fontanals, D. Jové, E. more...
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bacterial infections and mycoses - Abstract
Background. There is little information about the efficacy of active alternative drugs to carbapenems except ?-lactam/?-lactamase inhibitors for the treatment of bloodstream infections (BSIs) due to extended-spectrum ?-lactamase-producing Enterobacteriaceae (ESBL-E). The objective of this study was to assess the outcomes of patients with BSI due to ESBL-E who received empiric therapy with such drugs (other active drugs [OADs]) or carbapenems. Methods. A multinational retrospective cohort study of patients with BSI due to ESBL-E who received empiric treatment with OADs or carbapenems was performed. Cox regression including a propensity score for receiving OADs was performed to analyze 30-day all-cause mortality as main outcome. Clinical failure and length of stay were also analyzed. Results. Overall, 335 patients were included; 249 received empiric carbapenems and 86 OADs. The most frequent OADs were aminoglycosides (43 patients) and fluoroquinolones (20 patients). Empiric therapy with OADs was not associated with mortality (hazard ratio [HR], 0.75; 95% confidence interval [CI], .38-1.48) in the Cox regression analysis. Propensity score-matched pairs, subgroups, and sensitivity analyses did not show different trends; specifically, the adjusted HR for aminoglycosides was 1.05 (95% CI, .51-2.16). OADs were neither associated with 14-day clinical failure (adjusted odds ratio, 0.62; 95% CI, .29-1.36) nor length of hospital stay. Conclusions. We were unable to show that empiric treatment with OAD was associated with a worse outcome compared with carbapenems. This information allows more options to be considered for empiric therapy, at least for some patients, depending on local susceptibility patterns of ESBL-E. © The Author 2017. more...
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- 2017
43. Geographical variation in therapy for bloodstream infections due to multidrug-resistant Enterobacteriaceae: a post-hoc analysis of the INCREMENT study
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Harris, PNA, Pezzani, MD, Gutierrez-Gutierrez, B, Viale, P, Hsueh, PR, Ruiz-Garbajosa, P, Venditti, M, Tumbarello, M, Navarro-Francisco, C, Calbo, E, Akova, M, Giamarellou, H, Oliver, A, Almirante, B, Gasch, O, Martinez-Martinez, L, Schwaber, MJ, Daikos, G, Pitout, J, Pena, C, Hernandez-Torres, A, Doi, Y, Perez, F, Tuon, FF, Tacconelli, E, Carmeli, Y, Bonomo, RA, Pascual, A, Paterson, DL, Rodriguez-Bano, J, Prim N., Navarro F., Mirelis B., and Jové, E. more...
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Carbapenemase ,Klebsiella pneumoniae ,Carbapenems ,Escherichia coli ,beta-Lactam/beta-lactamase inhibitor ,Extended-spectrum beta-lactamase - Abstract
We describe regional differences in therapy for bloodstream infection (BSI) caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE). Patients (n = 1482) in 12 countries from an observational study of BSI caused by ESBL-E or CPE were included. Multivariate logistic regression was used to calculate adjusted odds ratios (aORs) for the influence of country of recruitment on empirical use of beta-lactam/beta-lactamase inhibitors (BLBLIs) or carbapenems, targeted use of BLBLIs for ESBL-E and use of targeted combination therapy for CPE. Compared with Spain, BLBLI use for empirical therapy was least likely in sites from Israel (aOR 0.34, 95% CI 0.14-0.81), Greece (aOR 0.49, 95% CI 0.26-0.94) and Canada (aOR 0.31, 95% CI 0.11-0.88) but more likely in Italy (aOR 1.58, 95% CI 1.11-2.25) and Turkey (aOR 2.09, 95% CI 1.14-3.81). Empirical carbapenem use was more likely in sites from Taiwan (aOR 1.73, 95% CI 1.03-2.92) and USA (aOR 1.89, 95% CI 1.053.39) and less likely in Italy (aOR 0.44, 95% CI 0.28-0.69) and Canada (aOR 0.10, 95% CI 0.01-0.74). Targeted BLBLIs for ESBL-E was more likely in Italian sites. Treatment at sites within Israel, Taiwan, Turkey and Brazil was associated with less combination therapy for CPE. Although this study does not provide precise data on the relative prevalence of ESBL-E or CPE, significant variation in therapy exists across countries even after adjustment for patient factors. Better understanding of what influences therapeutic choices for these infections will aid antimicrobial stewardship efforts. (C) 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. more...
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- 2017
44. Daptomycin plus fosfomycin versus daptomycin monotherapy in treating MRSA: protocol of a multicentre, randomised, phase III trial
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Shaw Perujo, Evelyn, Miró Meda, José M., Puig-Asensio, M., Pigrau, C., Barcenilla, F., Murillas Angoiti, Javier, Garcia-Pardo, G., Espejo, Elena, Padilla, Belén, Garcia-Reyne, A., Pasquau, Juan, Rodríguez Baño, Jesús, López-Contreras, J., Montero, Miguel, Calle, Cristina de la, Pintado, Vicente, Calbo, E., Gasch, Oriol, Montejo, Miguel, Salavert, Miguel, Garcia-Pais, M.J., Carratalà, Jordi, Pujol Rojo, Miquel, Spanish Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III, Madrid, Spain, GEIH (Hospital Infection Study Group), Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain, GEIH (Hospital Infection Study Group), [Shaw ,E, Carratalà,J, Pujol,M] Hospital Universitari de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain. [Miró,JM, de la Calle C] Hospital Universitari Clínic-IDIBAPS, Barcelona, Spain. [Puig-Asensio,M, Pigrau,C] Hospital Universitari Vall d'Hebron, Barcelona, Spain. [Barcenilla,F] Hospital Universitari Arnau de Vilanova, Lleida, Spain. [Murillas J] Hospital Universitari Son Espases, Mallorca, Spain. [Garcia-Pardo,G] Hospital Universitari Joan XXIII, Tarragona, Spain. [Espejo,E] Hospital Universitari de Terrassa, Terrassa, Barcelona, Spain. [Padilla,B] Hospital Universitario Gregorio Marañon, Madrid, Spain. [Garcia-Reyne,A] Hospital Universitario 12 de Octubre, Madrid, Spain. [Pasquau,J] Hospital Universitario Virgen de las Nieves, Granada, Spain. [Rodriguez-Baño,J] Hospital Universitario Virgen Macarena, Sevilla, Spain. [López-Contreras,J] Hospital Universitari Santa Creu i Sant Pau, Barcelona, Spain. [Montero,M] Hospital Universitari Parc de Salut Mar, Barcelona, Spain. [Pintado,V] Hospital Universitario Ramón y Cajal, Madrid, Spain. [Calbo,E] Hospital Universitari Mutúa de Terrassa, Barcelona, Spain. [Gasch,O] Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain. [Montejo,M] Hospital Universitario de Cruces, Barakaldo, Spain. [Salavert,M] Hospital Universitari i Politècnic la Fe, Valencia, Spain. [Garcia-Pais,MJ] Hospital Universitario Lucus Augusti, Lugo, Spain., This work is supported by grant funding from the National Institute of Health Research, Instituto de Salud Carlos III (ISCIII), Ministerio de Economía y Competitividad. Gobierno de España (Expediente PI12/01907)., and Universitat de Barcelona more...
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Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Recurrence [Medical Subject Headings] ,Pediatrics ,bacteraemia ,Insuficiencia del Tratamiento ,daptomycin ,humanos ,España ,adolescente ,Bacteremia ,Antibióticos Antituberculosos ,medicine.disease_cause ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome::Treatment Failure [Medical Subject Headings] ,combination therapy ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Bacterièmia ,Clinical trials ,infecciones estafilocócicas ,Protocol ,polycyclic compounds ,Organisms::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus::Staphylococcus aureus::Methicillin-Resistant Staphylococcus aureus [Medical Subject Headings] ,Geographicals::Geographic Locations::Europe::Spain [Medical Subject Headings] ,Adulto ,resultado del tratamiento ,Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia [Medical Subject Headings] ,Staphylococcus aureus Resistente a Meticilina ,bacteriemia ,General Medicine ,adulto ,Staphylococcal Infections ,Anti-Bacterial Agents ,Humanos ,Estafilococs daurats ,Drug Combinations ,Análisis de Intención de Tratar ,Infectious Diseases ,Treatment Outcome ,Antibacterianos ,Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics as Topic::Clinical Trials as Topic::Controlled Clinical Trials as Topic::Randomized Controlled Trials as Topic::Intention to Treat Analysis [Medical Subject Headings] ,Research Design ,Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Penicillins::Methicillin [Medical Subject Headings] ,pruebas de sensibilidad microbiana ,daptomicina ,lipids (amino acids, peptides, and proteins) ,antibacterianos ,medicine.drug ,Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [Medical Subject Headings] ,Adult ,Methicillin-Resistant Staphylococcus aureus ,medicine.medical_specialty ,Staphylococcus aureus ,Combination therapy ,Adolescent ,Resultado del Tratamiento ,Chemicals and Drugs::Polycyclic Compounds::Macrocyclic Compounds::Peptides, Cyclic::Daptomycin [Medical Subject Headings] ,Staphylococcus aureus resistente a meticilina ,Recurrencia ,Microbial Sensitivity Tests ,Fosfomycin ,Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents::Antibiotics, Antitubercular [Medical Subject Headings] ,medicine ,Named Groups::Persons::Age Groups::Adult [Medical Subject Headings] ,Humans ,Septicèmia ,Adverse effect ,Resistència als medicaments ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings] ,Intention-to-treat analysis ,methicillin-resistant Staphylococcus aureus (MRSA) ,business.industry ,Septicemia ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,bacterial infections and mycoses ,Methicillin-resistant Staphylococcus aureus ,Clinical trial ,fosfomicina ,Drug resistance ,combinaciones de fármacos ,Daptomicina ,Bacteriemia ,Daptomycin ,business ,diseño de la investigación ,Assaigs clínics ,Meticilina - Abstract
Introduction: Despite the availability of new antibiotics such as daptomycin, methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia continues to be associated with high clinical failure rates. Combination therapy has been proposed as an alternative to improve outcomes but there is a lack of clinical studies. The study aims to demonstrate that combination of daptomycin plus fosfomycin achieves higher clinical success rates in the treatment of MRSA bacteraemia than daptomycin alone. Methods and analysis: A multicentre open-label, randomised phase III study. Adult patients hospitalised with MRSA bacteraemia will be randomly assigned (1:1) to group 1: daptomycin 10 mg/kg/24 h intravenous; or group 2: daptomycin 10 mg/kg/24 h intravenous plus fosfomycin 2 gr/6 g intravenous. The main outcome will be treatment response at week 6 after stopping therapy (test-of-cure (TOC) visit). This is a composite variable with two values: Treatment success: resolution of clinical signs and symptoms (clinical success) and negative blood cultures (microbiological success) at the TOC visit. Treatment failure: if any of the following conditions apply: (1) lack of clinical improvement at 72 h or more after starting therapy; (2) persistent bacteraemia (positive blood cultures on day 7); (3) therapy is discontinued early due to adverse effects or for some other reason based on clinical judgement; (4) relapse of MRSA bacteraemia before the TOC visit; (5) death for any reason before the TOC visit. Assuming a 60% cure rate with daptomycin and a 20% difference in cure rates between the two groups, 103 patients will be needed for each group (alpha:0.05, beta: 0.2). Statistical analysis will be based on intention to treat, as well as per protocol and safety analysis. Ethics and dissemination: The protocol was approved by the Spanish Medicines and Healthcare Products Regulatory Agency (AEMPS). The sponsor commits itself to publishing the data in first quartile peer-review journals within 12 months of the completion of the study., This work is supported by grant funding from the National Institute of Health Research, Instituto de Salud Carlos III (ISCIII), Ministerio de Economia y Competitividad. Gobierno de Espana (Expediente PI12/01907). more...
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- 2015
45. A prospective multicentre study of the epidemiology and outcomes of bloodstream infection in cirrhotic patients
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Bartoletti, M., primary, Giannella, M., additional, Lewis, R., additional, Caraceni, P., additional, Tedeschi, S., additional, Paul, M., additional, Schramm, C., additional, Bruns, T., additional, Merli, M., additional, Cobos-Trigueros, N., additional, Seminari, E., additional, Retamar, P., additional, Muñoz, P., additional, Tumbarello, M., additional, Burra, P., additional, Torrani Cerenzia, M., additional, Barsic, B., additional, Calbo, E., additional, Maraolo, A.E., additional, Petrosillo, N., additional, Galan-Ladero, M.A., additional, D'Offizi, G., additional, Bar Sinai, N., additional, Rodríguez-Baño, J., additional, Verucchi, G., additional, Bernardi, M., additional, Viale, P., additional, Campoli, C., additional, Siccardi, G., additional, Ambretti, S., additional, Stallmach, A., additional, Venditti, M., additional, Lucidi, C., additional, Ludovisi, S., additional, De Cueto, M., additional, Navarro, M.D., additional, Lopez Cortes, E., additional, Bouza, E., additional, Valerio, M., additional, Eworo, A., additional, Losito, R., additional, Senzolo, M., additional, Nadal, E., additional, Ottobrelli, A., additional, Varguvic, M., additional, Badia, C., additional, Borgia, G., additional, Gentile, I., additional, Buonomo, A.R., additional, Boumis, E., additional, Beteta-Lopez, A., additional, Rianda, A., additional, Taliani, G., additional, and Grieco, S., additional more...
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- 2018
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46. Ceftolozane/tazobactam in the treatment of osteomyelitis and skin and soft-tissue infections due to extensively drug-resistant Pseudomonas aeruginosa : clinical and microbiological outcomes
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Dietl, B., primary, Sánchez, I., additional, Arcenillas, P., additional, Cuchi, E., additional, Gómez, L., additional, González de Molina, F.J., additional, Boix-Palop, L., additional, Nicolás, J., additional, and Calbo, E., additional more...
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- 2018
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47. ESGAP inventory of target indicators assessing antibiotic prescriptions: A cross-sectional survey
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Howard, P., Huttner, B., Beovic, B., Beraud, G., Kofteridis, D. P., Pardo, J. P., Schouten, J., Pulcini, C., Angioni, G., Arvaniti, K., Barac, A., Bolla, C., Calbo, E., Dyar, O. -J., Fantoni, Massimo, Fjeld, H., Keuleyan, E., Kumar, S., Harhxi, A., Jenkins, D., Maurer, F. P., Messiaen, P., Baranda, M. M., Munoz, P., Orlando, G., Pagani, L., Pepe, F., Gentil, P. R., Pereira, N. M. R., Rodrigues-Bano, J., Skodvin, B., Tangden, T., Vitrat, V., Vlahovic-Palcevski, V., Wechsler-Fordos, A., Zarb, P., Fantoni M. (ORCID:0000-0001-6913-8460), Howard, P., Huttner, B., Beovic, B., Beraud, G., Kofteridis, D. P., Pardo, J. P., Schouten, J., Pulcini, C., Angioni, G., Arvaniti, K., Barac, A., Bolla, C., Calbo, E., Dyar, O. -J., Fantoni, Massimo, Fjeld, H., Keuleyan, E., Kumar, S., Harhxi, A., Jenkins, D., Maurer, F. P., Messiaen, P., Baranda, M. M., Munoz, P., Orlando, G., Pagani, L., Pepe, F., Gentil, P. R., Pereira, N. M. R., Rodrigues-Bano, J., Skodvin, B., Tangden, T., Vitrat, V., Vlahovic-Palcevski, V., Wechsler-Fordos, A., Zarb, P., and Fantoni M. (ORCID:0000-0001-6913-8460) more...
- Abstract
Background A variety of indicators is commonly used to monitor antibiotic prescriptions as part of national antimicrobial stewardship (AMS) programmes. Objectives To make an inventory of indicators that assess antibiotic prescriptions and are linked to specific targets and incentives, at a national level. Methods A cross-sectional survey (three-item questionnaire) was conducted in 2017 among all ESGAP (ESCMID Study Group for Antimicrobial stewardshiP) members, coming from 23 European countries and 16 non-European countries. Results Almost all (20/23, 87%) European countries belonging to the ESGAP network participated, as well as one non-European country. Computerized systems routinely linking antibiotic prescriptions to clinical diagnoses were reported for only two countries (Turkey and Croatia). Only 6/21 (29%) countries had national indicators with both clear targets and incentives (Bulgaria, Croatia, France, the Netherlands, Norway and Portugal). We identified a total of 21 different indicators used in these countries, 16 concerning inpatients (9 quality indicators and 7 quantity metrics) and 8 concerning outpatients (all quantity metrics); some indicators were used in both settings. Three types of incentives were used: financing mechanism, hospitals' accreditation and public reporting. Some respondents reported that such indicators with both clear targets and incentives were used at a regional level in their country (e.g. Andalusia in Spain and England in the UK). Conclusions National indicators, with clear targets and incentives, are not commonly used in Europe and we observed wide variations between countries regarding the selected indicators, the units of measure and the chosen targets. more...
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- 2017
48. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study
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Gutierrez-Gutierrez, B., Salamanca, E., de Cueto, M., Hsueh, P. -R., Viale, P., Pano-Pardo, J. R., Venditti, M., Tumbarello, M., Daikos, G., Canton, R., Doi, Y., Tuon, F. F., Karaiskos, I., Perez-Nadales, E., Schwaber, M. J., Azap, O. K., Souli, M., Roilides, E., Pournaras, S., Akova, M., Perez, F., Bermejo, J., Oliver, A., Almela, M., Lowman, W., Almirante, B., Bonomo, R. A., Carmeli, Y., Paterson, D. L., Pascual, A., Rodriguez-Bano, J., del Toro, M. D., Galvez, J., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, E. M., Losito, A. R., Garcia-Vazquez, E., Hernandez, A., Gomez, J., Bou, G., Iosifidis, E., Prim, N., Navarro, F., Mirelis, B., Skiada, A., Origuen, J., Juan, R. S., Fernandez-Ruiz, M., Larrosa, N., Puig-Asensio, M., Cisneros, J. M., Molina, J., Gonzalez, V., Rucci, V., de Gopegui, E. R., Marinescu, C. I., Martinez-Martinez, L., Farinas, M. C., Cano, M. E., Gozalo, M., Mora-Rillo, M., Francisco, C. N. -S., Pena, C., Gomez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Antoniadou, A., Poulakou, G., Pitout, J., Virmani, D., Torre-Cisneros, J., Guzman-Puche, J., Helvaci, O., Sahin, A. O., Pintado, V., Ruiz, P., Bartoletti, M., Giannella, M., Tacconelli, E., Riemenschneider, F., Calbo, E., Badia, C., Xercavins, M., Gasch, O., Fontanals, D., Jove, E., Venditti M., Tumbarello M. (ORCID:0000-0002-9519-8552), Trecarichi E. M., Losito A. R., Tacconelli E. (ORCID:0000-0001-8722-5824), Gutierrez-Gutierrez, B., Salamanca, E., de Cueto, M., Hsueh, P. -R., Viale, P., Pano-Pardo, J. R., Venditti, M., Tumbarello, M., Daikos, G., Canton, R., Doi, Y., Tuon, F. F., Karaiskos, I., Perez-Nadales, E., Schwaber, M. J., Azap, O. K., Souli, M., Roilides, E., Pournaras, S., Akova, M., Perez, F., Bermejo, J., Oliver, A., Almela, M., Lowman, W., Almirante, B., Bonomo, R. A., Carmeli, Y., Paterson, D. L., Pascual, A., Rodriguez-Bano, J., del Toro, M. D., Galvez, J., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, E. M., Losito, A. R., Garcia-Vazquez, E., Hernandez, A., Gomez, J., Bou, G., Iosifidis, E., Prim, N., Navarro, F., Mirelis, B., Skiada, A., Origuen, J., Juan, R. S., Fernandez-Ruiz, M., Larrosa, N., Puig-Asensio, M., Cisneros, J. M., Molina, J., Gonzalez, V., Rucci, V., de Gopegui, E. R., Marinescu, C. I., Martinez-Martinez, L., Farinas, M. C., Cano, M. E., Gozalo, M., Mora-Rillo, M., Francisco, C. N. -S., Pena, C., Gomez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Antoniadou, A., Poulakou, G., Pitout, J., Virmani, D., Torre-Cisneros, J., Guzman-Puche, J., Helvaci, O., Sahin, A. O., Pintado, V., Ruiz, P., Bartoletti, M., Giannella, M., Tacconelli, E., Riemenschneider, F., Calbo, E., Badia, C., Xercavins, M., Gasch, O., Fontanals, D., Jove, E., Venditti M., Tumbarello M. (ORCID:0000-0002-9519-8552), Trecarichi E. M., Losito A. R., and Tacconelli E. (ORCID:0000-0001-8722-5824) more...
- Abstract
Background The best available treatment against carbapenemase-producing Enterobacteriaceae (CPE) is unknown. The objective of this study was to investigate the effect of appropriate therapy and of appropriate combination therapy on mortality of patients with bloodstream infections (BSIs) due to CPE. Methods In this retrospective cohort study, we included patients with clinically significant monomicrobial BSIs due to CPE from the INCREMENT cohort, recruited from 26 tertiary hospitals in ten countries. Exclusion criteria were missing key data, death sooner than 24 h after the index date, therapy with an active antibiotic for at least 2 days when blood cultures were taken, and subsequent episodes in the same patient. We compared 30 day all-cause mortality between patients receiving appropriate (including an active drug against the blood isolate and started in the first 5 days after infection) or inappropriate therapy, and for patients receiving appropriate therapy, between those receiving active monotherapy (only one active drug) or combination therapy (more than one). We used a propensity score for receiving combination therapy and a validated mortality score (INCREMENT-CPE mortality score) to control for confounders in Cox regression analyses. We stratified analyses of combination therapy according to INCREMENT-CPE mortality score (0–7 [low mortality score] vs 8–15 [high mortality score]). INCREMENT is registered with ClinicalTrials.gov, number NCT01764490. Findings Between Jan 1, 2004, and Dec 31, 2013, 480 patients with BSIs due to CPE were enrolled in the INCREMENT cohort, of whom we included 437 (91%) in this study. 343 (78%) patients received appropriate therapy compared with 94 (22%) who received inappropriate therapy. The most frequent organism was Klebsiella pneumoniae (375 [86%] of 437; 291 [85%] of 343 patients receiving appropriate therapy vs 84 [89%] of 94 receiving inappropriate therapy) and the most frequent carbapenemase was K pneumoniae carbapenemase more...
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- 2017
49. A Predictive Model of Mortality in Patients With Bloodstream Infections due to Carbapenemase-Producing Enterobacteriaceae
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Gutiérrez Gutiérrez, Belén, Salamanca, Elena, de Cueto, Marina, Pascual, Alvaro, Rodríguez Baño, Jesús, Hsueh, Po Ren, Viale, Pierluigi, Paño Pardo, José Ramón, Venditti, Mario, Tumbarello, Mario, Daikos, George, Pintado, Vicente, Doi, Yohei, Tuon, Felipe Francisco, Karaiskos, Ilias, Machuca, Isabel, Schwaber, Mitchell J., Azap, Özlem Kurt, Souli, Maria, Roilides, Emmanuel, Pournaras, Spyros, Akova, Murat, Pérez, Federico, Bonomo, Robert A., Bermejo, Joaquín, Oliver, Antonio, Almela, Manel, Lowman, Warren, Almirante, Benito, Carmeli, Yehuda, Paterson, David L., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, Enrico Maria, Losito, Angela Raffaella, García Vázquez, E., Hernández, A., Gómez, J., Iosifidis, E., Prim, N., Navarro, F., Mirelis, B., Origüen, J., San Juan, R., Fernández Ruiz, M., Larrosa, N., Puig Asensio, M., Cisneros, J. M., Molina, J., González, V., Rucci, V., Ruiz de Gopegui, E., Marinescu, C. I., Martínez Martínez, L., Fariñas, M. C., Cano, M. E., Gozalo, M., Mora Rillo, M., Navarro San Francisco, C., Peña, C., Gómez Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Azap, Ö. K., Pitout, J., Virmani, D., Torre Cisneros, J., Natera, C., Helvaci, Ö., Sahin, A. O., Cantón, R., Ruiz, P., Bartoletti, M., Giannella, M., Taconelli, E., Riemenschneider, F., Calbo, E., Badia, C., Xercavins, M., Gasch, E., Fontanals, D., and Jové, E. more...
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,carbapenems ,klebsiella pneumoniae ,pneumoniae carbapenemase ,030106 microbiology ,Bacteremia ,Comorbidity ,Logistic regression ,Settore MED/17 - MALATTIE INFETTIVE ,Sensitivity and Specificity ,beta-Lactamases ,Decision Support Techniques ,03 medical and health sciences ,0302 clinical medicine ,Bacterial Proteins ,Enterobacteriaceae ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Aged ,Anti-Bacterial Agents ,Enterobacteriaceae Infections ,Female ,Logistic Models ,Middle Aged ,Retrospective Studies ,Receiver operating characteristic ,business.industry ,Medicine (all) ,Retrospective cohort study ,General Medicine ,medicine.disease ,Surgery ,Predictive value of tests ,Observational study ,business - Abstract
Objective To develop a score to predict mortality in patients with bloodstream infections (BSIs) due to carbapenemase-producing Enterobacteriaceae (CPE). Patients and Methods A multinational retrospective cohort study (INCREMENT project) was performed from January 1, 2004, through December 31, 2013. Patients with clinically relevant monomicrobial BSIs due to CPE were included and randomly assigned to either a derivation cohort (DC) or a validation cohort (VC). The variables were assessed on the day the susceptibility results were available, and the predictive score was developed using hierarchical logistic regression. The main outcome variable was 14-day all-cause mortality. The predictive ability of the model and scores were measured by calculating the area under the receiver operating characteristic curve. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for different cutoffs of the score. Results The DC and VC included 314 and 154 patients, respectively. The final logistic regression model of the DC included the following variables: severe sepsis or shock at presentation (5 points); Pitt score of 6 or more (4 points); Charlson comorbidity index of 2 or more (3 points); source of BSI other than urinary or biliary tract (3 points); inappropriate empirical therapy and inappropriate early targeted therapy (2 points). The score exhibited an area under the receiver operating characteristic curve of 0.80 (95% CI, 0.74-0.85) in the DC and 0.80 (95% CI, 0.73-0.88) in the VC. The results for 30-day all-cause mortality were similar. Conclusion A validated score predictive of early mortality in patients with BSIs due to CPE was developed. Trial Registration clinicaltrials.gov Identifier: NCT01 764490. more...
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- 2016
50. Bloodstream infections caused by Escherichia coli producing AmpC beta-lactamases: epidemiology and clinical features
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Pascual, V, Alonso, N, Simo, M, Ortiz, G, Garcia, MC, Xercavins, M, Rivera, A, Morera, MA, Miro, E, Espejo, E, Navarro, F, Gurgui, M, Perez, J, Rodriguez-Carballeira, M, Garau, J, and Calbo, E
- Abstract
The aim of the study was to investigate the epidemiology and clinical features of bloodstream infections due to Escherichia coli producing AmpC beta-lactamases (AmpC-Ec-BSI). In a multi-centre case-control study, all third-generation-cephalosporin-resistant Escherichia coli BSI (3GC-Ec-BSI) isolates were analysed. Acquired bla (AmpC) (bla (ac-AmpC)) detection was done by polymerase chain reaction (PCR) and sequencing. Chromosomal bla (AmpC) (bla (c-AmpC)) expression was quantified by real-time PCR. Cases were patients with AmpC-Ec-BSI. Controls were patients with cephalosporin-susceptible E. coli BSI, matched 1:1 by sex and age. Demographics, comorbidities, intrinsic and extrinsic risk factors for antimicrobial resistance, clinical presentation and outcomes were investigated. Among 841 E. coli BSI, 17 were caused by AmpC-Ec (2 %). Eleven isolates (58.8 %) had bla (ac-AmpC) and six were bla (c-AmpC) overproducers. The mean age of cases was 66.2 years and 71 % were men. Cases were more frequently healthcare-related (82 vs. 52 % controls, p < 0.05) and presented more intrinsic and extrinsic risk factors. At least one risk factor was present in 94.1 % of cases vs. 41.7 % of controls (p = 0.002). Severity and length of stay (LOS) were higher among cases (mean Pitt Score 2.6 vs. 0.38 in controls, p = 0.03; LOS 17.5 days vs. 6 in controls, p = 0.02). Inappropriate empirical therapy (IET) was administered to 70.6 % of cases and 23.5 % of controls (p < 0.003). No differences were found in terms of cure rate at the 14th day and mortality. Bloodstream infections due to AmpC-Ec (mostly plasmid-mediated) are infrequent in our area. AmpC-Ec-BSI affects mainly patients with intrinsic risk factors and those with previous antibiotic exposure. A high proportion received IET. more...
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- 2016
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