40 results on '"López Contreras, Joaquín"'
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2. Cloxacillin plus fosfomycin versus cloxacillin alone for methicillin-susceptible Staphylococcus aureus bacteremia: a randomized trial
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Grillo, Sara, Pujol, Miquel, Miró, Josep M., López-Contreras, Joaquín, Euba, Gorane, Gasch, Oriol, Boix-Palop, Lucia, Garcia-País, Maria José, Pérez-Rodríguez, Maria Teresa, Gomez-Zorrilla, Silvia, Oriol, Isabel, López-Cortés, Luis Eduardo, Pedro-Botet, Maria Luisa, San-Juan, Rafael, Aguado, José María, Gioia, Francesca, Iftimie, Simona, Morata, Laura, Jover-Sáenz, Alfredo, García-Pardo, Graciano, Loeches, Belén, Izquierdo-Cárdenas, Álvaro, Goikoetxea, Ane Josune, Gomila-Grange, Aina, Dietl, Beatriz, Berbel, Damaris, Videla, Sebastian, Hereu, Pilar, Padullés, Ariadna, Pallarès, Natalia, Tebé, Cristian, Cuervo, Guillermo, and Carratalà, Jordi
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- 2023
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3. Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort
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Sánchez, Fernando Fernández, de Lomas, José Mª García, Rosas, Gabriel, de la Torre Lima, Javier, Bereciartua, Elena, Vidal, María José Blanco, Blanco, Roberto, Boado, María Victoria, Lázaro, Marta Campaña, Crespo, Alejandro, Carrión, Laura Guio, Del Álamo Martínez de Lagos, Mikel, Ugarte, Gorane Euba, Goikoetxea, Ane Josune, Hierro, Marta Ibarrola, Iruretagoyena, José Ramón, Zuazabal, Josu Irurzun, López-Soria, Leire, Montejo, Miguel, Nieto, Javier, Rodrigo, David, Rodríguez, Regino, Vitoria, Yolanda, Voces, Roberto, López, Mª Victoria García, Georgieva, Radka Ivanova, Ojeda, Guillermo, Bailón, Isabel Rodríguez, Morales, Josefa Ruiz, Rodríguez, Ignacio Álvarez, Galparsoro, Harkaitz Azkune, Boronat, Elisa Berritu, Odriozola, Mª Jesús Bustinduy, del Bosque Martín, Cristina, Echeverría, Tomás, Yarza, Alberto Eizaguirre, Fuentes, Ana, Goenaga, Miguel Ángel, del Río, Muskilda Goyeneche, Bauza, Ángela Granda, Iribarren, José Antonio, Urkola, Xabier Kortajarena, López, José Ignacio Pérez-Moreiras, Jiménez, Ainhoa Rengel, Reviejo, Karlos, Berbejillo, Alberto Sáez, Haza, Elou Sánchez, Alda, Rosa Sebastián, Ruiz, Itziar Solla, Ugartemendia, Irati Unamuno, Anza, Diego Vicente, Benito, Iñaki Villanueva, Arrieta, Mar Zabalo, Carrasco, Rafael, Climent, Vicente, Llamas, Patricio, Merino, Esperanza, Plazas, Joaquín, Reus, Sergio, Bouzas, Alberto, Castelo, Brais, Cuenca, José, Gutiérrez, Laura, Ramos, Lucía, Mayo, María Rodríguez, Serrano, Joaquín Manuel, Regueiro, Dolores Sousa, Martínez, Francisco Javier, del Mar Alonso, Mª, Castro, Beatriz, Melian, Teresa Delgado, Sarabia, Javier Fernández, Rosado, Dácil García, González, Julia González, Lacalzada, Juan, de la Peña, Lissete Lorenzo, Ramírez, Alina Pérez, Arrondo, Pablo Prada, Moreno, Fermín Rodríguez, Ciezar, Antonio Plata, Iglesias, José Mª Reguera, Álvarez, Víctor Asensi, Costas, Carlos, de la Hera, Jesús, Suárez, Jonnathan Fernández, Fraile, Lisardo Iglesias, Arguero, Víctor León, Menéndez, José López, Bajo, Pilar Mencia, Morales, Carlos, Torrico, Alfonso Moreno, Palomo, Carmen, Martínez, Begoña Paya, Esteban, Ángeles Rodríguez, García, Raquel Rodríguez, Asensio, Mauricio Telenti, Almela, Manuel, Ambrosioni, Juan, Azqueta, Manuel, Brunet, Mercè, Bodro, Marta, Cartañá, Ramón, Cuervo, Guillermo, Falces, Carlos, Fernández-Pittol, Mariana J, Fita, Guillermina, Fuster, David, de la Mària, Cristina García, García-Pares, Delia, Hernández-Meneses, Marta, Pérez, Jaume Llopis, Marco, Francesc, Miró, José M., Moreno, Asunción, Nicolás, David, Ninot, Salvador, Quintana, Eduardo, Paré, Carlos, Pereda, Daniel, Pericás, Juan M., Pomar, José L., Ramírez, José, Roque, Mercè, Rovira, Irene, Sandoval, Elena, Sitges, Marta, Soy, Dolors, Téllez, Adrián, Tolosana, José M., Vidal, Bárbara, Vila, Jordi, Adán, Iván, Alonso, David, Alonso, Juan Carlos, Álvarez-Uría, Ana, Bermejo, Javier, Bouza, Emilio, Caballero, Gregorio Cuerpo, Montero, Antonia Delgado, Estévez, Agustín, Ribas, Ramón Fortuny, Gargallo, Esther, Leoni, Mª Eugenia García, Mansilla, Ana González, Moraga, Francisco Javier González, Ramallo, Víctor González, Hernández, Martha Kestler, Hualde, Amaia Mari, Machado, Marina, Marín, Mercedes, Martínez-Sellés, Manuel, Melero, Rosa, Muñoz, Patricia, Monzón, Diego, Olmedo, María, Pedraz, Álvaro, Pinilla, Blanca, Pinto, Ángel, Rincón, Cristina, Rodríguez-Abella, Hugo, Rodríguez-Créixems, Marta, Sánchez-Pérez, Eduardo, Segado, Antonio, Toledo, Neera, Valerio, Maricela, Vázquez, Pilar, Moreno, Eduardo Verde, de la Villa, Sofía, Antorrena, Isabel, Loeches, Belén, Moreno, Mar, Ramírez, Ulises, Bastón, Verónica Rial, Romero, María, Rosillo, Sandra, Balbín, Jesús Agüero, Fernández, Cristina Amado, Castillo, Carlos Armiñanzas, de las Revillas, Francisco Arnaiz, Belaustegui, Manuel Cobo, Fariñas, María Carmen, Fariñas-Álvarez, Concepción, Sampedro, Marta Fernández, García, Iván, Rico, Claudia González, Gutiérrez-Fernández, Laura, Gutiérrez-Cuadra, Manuel, Díez, José Gutiérrez, Pajarón, Marcos, Parra, José Antonio, Teira, Ramón, Zarauza, Jesús, Parra, Jorge Calderón, Cobo, Marta, Domínguez, Fernando, Pavía, Pablo García, Cruz, Ana Fernández, Ramos-Martínez, Antonio, Romero, Isabel Sánchez, Centella, Tomasa, Hermida, José Manuel, Moya, José Luis, Martín-Dávila, Pilar, Navas, Enrique, Oliva, Enrique, del Río, Alejandro, Stuart, Jorge Rodríguez-Roda, Ruiz, Soledad, Tenorio, Carmen Hidalgo, Sequera, Sergio, Delia, Manuel Almendro, Araji, Omar, Barquero, José Miguel, Jambrina, Román Calvo, de Cueto, Marina, Acebal, Juan Gálvez, Méndez, Irene, Morales, Isabel, López-Cortés, Luis Eduardo, de Alarcón, Arístides, Gutiérrez-Carretero, Encarnación, Lepe, José Antonio, López-Haldón, José, Luque-Márquez, Rafael, Marín, Guillermo, Ortiz-Carrellán, Antonio, Sánchez-Domínguez, Eladio, Alonso, Luis Javier, Azcárate, Pedro, Gutiérrez, José Manuel Azcona, Blanco, José Ramón, Armas, Estíbaliz Corral, García-Álvarez, Lara, Oteo, José Antonio, Membrilla, Antonio Barros, Iglesias, Antonino Ginel, Grillo, Sara, Petracca, Rubén Leta, López-Contreras, Joaquín, Martínez, María Alba Rivera, Álvarez, M., Fernández, A.L., Martínez, Amparo, Prieto, A., Regueiro, Benito, Tijeira, E., Vega, Marino, Quiñonero, Amaia Aguirre, Miñambres, Ángela Alonso, Arana, Juan Carlos Gainzarain, de Alaiza Ortega, Sara González, Rodríguez, Miguel Ángel Morán, Rodríguez, Anai Moreno, de Zárate, Zuriñe Ortiz, Zapirain, José Joaquín Portu, de Adana Arroniz, Ester Sáez, Sánchez, Daisy Carolina Sorto, Antonio, Sánchez-Porto, Alejandro, Úbeda Iglesias, Leal, José Mª Arribas, Vázquez, Elisa García, Torres, Alicia Hernández, Blázquez, Ana, de la Morena Valenzuela, Gonzalo, Alonso, Ángel, Aramburu, Javier, Calvo, Felicitas Elena, Tarabini-Castellani, Paola, Gálvez, Eva Heredero, Bellido, Carolina Maicas, Pau, José Largo, Sepúlveda, Mª Antonia, Sierra, Pilar Toledano, Iqbal-Mirza, Sadaf Zafar, Alcolea, Eva Cascales, Yañez, Ivan Keituqwa, Martínez, Julián Navarro, Ballesta, Ana Peláez, Escobar, Eduardo Moreno, Monje, Alejandro Peña, Cabrera, Valme Sánchez, García, David Vinuesa, Asenjo, María Arrizabalaga, Luna, Carmen Cifuentes, Morcillo, Juana Núñez, Seco, Mª Cruz Pérez, Gelabert, Aroa Villoslada, Guallar, Carmen Aured, Abad, Nuria Fernández, Mangas, Pilar García, Adell, Marta Matamala, Ruiz, Mª Pilar Palacián, Porres, Juan Carlos, Vidal, Begoña Alcaraz, Del Amor Espín, María Jesús, Buendía, Francisco, Sánchez, Roberto Jiménez, Mármol, Rosario, Martínez, Francisco, Meseguer, Antonio, Pérez, Beatriz, Risco, Leticia, Saura, Zoser, Silva, Vanina, Villmarín, Mª Belén, Blanco, Mª Ángels Ribas, de Gopegui Bordes, Enrique Ruiz, Bonet, Laura Vidal, Borràs, Miquel Vives, Munera, Mª Carmen Bellón, Garaizabal, Elena Escribano, Martínez, Antonia Tercero, Luque, Juan Carlos Segura, Badía, Cristina, Palop, Lucía Boix, Xercavins, Mariona, Ibars, Sónia, Bosch, Xerach, Nebreda, Eloy Gómez, Herrera, Ibalia Horcajada, Gallego, Irene Menduiña, Pulido, Imanol, Santiago, Héctor Marrero, de Miguel Martínez, Isabel, Álamo, Elena Pisos, Sánchez, Daniel San Román, Pérez, Jorge Boan, Blanco, Eva Mª Aguilar, González, Mercedes Catalán, Peiretti, María Angélica Corres, Esteve, Andrea Eixerés, Pérez, Laura Domínguez, de Cossío Tejido, Santiago, Román, Francisco Galván, Robles, José Antonio García, Medrano, Francisco López, Gude, Mª Jesús López, Miguel, Mª Ángeles Orellana, Pilkington, Patrick, Ostalaza, Yolanda Revilla, Morales, Juan Ruiz, Solís, Sebastián Ruiz, Collado, Ana Sabín, Fernández, Marcos Sánchez, Rallo, Javier Solera, Martín, Jorge Solís, Escrihuela-Vidal, Francesc, Carratalà, Jordi, Grau, Inmaculada, Ardanuy, Carmen, Berbel, Dámaris, Salado, José Carlos Sánchez, Alegre, Oriol, Majoral, Alejandro Ruiz, Sbraga, Fabrizio, Blasco, Arnau, Sánchez, Laura Gracia, Sánchez-Rodríguez, Iván, Aldamiz, Gonzalo, Álvarez, Beatriz, Palacios, Marina Bernal, Úbeda, Alfonso Cabello, Roblas, Ricardo Fernández, Hernández, Rafael, Martín, Victoria Andrea Hortigüela, Kallmeyer, Andrea, Kancev, Cristina Landaeta, Martín, Marta, Ruiz, Miguel Morante, Lobato, Miguel Ángel Navas, Pello, Ana María, Prieto, Laura, Mallebrera, Marta Tomás, Varela, Laura, de la Peña Triguero, Mireia, Cerón, Ruth Esther Figueroa, Gómez, Lara Ruiz, Ble, Mireia, Gallego, Juan Pablo Horcajada, Ginel, Antonio José, López, Inmaculada, Mas, Alexandra, Mestres, Antoni, Molina, Lluís, Serrat, Ramón, Ribas, Núria, Sánchez, Francisca, Silverio, Ana, Suárez, Marina, Sorlí, Luisa, Recasens, Lluís, Taurón, Manuel, Regueras, María Fernández, Vallejo, María Ángeles Mantecón, Rivera, José Ángel Pérez, Mata, Nuria Sánchez, Cano, Antonia Calvo, Olivares, Miguel Fajardo, Núñez, María Victoria Millán, Sanz, Agustín Muñoz, Herrera-Hidalgo, Laura, Alonso-Menchén, David, Luque-Marquez, Rafael, Fariñas, María Del Carmen, Miró, Jose Maria, Goenaga, Miguel Angel, Angulo-Lara, Basilio, and Boix-Palop, Lucia
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- 2023
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4. mRNA-1273 SARS-CoV-2 vaccine in recently transplanted allogeneic hematopoietic cell transplant recipients: Dynamics of cellular and humoral immune responses and booster effect
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Albiol, Nil, Lynton-Pons, Elionor, Aso, Olga, Moga, Esther, Vidal, Silvia, Gómez-Pérez, Lucía, Santiago, Jose Alejandre, Triquell, Mercè, Roch, Nerea, Lázaro, Elisabeth, González, Iria, López-Contreras, Joaquín, Esquirol, Albert, Sierra, Jorge, Martino, Rodrigo, and García-Cadenas, Irene
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- 2023
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5. mRNA-1273 SARS-CoV-2 vaccine safety and COVID-19 risk perception in recently transplanted allogeneic hematopoietic stem cell transplant recipients
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Albiol, Nil, Aso, Olga, Gómez-Pérez, Lucía, Triquell, Mercè, Roch, Nerea, Lázaro, Elisabeth, Esquirol, Albert, González, Iria, López-Contreras, Joaquín, Sierra, Jorge, Martino, Rodrigo, and García-Cadenas, Irene
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- 2022
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6. Impact of adherence to individual quality-of-care indicators on the prognosis of bloodstream infection due to Staphylococcus aureus: a prospective observational multicentre cohort
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Escrihuela-Vidal, Francesc, Kaasch, Achim J., Von Cube, Maja, Rieg, Siegbert, Kern, Winfried V., Seifert, Harald, Song, Kyoung-Ho, Liao, Chun-Hsing, Tilley, Robert, Gott, Hannah, Scarborough, Matt, Gordon, Claire, Llewelyn, Martin J., Kuehl, Richard, Morata, Laura, Soriano, Alex, Edgeworth, Jonathan, De Gopegui, Enrique Ruiz, Nsutebu, Emmanuel, Cisneros, José Miguel, Fowler, Vance G., Thwaites, Guy, López-Contreras, Joaquín, Barlow, Gavin, Ternavasio-De La Vega, Hugo Guillermo, Rodríguez-Baño, Jesús, and López-Cortés, Luis Eduardo
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- 2023
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7. An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
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Arroyo-Garcia, Nares, Badia, Josep M., Vázquez, Ana, Pera, Miguel, Parés, David, Limón, Enric, Almendral, Alexander, Piriz, Marta, Díez, Cecilia, Fraccalvieri, Domenico, López-Contreras, Joaquín, and Pujol, Miquel
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- 2022
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8. Correction to: mRNA-1273 SARS-CoV-2 vaccine safety and COVID-19 risk perception in recently transplanted allogeneic hematopoietic stem cell transplant recipients
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Albiol, Nil, Aso, Olga, Gómez-Pérez, Lucía, Triquell, Mercè, Roch, Nerea, Lázaro, Elisabeth, Esquirol, Albert, González, Iria, López-Contreras, Joaquín, Sierra, Jorge, Martino, Rodrigo, and García-Cadenas, Irene
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- 2022
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9. Immune Response and Safety of SARS-CoV-2 mRNA-1273 Vaccine in Patients With Myasthenia Gravis
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Reyes-Leiva, David, López-Contreras, Joaquín, Moga, Esther, Pla-Juncà, Francesc, Lynton-Pons, Elionor, Rojas-Garcia, Ricardo, Turon-Sans, Janina, Querol, Luis, Olive, Montse, Álvarez-Velasco, Rodrigo, Caballero-Ávila, Marta, Carbayo, Álvaro, Vesperinas-Castro, Ana, Domingo, Pere, Illa, Isabel, Gallardo, Eduard, and Cortés-Vicente, Elena
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- 2022
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10. Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort
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Herrera-Hidalgo, Laura, primary, Muñoz, Patricia, additional, Álvarez-Uría, Ana, additional, Alonso-Menchén, David, additional, Luque-Marquez, Rafael, additional, Gutiérrez-Carretero, Encarnación, additional, Fariñas, María Del Carmen, additional, Miró, Jose Maria, additional, Goenaga, Miguel Angel, additional, López-Cortés, Luis Eduardo, additional, Angulo-Lara, Basilio, additional, Boix-Palop, Lucia, additional, de Alarcón, Arístides, additional, Sánchez, Fernando Fernández, additional, de Lomas, José Mª García, additional, Rosas, Gabriel, additional, de la Torre Lima, Javier, additional, Bereciartua, Elena, additional, Vidal, María José Blanco, additional, Blanco, Roberto, additional, Boado, María Victoria, additional, Lázaro, Marta Campaña, additional, Crespo, Alejandro, additional, Carrión, Laura Guio, additional, Del Álamo Martínez de Lagos, Mikel, additional, Ugarte, Gorane Euba, additional, Goikoetxea, Ane Josune, additional, Hierro, Marta Ibarrola, additional, Iruretagoyena, José Ramón, additional, Zuazabal, Josu Irurzun, additional, López-Soria, Leire, additional, Montejo, Miguel, additional, Nieto, Javier, additional, Rodrigo, David, additional, Rodríguez, Regino, additional, Vitoria, Yolanda, additional, Voces, Roberto, additional, López, Mª Victoria García, additional, Georgieva, Radka Ivanova, additional, Ojeda, Guillermo, additional, Bailón, Isabel Rodríguez, additional, Morales, Josefa Ruiz, additional, Rodríguez, Ignacio Álvarez, additional, Galparsoro, Harkaitz Azkune, additional, Boronat, Elisa Berritu, additional, Odriozola, Mª Jesús Bustinduy, additional, del Bosque Martín, Cristina, additional, Echeverría, Tomás, additional, Yarza, Alberto Eizaguirre, additional, Fuentes, Ana, additional, Goenaga, Miguel Ángel, additional, del Río, Muskilda Goyeneche, additional, Bauza, Ángela Granda, additional, Iribarren, José Antonio, additional, Urkola, Xabier Kortajarena, additional, López, José Ignacio Pérez-Moreiras, additional, Jiménez, Ainhoa Rengel, additional, Reviejo, Karlos, additional, Berbejillo, Alberto Sáez, additional, Haza, Elou Sánchez, additional, Alda, Rosa Sebastián, additional, Ruiz, Itziar Solla, additional, Ugartemendia, Irati Unamuno, additional, Anza, Diego Vicente, additional, Benito, Iñaki Villanueva, additional, Arrieta, Mar Zabalo, additional, Carrasco, Rafael, additional, Climent, Vicente, additional, Llamas, Patricio, additional, Merino, Esperanza, additional, Plazas, Joaquín, additional, Reus, Sergio, additional, Bouzas, Alberto, additional, Castelo, Brais, additional, Cuenca, José, additional, Gutiérrez, Laura, additional, Ramos, Lucía, additional, Mayo, María Rodríguez, additional, Serrano, Joaquín Manuel, additional, Regueiro, Dolores Sousa, additional, Martínez, Francisco Javier, additional, del Mar Alonso, Mª, additional, Castro, Beatriz, additional, Melian, Teresa Delgado, additional, Sarabia, Javier Fernández, additional, Rosado, Dácil García, additional, González, Julia González, additional, Lacalzada, Juan, additional, de la Peña, Lissete Lorenzo, additional, Ramírez, Alina Pérez, additional, Arrondo, Pablo Prada, additional, Moreno, Fermín Rodríguez, additional, Ciezar, Antonio Plata, additional, Iglesias, José Mª Reguera, additional, Álvarez, Víctor Asensi, additional, Costas, Carlos, additional, de la Hera, Jesús, additional, Suárez, Jonnathan Fernández, additional, Fraile, Lisardo Iglesias, additional, Arguero, Víctor León, additional, Menéndez, José López, additional, Bajo, Pilar Mencia, additional, Morales, Carlos, additional, Torrico, Alfonso Moreno, additional, Palomo, Carmen, additional, Martínez, Begoña Paya, additional, Esteban, Ángeles Rodríguez, additional, García, Raquel Rodríguez, additional, Asensio, Mauricio Telenti, additional, Almela, Manuel, additional, Ambrosioni, Juan, additional, Azqueta, Manuel, additional, Brunet, Mercè, additional, Bodro, Marta, additional, Cartañá, Ramón, additional, Cuervo, Guillermo, additional, Falces, Carlos, additional, Fernández-Pittol, Mariana J, additional, Fita, Guillermina, additional, Fuster, David, additional, de la Mària, Cristina García, additional, García-Pares, Delia, additional, Hernández-Meneses, Marta, additional, Pérez, Jaume Llopis, additional, Marco, Francesc, additional, Miró, José M., additional, Moreno, Asunción, additional, Nicolás, David, additional, Ninot, Salvador, additional, Quintana, Eduardo, additional, Paré, Carlos, additional, Pereda, Daniel, additional, Pericás, Juan M., additional, Pomar, José L., additional, Ramírez, José, additional, Roque, Mercè, additional, Rovira, Irene, additional, Sandoval, Elena, additional, Sitges, Marta, additional, Soy, Dolors, additional, Téllez, Adrián, additional, Tolosana, José M., additional, Vidal, Bárbara, additional, Vila, Jordi, additional, Adán, Iván, additional, Alonso, David, additional, Alonso, Juan Carlos, additional, Bermejo, Javier, additional, Bouza, Emilio, additional, Caballero, Gregorio Cuerpo, additional, Montero, Antonia Delgado, additional, Estévez, Agustín, additional, Ribas, Ramón Fortuny, additional, Gargallo, Esther, additional, Leoni, Mª Eugenia García, additional, Mansilla, Ana González, additional, Moraga, Francisco Javier González, additional, Ramallo, Víctor González, additional, Hernández, Martha Kestler, additional, Hualde, Amaia Mari, additional, Machado, Marina, additional, Marín, Mercedes, additional, Martínez-Sellés, Manuel, additional, Melero, Rosa, additional, Monzón, Diego, additional, Olmedo, María, additional, Pedraz, Álvaro, additional, Pinilla, Blanca, additional, Pinto, Ángel, additional, Rincón, Cristina, additional, Rodríguez-Abella, Hugo, additional, Rodríguez-Créixems, Marta, additional, Sánchez-Pérez, Eduardo, additional, Segado, Antonio, additional, Toledo, Neera, additional, Valerio, Maricela, additional, Vázquez, Pilar, additional, Moreno, Eduardo Verde, additional, de la Villa, Sofía, additional, Antorrena, Isabel, additional, Loeches, Belén, additional, Moreno, Mar, additional, Ramírez, Ulises, additional, Bastón, Verónica Rial, additional, Romero, María, additional, Rosillo, Sandra, additional, Balbín, Jesús Agüero, additional, Fernández, Cristina Amado, additional, Castillo, Carlos Armiñanzas, additional, de las Revillas, Francisco Arnaiz, additional, Belaustegui, Manuel Cobo, additional, Fariñas, María Carmen, additional, Fariñas-Álvarez, Concepción, additional, Sampedro, Marta Fernández, additional, García, Iván, additional, Rico, Claudia González, additional, Gutiérrez-Fernández, Laura, additional, Gutiérrez-Cuadra, Manuel, additional, Díez, José Gutiérrez, additional, Pajarón, Marcos, additional, Parra, José Antonio, additional, Teira, Ramón, additional, Zarauza, Jesús, additional, Parra, Jorge Calderón, additional, Cobo, Marta, additional, Domínguez, Fernando, additional, Pavía, Pablo García, additional, Cruz, Ana Fernández, additional, Ramos-Martínez, Antonio, additional, Romero, Isabel Sánchez, additional, Centella, Tomasa, additional, Hermida, José Manuel, additional, Moya, José Luis, additional, Martín-Dávila, Pilar, additional, Navas, Enrique, additional, Oliva, Enrique, additional, del Río, Alejandro, additional, Stuart, Jorge Rodríguez-Roda, additional, Ruiz, Soledad, additional, Tenorio, Carmen Hidalgo, additional, Sequera, Sergio, additional, Delia, Manuel Almendro, additional, Araji, Omar, additional, Barquero, José Miguel, additional, Jambrina, Román Calvo, additional, de Cueto, Marina, additional, Acebal, Juan Gálvez, additional, Méndez, Irene, additional, Morales, Isabel, additional, Lepe, José Antonio, additional, López-Haldón, José, additional, Luque-Márquez, Rafael, additional, Marín, Guillermo, additional, Ortiz-Carrellán, Antonio, additional, Sánchez-Domínguez, Eladio, additional, Alonso, Luis Javier, additional, Azcárate, Pedro, additional, Gutiérrez, José Manuel Azcona, additional, Blanco, José Ramón, additional, Armas, Estíbaliz Corral, additional, García-Álvarez, Lara, additional, Oteo, José Antonio, additional, Membrilla, Antonio Barros, additional, Iglesias, Antonino Ginel, additional, Grillo, Sara, additional, Petracca, Rubén Leta, additional, López-Contreras, Joaquín, additional, Martínez, María Alba Rivera, additional, Álvarez, M., additional, Fernández, A.L., additional, Martínez, Amparo, additional, Prieto, A., additional, Regueiro, Benito, additional, Tijeira, E., additional, Vega, Marino, additional, Quiñonero, Amaia Aguirre, additional, Miñambres, Ángela Alonso, additional, Arana, Juan Carlos Gainzarain, additional, de Alaiza Ortega, Sara González, additional, Rodríguez, Miguel Ángel Morán, additional, Rodríguez, Anai Moreno, additional, de Zárate, Zuriñe Ortiz, additional, Zapirain, José Joaquín Portu, additional, de Adana Arroniz, Ester Sáez, additional, Sánchez, Daisy Carolina Sorto, additional, Antonio, Sánchez-Porto, additional, Alejandro, Úbeda Iglesias, additional, Leal, José Mª Arribas, additional, Vázquez, Elisa García, additional, Torres, Alicia Hernández, additional, Blázquez, Ana, additional, de la Morena Valenzuela, Gonzalo, additional, Alonso, Ángel, additional, Aramburu, Javier, additional, Calvo, Felicitas Elena, additional, Tarabini-Castellani, Paola, additional, Gálvez, Eva Heredero, additional, Bellido, Carolina Maicas, additional, Pau, José Largo, additional, Sepúlveda, Mª Antonia, additional, Sierra, Pilar Toledano, additional, Iqbal-Mirza, Sadaf Zafar, additional, Alcolea, Eva Cascales, additional, Yañez, Ivan Keituqwa, additional, Martínez, Julián Navarro, additional, Ballesta, Ana Peláez, additional, Escobar, Eduardo Moreno, additional, Monje, Alejandro Peña, additional, Cabrera, Valme Sánchez, additional, García, David Vinuesa, additional, Asenjo, María Arrizabalaga, additional, Luna, Carmen Cifuentes, additional, Morcillo, Juana Núñez, additional, Seco, Mª Cruz Pérez, additional, Gelabert, Aroa Villoslada, additional, Guallar, Carmen Aured, additional, Abad, Nuria Fernández, additional, Mangas, Pilar García, additional, Adell, Marta Matamala, additional, Ruiz, Mª Pilar Palacián, additional, Porres, Juan Carlos, additional, Vidal, Begoña Alcaraz, additional, Del Amor Espín, María Jesús, additional, Buendía, Francisco, additional, Sánchez, Roberto Jiménez, additional, Mármol, Rosario, additional, Martínez, Francisco, additional, Meseguer, Antonio, additional, Pérez, Beatriz, additional, Risco, Leticia, additional, Saura, Zoser, additional, Silva, Vanina, additional, Villmarín, Mª Belén, additional, Blanco, Mª Ángels Ribas, additional, de Gopegui Bordes, Enrique Ruiz, additional, Bonet, Laura Vidal, additional, Borràs, Miquel Vives, additional, Munera, Mª Carmen Bellón, additional, Garaizabal, Elena Escribano, additional, Martínez, Antonia Tercero, additional, Luque, Juan Carlos Segura, additional, Badía, Cristina, additional, Palop, Lucía Boix, additional, Xercavins, Mariona, additional, Ibars, Sónia, additional, Bosch, Xerach, additional, Nebreda, Eloy Gómez, additional, Herrera, Ibalia Horcajada, additional, Gallego, Irene Menduiña, additional, Pulido, Imanol, additional, Santiago, Héctor Marrero, additional, de Miguel Martínez, Isabel, additional, Álamo, Elena Pisos, additional, Sánchez, Daniel San Román, additional, Pérez, Jorge Boan, additional, Blanco, Eva Mª Aguilar, additional, González, Mercedes Catalán, additional, Peiretti, María Angélica Corres, additional, Esteve, Andrea Eixerés, additional, Pérez, Laura Domínguez, additional, de Cossío Tejido, Santiago, additional, Román, Francisco Galván, additional, Robles, José Antonio García, additional, Medrano, Francisco López, additional, Gude, Mª Jesús López, additional, Miguel, Mª Ángeles Orellana, additional, Pilkington, Patrick, additional, Ostalaza, Yolanda Revilla, additional, Morales, Juan Ruiz, additional, Solís, Sebastián Ruiz, additional, Collado, Ana Sabín, additional, Fernández, Marcos Sánchez, additional, Rallo, Javier Solera, additional, Martín, Jorge Solís, additional, Escrihuela-Vidal, Francesc, additional, Carratalà, Jordi, additional, Grau, Inmaculada, additional, Ardanuy, Carmen, additional, Berbel, Dámaris, additional, Salado, José Carlos Sánchez, additional, Alegre, Oriol, additional, Majoral, Alejandro Ruiz, additional, Sbraga, Fabrizio, additional, Blasco, Arnau, additional, Sánchez, Laura Gracia, additional, Sánchez-Rodríguez, Iván, additional, Aldamiz, Gonzalo, additional, Álvarez, Beatriz, additional, Palacios, Marina Bernal, additional, Úbeda, Alfonso Cabello, additional, Roblas, Ricardo Fernández, additional, Hernández, Rafael, additional, Martín, Victoria Andrea Hortigüela, additional, Kallmeyer, Andrea, additional, Kancev, Cristina Landaeta, additional, Martín, Marta, additional, Ruiz, Miguel Morante, additional, Lobato, Miguel Ángel Navas, additional, Pello, Ana María, additional, Prieto, Laura, additional, Mallebrera, Marta Tomás, additional, Varela, Laura, additional, de la Peña Triguero, Mireia, additional, Cerón, Ruth Esther Figueroa, additional, Gómez, Lara Ruiz, additional, Ble, Mireia, additional, Gallego, Juan Pablo Horcajada, additional, Ginel, Antonio José, additional, López, Inmaculada, additional, Mas, Alexandra, additional, Mestres, Antoni, additional, Molina, Lluís, additional, Serrat, Ramón, additional, Ribas, Núria, additional, Sánchez, Francisca, additional, Silverio, Ana, additional, Suárez, Marina, additional, Sorlí, Luisa, additional, Recasens, Lluís, additional, Taurón, Manuel, additional, Regueras, María Fernández, additional, Vallejo, María Ángeles Mantecón, additional, Rivera, José Ángel Pérez, additional, Mata, Nuria Sánchez, additional, Cano, Antonia Calvo, additional, Olivares, Miguel Fajardo, additional, Núñez, María Victoria Millán, additional, and Sanz, Agustín Muñoz, additional
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- 2023
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11. P1534: MRNA-1273 SARS-COV-2 VACCINE IN RECENTLY TRANSPLANTED ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT RECIPIENTS: CELLULAR AND HUMORAL IMMUNE RESPONSES AND BOOSTER EFFECT
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Albiol, Nil, primary, Lynton-Pons, Elionor, additional, Aso, Olga, additional, Moga, Esther, additional, Gómez-Pérez, Lucía, additional, Alejandre-Santiago, Jose, additional, Triquell, Mercè, additional, Roch, Nerea, additional, Lázaro, Elisabeth, additional, González, Iria, additional, López-Contreras, Joaquín, additional, Sanfeliu, Albert Esquirol, additional, Sierra, Jorge, additional, Martino, Rodrigo, additional, and Cadenas, Irene Garcia, additional
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- 2023
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12. Impact of adherence to individual quality-of-care indicators on the prognosis of bloodstream infection due to Staphylococcus aureus: a prospective observational multicentre cohort
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National Institute for Health Research (UK), NIHR Biomedical Research Centre (UK), Instituto de Salud Carlos III, Ministerio de Economía y Competitividad (España), European Commission, Wellcome Trust, Escrihuela-Vidal, Francesc, Kaasch, Achim J., Cube, Maja Von, Rieg, Siegbert, Kern, Winfried V., Seifert, Harald, Song, Kyoung-Ho, Liao, Chun-Hsing, Tilley, Robert, Gott, Hannah, Scarborough, Matt, Gordon, Claire, Llewelyn, Martin J., Kuehl, Richard, Morata, Laura, Soriano, Álex, Edgeworth, Jonathan, Ruiz-de-Gopegui, Enrique, Nsutebu, Emmanuel, Cisneros, José Miguel, Fowler, Vance G., Thwaites, Guy, López-Contreras, Joaquín, Barlow, Gavin, Ternavasio-de la Vega, Hugo-Guillermo, Rodríguez-Baño, Jesús, López-Cortés, Luis Eduardo, International Staphylococcus Aureus Collaboration Study Group, The European Society of Clinical Microbiology and Infectious Diseases Study Group For Bloodstream Infections, Endocarditis And Sepsis, National Institute for Health Research (UK), NIHR Biomedical Research Centre (UK), Instituto de Salud Carlos III, Ministerio de Economía y Competitividad (España), European Commission, Wellcome Trust, Escrihuela-Vidal, Francesc, Kaasch, Achim J., Cube, Maja Von, Rieg, Siegbert, Kern, Winfried V., Seifert, Harald, Song, Kyoung-Ho, Liao, Chun-Hsing, Tilley, Robert, Gott, Hannah, Scarborough, Matt, Gordon, Claire, Llewelyn, Martin J., Kuehl, Richard, Morata, Laura, Soriano, Álex, Edgeworth, Jonathan, Ruiz-de-Gopegui, Enrique, Nsutebu, Emmanuel, Cisneros, José Miguel, Fowler, Vance G., Thwaites, Guy, López-Contreras, Joaquín, Barlow, Gavin, Ternavasio-de la Vega, Hugo-Guillermo, Rodríguez-Baño, Jesús, López-Cortés, Luis Eduardo, and International Staphylococcus Aureus Collaboration Study Group, The European Society of Clinical Microbiology and Infectious Diseases Study Group For Bloodstream Infections, Endocarditis And Sepsis
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[Objectives] To analyse the adherence and impact of quality-of-care indicators (QCIs) in the management of Staphylococcus aureus bloodstream infection in a prospective and multicentre cohort., [Methods] Analysis of the prospective, multicentre international S. Aureus Collaboration cohort of S. Aureus bloodstream infection cases observed between January 2013 and April 2015. Multivariable analysis was performed to evaluate the impact of adherence to QCIs on 90-day mortality., [Results] A total of 1784 cases were included. Overall, 90-day mortality was 29.9% and mean follow-up period was 118 days. Adherence was 67% (n = 1180/1762) for follow-up blood cultures, 31% (n = 416/1342) for early focus control, 77.6% (n = 546/704) for performance of echocardiography, 75.5% (n = 1348/1784) for adequacy of targeted antimicrobial therapy, 88.6% (n = 851/960) for adequacy of treatment duration in non-complicated bloodstream infections and 61.2% (n = 366/598) in complicated bloodstream infections. Full bundle adherence was 18.4% (n = 328/1784). After controlling for immortal time bias and potential confounders, focus control (adjusted hazard ratio = 0.76; 95% CI, 0.59–0.99; p 0.038) and adequate targeted antimicrobial therapy (adjusted hazard ratio = 0.75; 95% CI, 0.61–0.91; p 0.004) were associated with low 90-day mortality., [Discussion] Adherence to QCIs in S. Aureus bloodstream infection did not reach expected rates. Apart from the benefits of application as a bundle, focus control and adequate targeted therapy were independently associated with low mortality.
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- 2023
13. Cloxacillin plus fosfomycin versus cloxacillin alone for methicillin-susceptible Staphylococcus aureus bacteremia: a randomized trial
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Ministerio de Sanidad (España), Instituto de Salud Carlos III, Laboratorios ERN, European Commission, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Generalitat de Catalunya, Grillo, Sara, Pujol, Miquel, Miró, Josep M., López-Contreras, Joaquín, Euba, Gorane, Gasch, Oriol, Boix-Palop, Lucía, García-País, María José, Pérez-Rodríguez, María Teresa, Gómez-Zorrilla, Silvia, Oriol, Isabel, López-Cortés, Luis Eduardo, Pedro-Botet, María Luisa, San Juan, Rafael, Aguado, José María, Gioia, Francesca, Iftimie, Simona, Morata, Laura, Jover-Sáenz, Alfredo, García-Pardo, Graciano, Loeches, Belén, Izquierdo-Cárdenas, Álvaro, Goikoetxea, Ane Josune, Gomila-Grange, Aina, Dietl, Beatriz, Berbel, Damaris, Videla, Sebastian, Hereu, Pilar, Padullés, Ariadna, Pallarès, Natalia, Tebé, Cristian, Cuervo, Guillermo, Carratalà, Jordi, SAFO study group, Cueto, Marina de, Moreno-Mellado, Elisa, Ministerio de Sanidad (España), Instituto de Salud Carlos III, Laboratorios ERN, European Commission, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Generalitat de Catalunya, Grillo, Sara, Pujol, Miquel, Miró, Josep M., López-Contreras, Joaquín, Euba, Gorane, Gasch, Oriol, Boix-Palop, Lucía, García-País, María José, Pérez-Rodríguez, María Teresa, Gómez-Zorrilla, Silvia, Oriol, Isabel, López-Cortés, Luis Eduardo, Pedro-Botet, María Luisa, San Juan, Rafael, Aguado, José María, Gioia, Francesca, Iftimie, Simona, Morata, Laura, Jover-Sáenz, Alfredo, García-Pardo, Graciano, Loeches, Belén, Izquierdo-Cárdenas, Álvaro, Goikoetxea, Ane Josune, Gomila-Grange, Aina, Dietl, Beatriz, Berbel, Damaris, Videla, Sebastian, Hereu, Pilar, Padullés, Ariadna, Pallarès, Natalia, Tebé, Cristian, Cuervo, Guillermo, Carratalà, Jordi, SAFO study group, Cueto, Marina de, and Moreno-Mellado, Elisa
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Treatment failure occurs in about 25% of patients with methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. We assessed whether cloxacillin plus fosfomycin achieves better treatment success than cloxacillin alone in hospitalized adults with MSSA bacteremia. We conducted a multicenter, open-label, phase III–IV superiority randomized clinical trial. We randomly assigned patients (1:1) to receive 2 g of intravenous cloxacillin alone every 4 h or with 3 g of intravenous fosfomycin every 6 h for the initial 7 days. The primary endpoint was treatment success at day 7, a composite endpoint with the following criteria: patient alive, stable or with improved quick Sequential Organ Failure Assessment score, afebrile and with negative blood cultures for MSSA, adjudicated by an independent committee blinded to treatment allocation. We randomized 215 patients, of whom 105 received cloxacillin plus fosfomycin and 110 received cloxacillin alone. We analyzed the primary endpoint with the intention-to-treat approach in 214 patients who received at least 1 day of treatment. Treatment success at day 7 after randomization was achieved in 83 (79.8%) of 104 patients receiving combination treatment versus 82 (74.5%) of 110 patients receiving monotherapy (risk difference 5.3%; 95% confidence interval (CI), –5.95–16.48). Secondary endpoints, including mortality and adverse events, were similar in the two groups except for persistent bacteremia at day 3, which was less common in the combination arm. In a prespecified interim analysis, the independent committee recommended stopping recruitment for futility prior to meeting the planned randomization of 366 patients. Cloxacillin plus fosfomycin did not achieve better treatment success at day 7 of therapy than cloxacillin alone in MSSA bacteremia. Further trials should consider the intrinsic heterogeneity of the infection by using a more personalized approach. ClinicalTrials.gov registration: NCT03959345.
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- 2023
14. Dysregulated neutrophil extracellular traps formation in sepsis.
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Mulet, Maria, Osuna‐Gómez, Ruben, Zamora, Carlos, Artesero, Iris, Arús, Marc, Vera‐Artazcoz, Paula, Cordón, Alejandra, Vilalta, Noelia, San‐José, Paula, Abril, Andrés, Moliné, Antoni, Morán, Indalecio, López‐Contreras, Joaquín, and Vidal, Silvia
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SEPSIS ,NEUTROPHILS ,INTENSIVE care patients - Abstract
The migration and antimicrobial functions of neutrophils seem to be impaired during sepsis and contribute to the dysregulation of immune responses and disease pathogenesis. However, the role of neutrophil extracellular traps (NETs) remains to be clarified. The study aimed to analyse sequential phenotypic and functional changes of neutrophils during the time following the diagnosis of sepsis. We prospectively enrolled 49 septic and 18 non‐septic patients from the intensive care unit (ICU) and emergency room (ER) and 20 healthy volunteers (HV). Baseline blood samples from septic and non‐septic patients were collected within 12 h of admission to the hospital. Additional septic samples were drawn at 24, 48 and 72 h after baseline. Neutrophil phenotype and degranulation capacity were assessed by flow cytometry and NET formation was quantified by fluorescence. Neutrophils from septic patients exhibited increased CD66b, CD11b and CD177 expression but displayed reduced NET formation at baseline compared with non‐septic patients and HV controls. Neutrophils expressing CD177 interacted less with platelets, were related to reduced NETosis and tended to indicate a worse sepsis outcome. In vitro experiments revealed that neutrophil function is compromised by the origin of sepsis, including the pathogen type and the affected organ. Assessing a decision tree model, our study showed that CD11b expression and NETosis values are useful variables to discriminate septic from non‐septic patients. We conclude that sepsis induces changes in neutrophil phenotype and function that may compromise the effective capacity of the host to eliminate pathogens. [ABSTRACT FROM AUTHOR]
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- 2023
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15. Evolution of notified sexually transmitted infections in Barcelona during the first wave of the COVID‐19 pandemic
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Martin Ezquerra, Gemma, Monreal, P., Mercuriali, Lilas, Cañas-Ruano, Esperanza, Pujol, Ramón M., Duran Jordà, Xavier, 1974, Masferrer Niubò, Magalí, Domingo, Pere, Villar García, Judit, López Contreras, Joaquín, González-Cordón, Ana, Garcia-Olalla, Patricia, Barberà, María Jesús, and STI-HIV group of Barcelona
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0301 basic medicine ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Human immunodeficiency virus (HIV) ,Sexually Transmitted Diseases ,Covid‐19 Special Forum ,Dermatology ,urologic and male genital diseases ,medicine.disease_cause ,03 medical and health sciences ,Pandemic ,medicine ,Humans ,Letter to the Editor ,Pandemics ,030505 public health ,business.industry ,SARS-CoV-2 ,virus diseases ,COVID-19 ,030112 virology ,female genital diseases and pregnancy complications ,Infectious Diseases ,Emergency medicine ,0305 other medical science ,business - Abstract
With the arrival of COVID-19, STI units decreased their activity or even closed and individuals avoided healthcare facilities. These factors conditioned the diagnosis of severe conditions1 , including STI. The main objective of this study was to analyze the number of newly notified STI cases and HIV postexposure prophylaxis (PEP) in Barcelona during the COVID-19 pandemic.
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- 2021
16. An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008-2019)
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Arroyo-García, Nares, Badia, Josep M., Vázquez, Ana, Pera Roman, Miguel, Parés, David, Limón, Enric, Almendral, Alexander, Piriz, Marta, Cecilia, Díez, Fraccalvieri, Domenico, López Contreras, Joaquín, Pujol, Miquel, Colorectal Surveillance Team, VINCat Program, Arroyo-García, Nares, Badia, Josep M., Vázquez, Ana, Pera Roman, Miguel, Parés, David, Limón, Enric, Almendral, Alexander, Piriz, Marta, Cecilia, Díez, Fraccalvieri, Domenico, López Contreras, Joaquín Pujol, Miquel, Colorectal Surveillance Team, VINCat Program, [Arroyo-Garcia N, Badia JM] Department of Surgery, Hospital General Granollers, Granollers, Spain. School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain. [Vázquez A] Servei d’Estadística Aplicada, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Pera M] Department of Surgery, Hospital del Mar, Barcelona, Spain. [Parés D] Department of Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. [Limón E] VINCat Program, Universitat de Barcelona, Barcelona, Spain, and Hospital General de Granollers
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Prevenció i control ,Infeccions quirúrgiques ,Cirurgia colorectal ,Surgical wound infection ,Estudios de cohortes ,Infection control ,Còlon - Cirurgia ,Cohort Studies ,Health Occupations::Medicine::Specialties, Surgical::Colorectal Surgery [DISCIPLINES AND OCCUPATIONS] ,Cirugía colorrectal ,Control d'infeccions ,Prevención y control ,Colorectal surgery ,Risk Factors ,Infección del sitio quirúrgico ,Humans ,Surgical Wound Infection ,Estudis de cohorts ,Epidemiologia ,Proporción de infección estandarizada ,Digestive System Surgical Procedures ,Standardized infection ratio ,Infecció del lloc quirúrgic ,Adverse effects ,Prevention & control ,Infeccions quirúrgiques - Estudi de casos ,Cirurgia colorrectal ,General Medicine ,Efectos adversos ,Infección de la herida quirúrgica ,Elective Surgical Procedures ,profesiones sanitarias::medicina::especialidades quirúrgicas::cirugía colorrectal [DISCIPLINAS Y OCUPACIONES] ,Ratio d'infecció estandarditzat ,Surgery ,Efectes adversos ,Colorectal Surgery ,Surgical site infection ,Infecció de ferides quirúrgiques - Abstract
Colorectal surgery; Postoperative infection; Cohort studies Cirugía colorrectal; Infección postoperatoria; Estudios de cohortes Cirurgia colorectal; Infecció postoperatòria; Estudis de cohorts Background: Colorectal surgery is associated with the highest rate of surgical site infection (SSI). This study analyses the effectiveness of an interventional surveillance program on SSI rates after elective colorectal surgery. Material and methods: Cohort study showing temporal trends of SSI rates and Standardized Infection Ratio (SIR) in elective colorectal surgery over a 12-year period. Prospectively collected data of a national SSI surveillance program was analysed and the effect of specific interventions was evaluated. Patient and procedure characteristics, as well as SIR and SSI rates were stratified by risk categories and type of SSI analysed using stepwise multivariate logistic regression models. Results: In a cohort of 42,330 operations, overall cumulative SSI incidence was 16.31%, and organ-space SSI (O/S-SSI) was 8.59%. There was a 61.63% relative decrease in SSI rates (rho = -0.95804). The intervention which achieved the greatest SSI reduction was a bundle of 6 measures. SSI in pre-bundle period was 19.73% vs. 11.10% in post-bundle period (OR 1.969; IC 95% 1.860-2.085; p < 0.0001). O/S-SSI were 9.08% vs. 6.06%, respectively (OR 1.547; IC 95% 1.433-1.670; p < 0.0001). Median length of stay was 7 days, with a significant decrease over the studied period (rho = -0.98414). Mortality of the series was 1.08%, ranging from 0.35% to 2.0%, but a highly significant decrease was observed (rho = -0.67133). Conclusions: Detailed analysis of risk factors and postoperative infection in colorectal surgery allows strategies for reducing SSI incidence to be designed. An interventional surveillance program has been effective in decreasing SIR and SSI rates.
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- 2021
17. Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019
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Badia-Cebada, Laia, Peñafiel, Judit, Saliba, Patrick, Andrés, Marta, Càmara, Jordi, Domènech, Dolors, Jiménez-Martínez, Emili, Marrón, Anna, Moreno, Encarna, Pomar, Virginia, Vaqué, Montserrat, Limón, Enric, Masats, Úrsula, Pujol, Miquel, Gasch Blasi, Oriol, Jover, Alfredo, Castellana, Dolors, Olona, Montserrat, García Pino, Antonia, Rebull Fatsini, Josep, Domènech, Mª France, Hornero, Ana, Ardanuy Tisaire, Carmen, Berbel Palau, Dàmaris, López-Contreras, Joaquín, Fernández, Engracia, Salgado, Xavier, Lérida, Ana, Martin, Lydia, Sopena, Nieves, Casas Garcia, Irma, Pérez, Rafael, Maraver, Encarna, Palau, Eva, Serrats, Pepi, Martínez, José Antonio, Santana, Gemina, Martínez, Ana, Ferrer, Lourdes, Moreno, Mª José, Calbo, Esther, Porta, Carolina, Smithson, Alex, de la Roca Toda, Maria, Aliu, Teresa, Camps, Susana, Ortega, Montserrat, Diaz-Brito, Vicens, Agusti, Carme, Perea Garcia, Miquel, Grau Palafox, Laura, Carrera, Raquel, Besolí, Anna, Horcajada, Juan Pablo, Gonzalez, Cristina, Cuquet, Jordi, Maldonado López, Demelsa Maria, Benítez, Rosa, Duch, Mireia, Blancas, David, Moreno, Esther, Villalba, Naiara, Martínez, Sara, García Flores, Àngels, Ferrer, Roser, Bisbe, Josep, Blascó, Montse, Castro Salom, Antoni, López, Ana Felisa, Espinach Alvarós, Joan, Perez, Àngels, Castander, David, Calaf, Elisabet, Clarós, Mercè, Bosch Ros, Núria, Montardit, Irene, Porta, Roser, De la Cruz Sol, Pilar, Coll Colell, Mª Rosa, García Penche Sanches, Rosa, Tricas, Josep Maria, Redon, Eva, Brugués, Montse, Linares, Laura, Cusco, Maria, Barrufet, Mª Pilar, Vidal, Elena, Barbadillo, Sandra, Marimón, Mariló, Meije, Yolanda, Laplace Enguinados, M.Rosa, Vila, Blanca, Coloma, Ana Guadalupe, López, Lucrecia, Campins Martí, Magda, Almirante Gragera, Benito, Ferrer, Carme, Juan Serra, Natalia, Farguell Carrera, Josep, Garcia Flores, Àngels, Milian Sanz, Marta, Moise, Alexandra, Jiménez Zarate, Ana Mª, Eito Navasal, M. Carmen, Garcia Ramirez, María Gracia, Armario Fernández, Mar, Universitat Autònoma de Barcelona, [Badia-Cebada L] Internal Medicine Department, Hospital Universitari Parc Taulí, Sabadell, Spain. School of Medicine, Universitat Autònoma de Barcelona, Sabadell, Spain. [Peñafiel J] Unit of Statistics, Hospital Universitari de Bellvitge/Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain. [Saliba P] VINCat programme: Infection Control Catalan Programme, Barcelona, Spain. [Andrés M] Infectious Diseases Unit, Departament de Medicina Interna, Hospital de Terrassa, Consorci Sanitari de Terrassa, Spain. [Càmara J] Department of Microbiology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain. Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain. CIBER de Malalties Respiratòries (CIBERes), ISCIII, Madrid, Spain. [Domenech D] Infermera de control d'infeccions, Hospital Josep Trueta, Girona, Spain, and Consorci Sanitari de Terrassa
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Health Occupations::Medicine::Public Health::Epidemiology [DISCIPLINES AND OCCUPATIONS] ,Male ,Catheterization, Central Venous ,Catheters ,Epidemiology ,profesiones sanitarias::medicina::salud pública::epidemiología [DISCIPLINAS Y OCUPACIONES] ,Bacteremia ,Infections ,Cohort Studies ,Virology ,Sepsis ,Humans ,Prospective Studies ,Espanya ,Epidemiologia ,Polyvinyl Chloride ,Incidence ,infecciones bacterianas y micosis::infección [ENFERMEDADES] ,Public Health, Environmental and Occupational Health ,Fluids and Secretions::Body Fluids::Blood [ANATOMY] ,Catèters ,Middle Aged ,Infeccions ,Bacterial Infections and Mycoses::Infection [DISEASES] ,Spain ,Catheter-Related Infections ,Infecció ,líquidos y secreciones::líquidos corporales::sangre [ANATOMÍA] ,Female - Abstract
Background Catheter-related bloodstream infections (CRBSI) are frequent healthcare-associated infections and an important cause of death. Aim To analyse changes in CRBSI epidemiology observed by the Infection Control Catalan Programme (VINCat). Methods A cohort study including all hospital-acquired CRBSI episodes diagnosed at 55 hospitals (2007–2019) in Catalonia, Spain, was prospectively conducted. CRBSI incidence rates were adjusted per 1,000 patient days. To assess the CRBSI rate trend per year, negative binomial models were used, with the number of events as the dependent variable, and the year as the main independent variable. From each model, the annual rate of CRBSI diagnosed per 1,000 patient days and the incidence rate ratio (IRR) with its 95% confidence intervals (CI) were reported. Results During the study, 9,290 CRBSI episodes were diagnosed (mean annual incidence rate: 0.20 episodes/1,000 patient days). Patients’ median age was 64.1 years; 36.6% (3,403/9,290) were female. In total, 73.7% (n = 6,845) of CRBSI occurred in non-intensive care unit (ICU) wards, 62.7% (n = 5,822) were related to central venous catheter (CVC), 24.1% (n = 2,236) to peripheral venous catheters (PVC) and 13.3% (n = 1,232) to peripherally-inserted central venous catheters (PICVC). Incidence rate fell over the study period (IRR: 0.94; 95%CI: 0.93–0.96), especially in the ICU (IRR: 0.88; 95%CI: 0.87–0.89). As a whole, while episodes of CVC CRBSI fell significantly (IRR: 0.88; 95%CI: 0.87–0.91), peripherally-inserted catheter CRBSI (PVC and PICVC) rose, especially in medical wards (IRR PICVC: 1.08; 95%CI: 1.05–1.11; IRR PVC: 1.03; 95% 1.00-1.05). Conclusions Over the study, CRBSIs associated with CVC and diagnosed in ICUs decreased while episodes in conventional wards involving peripherally-inserted catheters increased. Hospitals should implement preventive measures in conventional wards.
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- 2022
18. Epidemiology of surgical site infections after total hip and knee joint replacement during 2007–2009: a report from the VINCat Program
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López-Contreras, Joaquín, Limón, Enric, Matas, Lourdes, Olona, Montserrat, Sallés, Montserrat, and Pujol, Miquel
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- 2012
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19. Surveillance of surgical site infections in elective colorectal surgery. Results of the VINCat Program (2007–2010)
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Pujol, Miquel, Limón, Enric, López-Contreras, Joaquín, Sallés, Montserrat, Bella, Feliu, and Gudiol, Francesc
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- 2012
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20. Multicentre, randomised, open-label, phase IV-III study to evaluate the efficacy of cloxacillin plus fosfomycin versus cloxacillin alone in adult patients with methicillin-susceptible Staphylococcus aureus bacteraemia: study protocol for the SAFO trial
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Grillo, Sara, Cuervo Requena, Guillermo, Carratalà, Jordi, Sanjuan, Rafael, Aguado, José María, Morata, Laura, Gómez-Zorrilla Martín, Silvia, López-Contreras, Joaquín, Gasch, Oriol, Gomila Grange, Aina, Iftimie, Simona, Garcia Pardo, Graciano, Calbo, Esther, Boix Palop, Lucía, Oriol, Isabel, Jover-Sáenz, Alfredo, López-Cortés, Luis Eduardo, Euba, Gorane, Aguirregabiria, Malen, Garcia-Pais, Maria Jose, Gioia, Francesca, Paño, Jose Ramón, Pedro-Botet Montoya, Ma Luisa, Benítez, Rosa M., Pérez-Rodríguez, Maria Teresa, Meije, Yolanda, Loeches-Yagüe, Maria Belén, Horna, Gertrudis, Berbel, Dámaris, Domínguez, María Ángeles, Padullés Zamora, Ariadna, Cobo Sacristán, Sara, Hereu, Pilar, Videla Cés, Sebastià, Tebé, Cristian, Pallarès, Natàlia, Miró Meda, José M., Pujol, Miquel, SAFO study group, and Spanish Network for Research in Infectious Diseases (REIPI).
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Clinical trials ,Microbiologia ,Malalties infeccioses ,Communicable diseases ,Microbiology ,Assaigs clínics - Abstract
Introduction: Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia is a frequent condition, with high mortality rates. There is a growing interest in identifying new therapeutic regimens able to reduce therapeutic failure and mortality observed with the standard of care of beta-lactam monotherapy. In vitro and small-scale studies have found synergy between cloxacillin and fosfomycin against S. aureus. Our aim is to test the hypothesis that cloxacillin plus fosfomycin achieves higher treatment success than cloxacillin alone in patients with MSSA bacteraemia. Methods: We will perform a superiority, randomised, open-label, phase IV-III, two-armed parallel group (1:1) clinical trial at 20 Spanish tertiary hospitals. Adults (≥18 years) with isolation of MSSA from at least one blood culture ≤72 hours before inclusion with evidence of infection, will be randomly allocated to receive either cloxacillin 2 g/4-hour intravenous plus fosfomycin 3 g/6-hour intravenous or cloxacillin 2 g/4-hour intravenous alone for 7 days. After the first week, sequential treatment and total duration of antibiotic therapy will be determined according to clinical criteria by the attending physician. Primary endpoints: (1) Treatment success at day 7, a composite endpoint comprising all the following criteria: patient alive, stable or with improved quick-Sequential Organ Failure Assessment score, afebrile and with negative blood cultures for MSSA at day 7. (2) Treatment success at test of cure (TOC) visit: patient alive and no isolation of MSSA in blood culture or at another sterile site from day 8 until TOC (12 weeks after randomisation). We assume a rate of treatment success of 74% in the cloxacillin group. Accepting alpha risk of 0.05 and beta risk of 0.2 in a two-sided test, 183 subjects will be required in each of the control and experimental groups to obtain statistically significant difference of 12% (considered clinically significant). Ethics and dissemination: Ethical approval has been obtained from the Ethics Committee of Bellvitge University Hospital (AC069/18) and from the Spanish Medicines and Healthcare Product Regulatory Agency (AEMPS, AC069/18), and is valid for all participating centres under existing Spanish legislation. The results will be presented at international meetings and will be made available to patients and funders.
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- 2021
21. Multicentre, randomised, open-label, phase IV–III study to evaluate the efficacy of cloxacillin plus fosfomycin versus cloxacillin alone in adult patients with methicillin-susceptibleStaphylococcus aureusbacteraemia: study protocol for the SAFO trial
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Grillo, Sara, primary, Cuervo, Guillermo, additional, Carratala, Jordi, additional, San-Juan, Rafael, additional, Aguado, Jose M, additional, Morata, Laura, additional, Gomez-Zorrilla, Silvia, additional, López-Contreras, Joaquín, additional, Gasch, Oriol, additional, Gomila-Grange, Aina, additional, Iftimie, Simona, additional, Garcia-Pardo, Graciano, additional, Calbo, Esther, additional, Boix-Palop, Lucía, additional, Oriol, Isabel, additional, Jover-Sáenz, Alfredo, additional, López-Cortés, Luis Eduardo, additional, Euba, Gorane, additional, Aguirregabiria, Malen, additional, Garcia-Pais, Maria Jose, additional, Gioia, Francesca, additional, Paño, Jose Ramón, additional, Pedro-Botet, Maria Luisa, additional, Benítez, Rosa Maria, additional, Pérez-Rodríguez, Maria Teresa, additional, Meije, Yolanda, additional, Loeches-Yagüe, Maria Belén, additional, Horna, Gertrudis, additional, Berbel, Damaris, additional, Domínguez, Maria Ángeles, additional, Padullés, Ariadna, additional, Cobo, Sara, additional, Hereu, Pilar, additional, Videla, Sebastian, additional, Tebe, Cristian, additional, Pallarés, Natàlia, additional, Miro, Josep M, additional, and Pujol, Miquel, additional
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- 2021
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22. Oral antibiotic prophylaxis lowers surgical site infection in elective colorectal surgery : results of a pragmatic cohort study in Catalonia
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Badia, Josep M., Flores-Yelamos, Miriam, Vázquez, Ana, Arroyo-garcía, Nares, Puig-Asensio, Mireia, Parés, David, Pera, Miguel, López-Contreras, Joaquín, Limón, Enric, Pujol, Miquel, Badia, Josep M., Flores-Yelamos, Miriam, Vázquez, Ana, Arroyo-garcía, Nares, Puig-Asensio, Mireia, Parés, David, Pera, Miguel, López-Contreras, Joaquín, Limón, Enric, and Pujol, Miquel
- Abstract
Background: The role of oral antibiotic prophylaxis (OAP) and mechanical bowel preparation (MBP) in the prevention of surgical site infection (SSI) after colorectal surgery is still controversial. The aim of this study was to analyze the effect of a bundle including both measures in a National Infection Surveillance Network in Catalonia. Methods: Pragmatic cohort study to assess the effect of OAP and MBP in reducing SSI rate in 65 hospitals, comparing baseline phase (BP: 2007-2015) with implementation phase (IP: 2016-2019). To compare the results, a logistic regression model was established. Results: Out of 34,421 colorectal operations, 5180 had SSIs (15.05%). Overall SSI rate decreased from 18.81% to 11.10% in BP and IP, respectively (OR 0.539, CI95 0.507-0.573, p < 0.0001). Information about bundle implementation was complete in 61.7% of cases. In a univariate analysis, OAP and MBP were independent factors in decreasing overall SSI, with OR 0.555, CI95 0.483-0.638, and OR 0.686, CI95 0.589-0.798, respectively; and similarly, organ/space SSI (O/S-SSI) (OR 0.592, CI95 0.494-0.710, and OR 0.771, CI95 0.630-0.944, respectively). However, only OAP retained its protective effect at both levels at multivariate analyses. Conclusions: oral antibiotic prophylaxis decreased the rates of SSI and O/S-SSI in a large series of elective colorectal surgery.
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- 2021
23. Daptomycin Plus Fosfomycin Versus Daptomycin Alone for Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis: A Randomized Clinical Trial
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Ministerio de Ciencia, Innovación y Universidades (España), Red Española de Investigación en Patología Infecciosa, Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), European Commission, Spanish Clinical Research Network, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Pujol, Miquel, Miró, José María, Shaw, Evelyn, Aguado, José María, San Juan, Rafael, Puig-Asensio, M., Pigrau, Carlos, Calbo, Esther, Montejo, Miguel, Rodríguez-Álvarez, Regino José, García-País, María José, Pintado, Vicente, Escudero-Sánchez, Rosa, López-Contreras, Joaquín, Morata, Laura, Montero, Milagros, Andrés, Marta, Pasquau-Liaño, Juan, Arenas-Miras, Maria del Mar, Padilla, Belén, Murillas, Javier, Jover-Sáenz, Alfredo, López-Cortés, Luis Eduardo, García-Prado, Graciano, Gasch, Oriol, Videla, Sebastián, Hereu, Pilar, Tebé, Cristian, Pallarès, Natalia, Sanllorente, Mireia, Domínguez, María Ángeles, Càmara, Jordi, Ferrer, Anna, Padullés, Ariadna, Cuervo, Guillermo, Carratalà, Jordi, Ministerio de Ciencia, Innovación y Universidades (España), Red Española de Investigación en Patología Infecciosa, Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), European Commission, Spanish Clinical Research Network, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Pujol, Miquel, Miró, José María, Shaw, Evelyn, Aguado, José María, San Juan, Rafael, Puig-Asensio, M., Pigrau, Carlos, Calbo, Esther, Montejo, Miguel, Rodríguez-Álvarez, Regino José, García-País, María José, Pintado, Vicente, Escudero-Sánchez, Rosa, López-Contreras, Joaquín, Morata, Laura, Montero, Milagros, Andrés, Marta, Pasquau-Liaño, Juan, Arenas-Miras, Maria del Mar, Padilla, Belén, Murillas, Javier, Jover-Sáenz, Alfredo, López-Cortés, Luis Eduardo, García-Prado, Graciano, Gasch, Oriol, Videla, Sebastián, Hereu, Pilar, Tebé, Cristian, Pallarès, Natalia, Sanllorente, Mireia, Domínguez, María Ángeles, Càmara, Jordi, Ferrer, Anna, Padullés, Ariadna, Cuervo, Guillermo, and Carratalà, Jordi
- Abstract
[Background] We aimed to determine whether daptomycin plus fosfomycin provides higher treatment success than daptomycin alone for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and endocarditis., [Methods] A randomized (1:1) phase 3 superiority, open-label, and parallel group clinical trial of adult inpatients with MRSA bacteremia was conducted at 18 Spanish hospitals. Patients were randomly assigned to receive either 10 mg/kg of daptomycin intravenously daily plus 2 g of fosfomycin intravenously every 6 hours, or 10 mg/kg of daptomycin intravenously daily. Primary endpoint was treatment success 6 weeks after the end of therapy., [Results] Of 167 patients randomized, 155 completed the trial and were assessed for the primary endpoint. Treatment success at 6 weeks after the end of therapy was achieved in 40 of 74 patients who received daptomycin plus fosfomycin and in 34 of 81 patients who were given daptomycin alone (54.1% vs 42.0%; relative risk, 1.29 [95% confidence interval, .93–1.8]; P = .135). At 6 weeks, daptomycin plus fosfomycin was associated with lower microbiologic failure (0 vs 9 patients; P = .003) and lower complicated bacteremia (16.2% vs 32.1%; P = .022). Adverse events leading to treatment discontinuation occurred in 13 of 74 patients (17.6%) receiving daptomycin plus fosfomycin, and in 4 of 81 patients (4.9%) receiving daptomycin alone (P = .018)., [Conclusions] Daptomycin plus fosfomycin provided 12% higher rate of treatment success than daptomycin alone, but this difference did not reach statistical significance. This antibiotic combination prevented microbiological failure and complicated bacteremia, but it was more often associated with adverse events., [Clinical Trials Registration] NCT01898338.
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- 2021
24. Multicentre, randomised, open-label, phase IV–III study to evaluate the efficacy of cloxacillin plus fosfomycin versus cloxacillin alone in adult patients with methicillin-susceptible Staphylococcus aureus bacteraemia: study protocol for the SAFO trial
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Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), Red Española de Investigación en Patología Infecciosa, Grillo, Sara, Cuervo, Guillermo, Carratalà, Jordi, San Juan, Rafael, Aguado, José María, Morata, Laura, Gómez-Zorrilla, Silvia, López-Contreras, Joaquín, Gasch, Oriol, Gomila-Grange, Aina, Iftimie, Simona, García-Prado, Graciano, Calbo, Esther, Boix-Palop, Lucía, Oriol, Isabel, Jover-Sáenz, Alfredo, López-Cortés, Luis Eduardo, Euba, Gorane, Aguirregabiria, Malen, García-País, María José, Gioia, Francesca, Paño, José Ramón, Pedro-Botet, María Luisa, Benítez, Rosa María, Pérez-Rodríguez, María Teresa, Meije, Yolanda, Loeches, Belén, Horna, Gestrudis, Berbel, Dàmaris, Domínguez, María Ángeles, Padullés, Ariadna, Cobo, Sara, Hereu, Pilar, Videla, Sebastián, Tebé, Cristian, Pallarès, Natalia, Miró, José María, Pujol, Miquel, Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), Red Española de Investigación en Patología Infecciosa, Grillo, Sara, Cuervo, Guillermo, Carratalà, Jordi, San Juan, Rafael, Aguado, José María, Morata, Laura, Gómez-Zorrilla, Silvia, López-Contreras, Joaquín, Gasch, Oriol, Gomila-Grange, Aina, Iftimie, Simona, García-Prado, Graciano, Calbo, Esther, Boix-Palop, Lucía, Oriol, Isabel, Jover-Sáenz, Alfredo, López-Cortés, Luis Eduardo, Euba, Gorane, Aguirregabiria, Malen, García-País, María José, Gioia, Francesca, Paño, José Ramón, Pedro-Botet, María Luisa, Benítez, Rosa María, Pérez-Rodríguez, María Teresa, Meije, Yolanda, Loeches, Belén, Horna, Gestrudis, Berbel, Dàmaris, Domínguez, María Ángeles, Padullés, Ariadna, Cobo, Sara, Hereu, Pilar, Videla, Sebastián, Tebé, Cristian, Pallarès, Natalia, Miró, José María, and Pujol, Miquel
- Abstract
[Introduction] Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia is a frequent condition, with high mortality rates. There is a growing interest in identifying new therapeutic regimens able to reduce therapeutic failure and mortality observed with the standard of care of beta-lactam monotherapy. In vitro and small-scale studies have found synergy between cloxacillin and fosfomycin against S. aureus. Our aim is to test the hypothesis that cloxacillin plus fosfomycin achieves higher treatment success than cloxacillin alone in patients with MSSA bacteraemia., [Methods] We will perform a superiority, randomised, open-label, phase IV–III, two-armed parallel group (1:1) clinical trial at 20 Spanish tertiary hospitals. Adults (≥18 years) with isolation of MSSA from at least one blood culture ≤72 hours before inclusion with evidence of infection, will be randomly allocated to receive either cloxacillin 2 g/4-hour intravenous plus fosfomycin 3 g/6-hour intravenous or cloxacillin 2 g/4-hour intravenous alone for 7 days. After the first week, sequential treatment and total duration of antibiotic therapy will be determined according to clinical criteria by the attending physician. Primary endpoints: (1) Treatment success at day 7, a composite endpoint comprising all the following criteria: patient alive, stable or with improved quick-Sequential Organ Failure Assessment score, afebrile and with negative blood cultures for MSSA at day 7. (2) Treatment success at test of cure (TOC) visit: patient alive and no isolation of MSSA in blood culture or at another sterile site from day 8 until TOC (12 weeks after randomisation). We assume a rate of treatment success of 74% in the cloxacillin group. Accepting alpha risk of 0.05 and beta risk of 0.2 in a two-sided test, 183 subjects will be required in each of the control and experimental groups to obtain statistically significant difference of 12% (considered clinically significant)., [Ethics and dissemination] Ethical approval has been obtained from the Ethics Committee of Bellvitge University Hospital (AC069/18) and from the Spanish Medicines and Healthcare Product Regulatory Agency (AEMPS, AC069/18), and is valid for all participating centres under existing Spanish legislation. The results will be presented at international meetings and will be made available to patients and funders., [Trial registration number] The protocol has been approved by AEMPS with the Trial Registration Number EudraCT 2018-001207-37. ClinicalTrials.gov Identifier: NCT03959345; Pre-results.
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- 2021
25. Etiology of surgical site infections after primary total joint arthroplasties
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Benito, Natividad, Franco, María, Coll, Pere, Gálvez, María Luz, Jordán, Marcos, López-Contreras, Joaquín, Pomar, Virginia, Monllau, Joan Carles, Mirelis, Beatriz, and Gurguí, Mercè
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- 2014
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26. Cloxacillin plus fosfomycin versus cloxacillin alone for methicillin-susceptible Staphylococcusaureusbacteremia: a randomized trial
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Grillo, Sara, Pujol, Miquel, Miró, Josep M., López-Contreras, Joaquín, Euba, Gorane, Gasch, Oriol, Boix-Palop, Lucia, Garcia-País, Maria José, Pérez-Rodríguez, Maria Teresa, Gomez-Zorrilla, Silvia, Oriol, Isabel, López-Cortés, Luis Eduardo, Pedro-Botet, Maria Luisa, San-Juan, Rafael, Aguado, José María, Gioia, Francesca, Iftimie, Simona, Morata, Laura, Jover-Sáenz, Alfredo, García-Pardo, Graciano, Loeches, Belén, Izquierdo-Cárdenas, Álvaro, Goikoetxea, Ane Josune, Gomila-Grange, Aina, Dietl, Beatriz, Berbel, Damaris, Videla, Sebastian, Hereu, Pilar, Padullés, Ariadna, Pallarès, Natalia, Tebé, Cristian, Cuervo, Guillermo, and Carratalà, Jordi
- Abstract
Treatment failure occurs in about 25% of patients with methicillin-susceptible Staphylococcusaureus(MSSA) bacteremia. We assessed whether cloxacillin plus fosfomycin achieves better treatment success than cloxacillin alone in hospitalized adults with MSSA bacteremia. We conducted a multicenter, open-label, phase III–IV superiority randomized clinical trial. We randomly assigned patients (1:1) to receive 2 g of intravenous cloxacillin alone every 4 h or with 3 g of intravenous fosfomycin every 6 h for the initial 7 days. The primary endpoint was treatment success at day 7, a composite endpoint with the following criteria: patient alive, stable or with improved quick Sequential Organ Failure Assessment score, afebrile and with negative blood cultures for MSSA, adjudicated by an independent committee blinded to treatment allocation. We randomized 215 patients, of whom 105 received cloxacillin plus fosfomycin and 110 received cloxacillin alone. We analyzed the primary endpoint with the intention-to-treat approach in 214 patients who received at least 1 day of treatment. Treatment success at day 7 after randomization was achieved in 83 (79.8%) of 104 patients receiving combination treatment versus 82 (74.5%) of 110 patients receiving monotherapy (risk difference 5.3%; 95% confidence interval (CI), –5.95–16.48). Secondary endpoints, including mortality and adverse events, were similar in the two groups except for persistent bacteremia at day 3, which was less common in the combination arm. In a prespecified interim analysis, the independent committee recommended stopping recruitment for futility prior to meeting the planned randomization of 366 patients. Cloxacillin plus fosfomycin did not achieve better treatment success at day 7 of therapy than cloxacillin alone in MSSA bacteremia. Further trials should consider the intrinsic heterogeneity of the infection by using a more personalized approach. ClinicalTrials.gov registration: NCT03959345.
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- 2023
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27. Do prosthetic joint infections cured at the first treatment attempt worsen the functional outcome of patients with joint replacements? A retrospective matched cohort study
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Mur, Isabel, Jordán, Marcos, Rivera, Alba, Pomar, Virginia, González, José Carlos, López-Contreras, Joaquín, Crusi, Xavier, Navarro Risueño, Ferran, Gurguí Ferrer, Mercè., and Benito, Natividad
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musculoskeletal diseases ,Prosthetic joint infection ,Arthroplasty infection ,Prosthetic joint infection functional outcome ,Prosthetic joint infection ambulatory outcome - Abstract
Objectives: To assess the effect on the functional ambulatory outcome of postoperative joint infection (PJI) cured at the first treatment attempt versus not developing PJI in patients with hip and knee prostheses. Methods: In a single-hospital retrospectively matched cohort study, each patient with PJI between 2007 and 2016 was matched on age, sex, type of prosthesis and year of implantation with two other patients with uninfected arthroplasties. The definition of a PJI cure included infection eradication, no further surgical procedures, no PJI-related mortality and no suppressive antibiotics. Functional ambulatory status evaluated one year after the last surgery was classified into four simple categories: able to walk without assistance, able to walk with one crutch, able to walk with two crutches, and unable to walk. Patients with total hip arthroplasties (THAs), total knee arthroplasties (TKAs) and partial hip arthroplasties (PHAs) were analysed separately. Results: A total of 109 PJI patients (38 TKA, 41 THA, 30 PHA) and 218 non-PJI patients were included. In a model adjusted for clinically relevant variables, PJI was associated with a higher risk of needing an assistive device for ambulation (vs. walking without aid) among THA (adjusted odds ratio (OR) 3.10, 95% confidence interval (95% CI) 1.26-7.57; p = 0.014) and TKA patients (OR 5.40, 95% CI 2.12-13.67; p < 0.001), and with requiring two crutches to walk or being unable to walk (vs. walking unaided or with one crutch) among PHA patients (OR 3.05, 95% CI 1.01-9.20; p = 0.047). Conclusions: Ambulatory outcome in patients with hip and knee prostheses with postoperative PJI is worse than in patients who do not have PJI.
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- 2020
28. Do Prosthetic Joint Infections Worsen the Functional Ambulatory Outcome of Patients with Joint Replacements? A Retrospective Matched Cohort Study
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Mur, Isabel, primary, Jordán, Marcos, additional, Rivera, Alba, additional, Pomar, Virginia, additional, González, José Carlos, additional, López-Contreras, Joaquín, additional, Crusi, Xavier, additional, Navarro, Ferran, additional, Gurguí, Mercè, additional, and Benito, Natividad, additional
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- 2020
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29. Validation of the catheter-related bloodstream infection: data among the hospitals of the VINCat Program
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Saliba, Patrick, Gasch, Oriol, Calbo, Esther, López-Contreras, Joaquín, and Limon, Enrique
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Cardiovascular system ,Catheters ,Catèters ,Infections ,Infeccions ,Sistema cardiovascular - Abstract
Introduction: During the last three decades, the surveillance of healthcare associated infections (HAIs) has been recognized as the cornerstone of an effective program of prevention and control of HAIs. Catheter-related bloodstream infections (CRBSIs) are one of the most common types of HAIs. In 2018, the VINCat program (vigilància de les infeccions nosocomials als hospitals de Catalunya) conducted a national validation of CRBSIs´ data to validate the actual recorded rates and assess the data concordance between VINCat and the participating hospitals. Objectives: To validate the declared CRBSIs data of the hospitals participating in the VINCat program Methods: This validation included 44 participating hospitals divided into 3 main groups according to bed number. All hospitals were asked to submit microbilogical data lists of all registered cases of CRBSIs with Staphylococcus aureus (S.aureus) and Coagulase-negative staphylococci (CoNS) reported to the VINCat during the cut period (March to December) and were subject for validation. Main outcomes were false negative cases of CRBSIs that should have been declared to VINCat and false positive cases that do not comply VINCat criteria for a CRBSI.To evaluate the agreement between the two validators statistically, the Cohen's Kappa value is used with '1' being the highest value of concordance. Results: The total number of validated cases of bacteremia was 2327, of which 585 were cases of CRBSIs. In total, 89 (5%) were discordant cases of which 2 cases (2%) were not declared, 4 cases (5%) did not meet the VINCat criteria and 83 cases (93%) were not shown in the list of microbiology provided by hospitals. The Kappa value between the two validators was 0.92. Conclusion: This validation shows a high level of concordance between the CRBSIs´data declared to the VINCat program and the participating hospitals up to 96% (almost perfect). Therefore, the CRBSIs ´data within the VINCat program are reliable and eligible for the benchmarking and for public declaration.
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- 2019
30. Blood Pressure Variability in Binswangerʼs Disease and Isolated Lacunar Infarction
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Martí-Fàbregas, Joan, Valencia, Carlos, López-Contreras, Joaquín, Roca-Cusachs, Alex, Solé, María José, García-Sánchez, Carmen, and Martí-Vilalta, Josep-Lluis
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- 2001
31. Programa de prevenció de les infeccions quirúrgiques a Catalunya : PREVINQ-CAT
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Badia, Josep M., Abad, Anna, Barrufet Barqué, Pilar, Díez, Cecilia, Guirao Garriga, Xavier, Navarro, Laura, López-Contreras, Joaquín, Ortiz, Daniel, Píriz, Marta, Torner i Pifarré, Pere, Rams, Neus, Davins Miralles, Josep, Gudiol, Francesc, Pujol, Miquel, and Universitat Autònoma de Barcelona
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- 2018
32. Characteristics and outcome of spontaneous bacterial meningitis in patients with cancer compared to patients without cancer
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Pomar, Virginia, Benito, Natividad, López-Contreras, Joaquín, Coll Figa, Pedro, Gurguí, Mercedes, Domingo, Pere, and Universitat Autònoma de Barcelona
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Male ,0301 basic medicine ,medicine.medical_specialty ,030106 microbiology ,Bacterial meningitis ,Observational Study ,Comorbidity ,Meningococcal disease ,Gastroenterology ,Meningitis, Bacterial ,Hospitals, University ,Tertiary Care Centers ,03 medical and health sciences ,Bacterial infection of the central nervous system ,0302 clinical medicine ,Interquartile range ,Neoplasms ,Internal medicine ,medicine ,Humans ,cancer ,Hospital Mortality ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Neck stiffness ,spontaneous meningitis ,Cancer ,bacterial infection of the central nervous system ,business.industry ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Anti-Bacterial Agents ,Surgery ,Spain ,Spontaneous meningitis ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Female ,bacterial meningitis ,business ,Meningitis ,Research Article - Abstract
Supplemental Digital Content is available in the text, In cancer patients, who are frequently immunocompromised, bacterial meningitis (BM) can be a severe complication, with a different presentation, etiology, and course, compared to patients without cancer. Our objective is to compare the characteristics and outcomes of BM in patients with and without cancer. A single-center, prospective observational cohort study, conducted between 1982 and 2012, in a tertiary university hospital in Barcelona (Spain). The main outcome measure is in-hospital mortality. We evaluated 659 episodes of BM; 97 (15%) had active cancer. Patients with malignancies were older (median 63 (interquartile range [IQR] 24) vs 52 [IQR 42] years, P
- Published
- 2017
33. Resultados de un programa de intervención aleatorizado, abierto, con analista enmascarado para la optimización del tratamiento antimicrobiano de las bacteriemias y fungemias nosocomiales en un hospital terciario
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López Contreras, Joaquín, Gurguí Ferrer, Mercè, Universitat Autònoma de Barcelona. Departament de Medicina, López Contreras, Joaquín, Gurguí Ferrer, Mercè, and Universitat Autònoma de Barcelona. Departament de Medicina
- Abstract
La elevada y creciente incidencia de la bacteriemia nosocomial, el aumento de las resistencias bacterianas con sus importantes consecuencias clínicas y económicas, junto con el hecho de que sigue siendo muy frecuente la inadecuación en el uso de los antibióticos en los hospitales, hace necesario buscar las mejores estrategias para optimizar el uso de los antibióticos. Se consideró que el diseño del estudio utilizando la metodología más exigente y rigurosa, permitiría demostrar si la intervención inmediata por el médico especialista en Enfermedades Infecciosas en los pacientes con sospecha de bacteriemia nosocomial, mejora o no la adecuación del uso de los antimicrobianos. En nuestro conocimiento nunca antes se había realizado un ensayo clínico para tal fin. Hipótesis: 1) La intervención inmediata del especialista en Enfermedades Infecciosas tras conocerse el resultado del Gram en la bacteriemia nosocomial es capaz de mejorar la adecuación del uso de los antimicrobianos. 2) Los pacientes en los que se sospecha una bacteriemia nosocomial que debuta durante el fin de semana tienen una peor adecuación en el uso de los antimicrobianos, que aquellos que debutan durante los días laborables. Objetivos: 1) Principal: Evaluar el impacto de una intervención precoz por el médico especialista en Enfermedades Infecciosas en los pacientes con sospecha de bacteriemia nosocomial en cuanto a: a) Adecuación de la prescripción de los antimicrobianos; b) Evolución clínica y microbiológica de los pacientes; c) Evolución de indicadores asistenciales como la estancia media, la mortalidad y los reingresos; d) Consumos y gasto de antibióticos. 2) Secundario: Evaluar si existen diferencias, en la adecuación de los antibióticos entre los pacientes atendidos en los días laborables y los festivos. Métodos: 1) Estudio de intervención aleatorizado, controlado y con un análisis ciego de los datos, y con una ratio de intervención 1:2 (n=178 vs. 346) y 2) Estudio observacional prospectivo y comparati, The high and increasing incidence of nosocomial bacteremia and increased bacterial resistance has an important clinical impact and also economic consequences. The fact that inadequate use of antibiotics is still happening, very often in hospitals makes necessary to seek for the best strategies to optimize the antibiotics use. It was thought that a study design using the most demanding and rigorous methodology would show whether immediate intervention by the medical specialist in Infectious Diseases could improve antibiotic use in patients with microbiological suspected nosocomial bacteremia. To our knowledge, there has never been a clinical trial to achieve this purpose. Hypotheses: 1) The immediate intervention of the specialist in Infectious Diseases (ID) after the receiving the results from Gram stain can improve the appropriate use of antimicrobials in patients with nosocomial bacteremia. 2) Patients with a nosocomial bacteremia which begins during the weekend are thought to have a worse appropriateness in the use of antimicrobials, than those who begin on weekdays. Objectives: 1) Main objective: Evaluate the impact of early intervention by the specialist in Infectious Diseases in patients with suspected nosocomial bacteremia in terms of: a) appropriateness of antimicrobials; b) clinical and microbiological evolution of patients; c) development of welfare indicators such as average length of stay, mortality, and readmissions; d) consumption of antibiotics. 2) Secondary objective: To evaluate whether there are differences in the adequacy of antibiotics among patients treated on weekdays or on weekends. Methods: 1) Randomized, controlled, intervention clinical trial with blind data analyst. Intervention ratio of 1: 2 (n = 178 vs. 346) Intervention group: Immediate ID specialist recommendation after Gram result vs. control group (standard of care, physicians can c p=0.001onsult or not to ID specialist) and 2) prospective observational and comparative study between
- Published
- 2015
34. Rates of faecal colonization by carbapenemase-producing Enterobacteriaceae among patients admitted to ICUs in Spain: Table 1.
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Oteo, Jesús, primary, Alcaraz, Rosa, additional, Bou, Germán, additional, Conejo, Carmen, additional, Díaz-Lamas, Ana María, additional, Fernández-Martínez, Marta, additional, Fontanals, Dionisia, additional, González-López, Juan José, additional, López-Contreras, Joaquín, additional, Martínez-Martínez, Luis, additional, Mora-Rillo, Marta, additional, Muñoz, María, additional, Navarro, Ferran, additional, Oliver, Antonio, additional, Pintado, Vicente, additional, Ruiz-Carrascoso, Guillermo, additional, Ruiz-Garbajosa, Patricia, additional, Sánchez-Porto, Antonio, additional, Sánchez-Romero, Isabel, additional, Zamorano, Laura, additional, Aracil, Belén, additional, and Rodríguez-Baño, Jesús, additional
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- 2015
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35. Boletín de la Institución Libre de Enseñanza
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López Contreras, Joaquín
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método de enseñanza ,Fundación Sierra Pambley ,colonia escolar ,Institución Libre de Enseñanza ,educación de adultos - Abstract
Este artículo, se relaciona con Recuerdos de una alumna de las colonias, de Carmen López Contreras, (BILE, número 55 del 2004) La Fundación Sierra Pambley ayudó a la Institución Libre de la Enseñanza a poner en marcha otra vez la educación de adultos y las colonias. Madrid Biblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5; 28014 Madrid; Tel. +34917748000; biblioteca@mecd.es ESP
- Published
- 2004
36. Pachymeningitis, Painful Ophthalmoplegia, and Multiple Cranial Neuropathy of Presumed Tuberculous Origin
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Suárez-Calvet, Marc, primary, Rojas-García, Ricardo, additional, López-Contreras, Joaquín, additional, Gómez-Ansón, Beatriz, additional, and Roig-Arnall, Carles, additional
- Published
- 2011
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37. Tuberculous Pulmonary Gangrene: Report of a Case and Review.
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López-Contreras, Joaquín, Ris, Josep, Domingo, Pere, Puig, Mireia, and Martínez, Esteban
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Pulmonary gangrene is an uncommon but life-threatening complication of bacterial pneumonia. Only four cases of pulmonary gangrene due to Mycobacterium tuberculosis have been described to date; another case of pulmonary gangrene was attributed to unidentified mycobacteria. We report a fatal case of tuberculous pulmonary gangrene (TPG) and review the literature on this infection. To our knowledge this is the first case of TPG documented by thoracic computed tomographic scanning. Radiological features of pulmonary gangrene are distinctive, and identification of pulmonary parenchyma in the mass on computed tomography may be considered as pathognomonic. Analysis of the six cases revealed that most of the patients were aged, and one-half of them were alcohol abusers. Right-upper-lobe involvement predominated. When performed, sputum smears disclosed acid-fast bacilli. M. tuberculosis was cultured from sputum or pathologic material in five of the six cases. Four patients (66.7%) died. Four of six patients with TPG received antituberculous therapy, and two of them survived; no patient underwent surgical intervention. Although surgical management has been successfully employed in cases of bacterial pulmonary gangrene, TPG has always been treated with medical therapy alone. In spite of administration of antituberculous therapy, mortality is high. [ABSTRACT FROM PUBLISHER]
- Published
- 1994
38. Spontaneous gram-negative bacillary meningitis in adult patients: characteristics and outcome
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Pomar, Virginia, Benito, Natividad, López-Contreras, Joaquín, Coll Figa, Pedro, Gurguí, Mercè, Domingo, Pere, and Universitat Autònoma de Barcelona
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Adult ,Male ,Bacilli ,medicine.medical_specialty ,Gram-negative bacteria ,Adolescent ,medicine.disease_cause ,Meningitis, Bacterial ,Cohort Studies ,Young Adult ,Medical microbiology ,Internal medicine ,Gram-Negative Bacteria ,Outcome Assessment, Health Care ,Medicine ,Humans ,Prospective Studies ,Young adult ,Prospective cohort study ,Cross Infection ,biology ,Adult patients ,business.industry ,Neisseria meningitidis ,Middle Aged ,biology.organism_classification ,medicine.disease ,Anti-Bacterial Agents ,Infectious Diseases ,Spain ,Immunology ,Female ,business ,Meningitis ,Research Article - Abstract
Background: Spontaneous meningitis caused by gram-negative bacilli in adult patients is uncommon and poorly characterized. Our objective is to describe and compare the characteristics and the outcome of adult patients with spontaneous gram-negative bacilli meningitis (GNBM) and spontaneous meningitis due to other pathogens. Methods: Prospective single hospital-based observational cohort study conducted between 1982 and 2006 in a university tertiary hospital in Barcelona (Spain). The Main Outcome Measure: In-hospital mortality. Results: Gram-negative bacilli meningitis was diagnosed in 40 (7%) of 544 episodes of spontaneous acute bacterial meningitis. The most common pathogens were Escherichia coli and Pseudomonas species. On admission, characteristics associated with spontaneous gram-negative bacilli meningitis by multivariate modeling were advanced age, history of cancer, nosocomial acquisition of infection, urinary tract infection as distant focus of infection, absence of rash, hypotension, and a high cerebrospinal fluid white-cell count. Nine (23%) episodes were acquired in the hospital and they were most commonly caused by Pseudomonas. The in-hospital mortality rate was 53%. The mortality rate was higher among patients with Gram-negative bacillary meningitis than among those with other bacterial meningitis and their risk of death was twenty times higher than among patients infected with Neisseria meningitidis (odds ratio 20.47; 95% confidence interval 4.03-103.93; p
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39. Oral Antibiotic Prophylaxis Lowers Surgical Site Infection in Elective Colorectal Surgery: Results of a Pragmatic Cohort Study in Catalonia.
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Badia JM, Flores-Yelamos M, Vázquez A, Arroyo-García N, Puig-Asensio M, Parés D, Pera M, López-Contreras J, Limón E, Pujol M, and Members Of The VINCat Colorectal Surveillance Team
- Abstract
Background: The role of oral antibiotic prophylaxis (OAP) and mechanical bowel preparation (MBP) in the prevention of surgical site infection (SSI) after colorectal surgery is still controversial. The aim of this study was to analyze the effect of a bundle including both measures in a National Infection Surveillance Network in Catalonia., Methods: Pragmatic cohort study to assess the effect of OAP and MBP in reducing SSI rate in 65 hospitals, comparing baseline phase (BP: 2007-2015) with implementation phase (IP: 2016-2019). To compare the results, a logistic regression model was established., Results: Out of 34,421 colorectal operations, 5180 had SSIs (15.05%). Overall SSI rate decreased from 18.81% to 11.10% in BP and IP, respectively (OR 0.539, CI
95 0.507-0.573, p < 0.0001). Information about bundle implementation was complete in 61.7% of cases. In a univariate analysis, OAP and MBP were independent factors in decreasing overall SSI, with OR 0.555, CI95 0.483-0.638, and OR 0.686, CI95 0.589-0.798, respectively; and similarly, organ/space SSI (O/S-SSI) (OR 0.592, CI95 0.494-0.710, and OR 0.771, CI95 0.630-0.944, respectively). However, only OAP retained its protective effect at both levels at multivariate analyses., Conclusions: oral antibiotic prophylaxis decreased the rates of SSI and O/S-SSI in a large series of elective colorectal surgery.- Published
- 2021
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40. Multicentre, randomised, open-label, phase IV-III study to evaluate the efficacy of cloxacillin plus fosfomycin versus cloxacillin alone in adult patients with methicillin-susceptible Staphylococcus aureus bacteraemia: study protocol for the SAFO trial.
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Grillo S, Cuervo G, Carratala J, San-Juan R, Aguado JM, Morata L, Gomez-Zorrilla S, López-Contreras J, Gasch O, Gomila-Grange A, Iftimie S, Garcia-Pardo G, Calbo E, Boix-Palop L, Oriol I, Jover-Sáenz A, López-Cortés LE, Euba G, Aguirregabiria M, Garcia-Pais MJ, Gioia F, Paño JR, Pedro-Botet ML, Benítez RM, Pérez-Rodríguez MT, Meije Y, Loeches-Yagüe MB, Horna G, Berbel D, Domínguez MÁ, Padullés A, Cobo S, Hereu P, Videla S, Tebe C, Pallarés N, Miro JM, and Pujol M
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- Adult, Cloxacillin therapeutic use, Humans, Methicillin, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Safrole analogs & derivatives, Staphylococcus aureus, Treatment Outcome, Bacteremia drug therapy, Fosfomycin therapeutic use, Staphylococcal Infections drug therapy
- Abstract
Introduction: Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia is a frequent condition, with high mortality rates. There is a growing interest in identifying new therapeutic regimens able to reduce therapeutic failure and mortality observed with the standard of care of beta-lactam monotherapy. In vitro and small-scale studies have found synergy between cloxacillin and fosfomycin against S. aureus . Our aim is to test the hypothesis that cloxacillin plus fosfomycin achieves higher treatment success than cloxacillin alone in patients with MSSA bacteraemia., Methods: We will perform a superiority, randomised, open-label, phase IV-III, two-armed parallel group (1:1) clinical trial at 20 Spanish tertiary hospitals. Adults (≥18 years) with isolation of MSSA from at least one blood culture ≤72 hours before inclusion with evidence of infection, will be randomly allocated to receive either cloxacillin 2 g/4-hour intravenous plus fosfomycin 3 g/6-hour intravenous or cloxacillin 2 g/4-hour intravenous alone for 7 days. After the first week, sequential treatment and total duration of antibiotic therapy will be determined according to clinical criteria by the attending physician.Primary endpoints: (1) Treatment success at day 7, a composite endpoint comprising all the following criteria: patient alive, stable or with improved quick-Sequential Organ Failure Assessment score, afebrile and with negative blood cultures for MSSA at day 7. (2) Treatment success at test of cure (TOC) visit: patient alive and no isolation of MSSA in blood culture or at another sterile site from day 8 until TOC (12 weeks after randomisation).We assume a rate of treatment success of 74% in the cloxacillin group. Accepting alpha risk of 0.05 and beta risk of 0.2 in a two-sided test, 183 subjects will be required in each of the control and experimental groups to obtain statistically significant difference of 12% (considered clinically significant)., Ethics and Dissemination: Ethical approval has been obtained from the Ethics Committee of Bellvitge University Hospital (AC069/18) and from the Spanish Medicines and Healthcare Product Regulatory Agency (AEMPS, AC069/18), and is valid for all participating centres under existing Spanish legislation. The results will be presented at international meetings and will be made available to patients and funders., Trial Registration Number: The protocol has been approved by AEMPS with the Trial Registration Number EudraCT 2018-001207-37. ClinicalTrials.gov Identifier: NCT03959345; Pre-results., Competing Interests: Competing interests: GH received a research grant from ERN (19PNJ145)., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2021
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