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2. Candidemia in solid organ transplant recipients in Spain: Epidemiological trends and determinants of outcome

Author

Fernandez-Ruiz, M., Cardozo, C., Salavert, M., Aguilar-Guisado, M., Escola-Verge, L., Munoz, P., Gioia, F., Montejo, M., Merino, P., Cuervo, G., Garcia-Vidal, C., Aguado, J. M., Padilla, B., Guinea, J., Pano-Pardo, J. R., Garcia-Rodriguez, J., Garcia Cerrada, C., Fortun, J., Martin-Davila, P., Gomez-Garcia de la Pedrosa, E., Ryan, P., Campelo, C., de los Santos Gil, I., Buendia, V., Perez Gorricho, B., Alonso, M., Sanz Sanz, F., Gonzalez Romo, F., Gorgolas, M., Gadea, I., Delgado-Iribarren, A., Ramos, A., Romero, Y., Sanchez Romero, I., Zaragoza, O., Cuenca-Estrella, M., Rodriguez-Bano, J., Suarez, A. I., Loza, A., Aller Garcia, A. I., Martin-Mazuelos, E., Ruiz Perez de Pipaon, M., Garnacho, J., Ortiz, C., Chavez, M., Maroto, F. L., Peman, J., Blanquer, J., Navarro, D., Camarena, J. J., Zaragoza, R., Abril, V., Gimeno, C., Hernandez, S., Ezpeleta, G., Bereciartua, E., Hernandez Almaraz, J. L., Rivas, R. A., Ayarza, R., Planes, A. M., Ruiz-Camps, I., Almirante, B., Mensa, J., Almela, M., Gurgui, M., Sanchez-Reus, F., Martinez-Montauti, J., Sierra, M., Horcajada, J. P., Sorli, L., Gomez, J., Gene, A., Urrea, M., Valerio, M., Diaz-Martin, A., Puchades, F., Mularoni, A., Puerta-Alcalde, P., Morata, L., Rodriguez-Nunez, O., Guerrero, M. A., Carratala, J., Sabe, N., Ayats, J., Grau, I., Calabuig, E., Castro, I., Cuellar, S., Perez-Ayala, A., Losada, I., Suarez, M. I., Martin-Gomez, M. T., Rodriguez-Alvarez, R., Lopez-Soira, L., Vena, A., Bouza, E., Martin, C., Gilead Sciences, Astellas Pharma, Pfizer, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, Fundación SEIMC-GESIDA, Ministerio de Ciencia, Innovación y Universidades (España), Red Española de Investigación en Patología Infecciosa, and Instituto de Salud Carlos III

Subjects
Male, Antifungal Agents, Epidemiology, candidemia, epidemiology, outcome, solid organ transplantation, treatment, Adult, Aged, Candida albicans, Candida glabrata, Candidemia, Drug Resistance, Fungal, Female, Fluconazole, Hospital Mortality, Humans, Microbial Sensitivity Tests, Middle Aged, Multicenter Studies as Topic, Organ Transplantation, Prospective Studies, Risk Factors, Spain, Transplant Recipients, Drug Resistance, Solid organ transplantation, Kidney transplantation, Outcome, education.field_of_study, Univariate analysis, Infectious Diseases, Fungal, medicine.drug, medicine.medical_specialty, Population, Internal medicine, medicine, education, Transplantation, business.industry, Septic shock, Odds ratio, medicine.disease, Confidence interval, Treatment, business
Abstract

CANDIPOP Project, the CANDI‐Bundle Group GEIRAS‐GEMICOMED (SEIMC) REIPI., [Background] Despite being considered a high‐risk population for invasive fungal disease, specific features of candidemia among solid organ transplant (SOT) recipients remain poorly characterized., [Methods] We compiled prospective data from two multicenter studies on candidemia performed over two consecutive periods in Spain: the CANDIPOP Study (2010‐2011) and the CANDI‐Bundle Study (2016‐2018). Episodes diagnosed in adult SOT recipients in 10 participating centers were included. Risk factors for clinical failure (all‐cause 7‐day mortality and/or persistent candidemia for ≥72 hours) and 30‐day mortality were investigated by univariate analysis., [Results] We included 55 episodes of post‐transplant candidemia (32 and 23 of which occurred during the first and second periods). Kidney (38.2%) and liver recipients (30.9%) were the most common populations. Candida albicans accounted for 27.3% of episodes. The proportion of C glabrata increased over time (18.8% vs 30.4% for the first and second periods). There were no differences in the rate of fluconazole non‐susceptible isolates (50.0% vs 60.0%, respectively). Clinical failure and 30‐day mortality occurred in 25.5% and 27.3% of episodes and were associated with the severity of candidemia (Pitt score and severe sepsis/septic shock). Kidney transplantation (unadjusted odds ratio [uOR]: 0.17; 95% confidence interval [CI]: 0.03‐0.85; P ‐value = .020), early catheter removal (uOR: 0.15; 95% CI: 0.03‐0.76; P ‐value = .013), and appropriate early antifungal therapy (uOR: 0.14; 95% CI: 0.02‐0.89; P ‐value = .041) were protective for 30‐day mortality., [Conclusions] High rates of non‐albicans species and fluconazole non‐susceptibility must be taken into account to optimize therapeutic management and outcomes in SOT recipients with candidemia., The CANDIPOP Project was supported by non‐restrictive research grants from Gilead Sciences, MSD, Astellas Pharma, and Pfizer. This study was cofounded by Fundación SEIMC‐GESIDA, by the Spanish Ministry of Science, Innovation and Universities, Instituto de Salud Carlos III (co‐financed by the European Development Regional Fund [ERDF] >A way to achieve Europe>), and by the Spanish Network for Research in Infectious Diseases (REIPI RD12/0015). The CANDI‐Bundle Study was supported by “Plan Nacional de I + D+I” and Instituto de Salud Carlos III (Fondo de Investigaciones Sanitarias [FIS] PI15/00744), Subdirección General de Redes y Centros de Investigación Cooperativa, Spanish Ministry of Science, Innovation and Universities, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016). MFR holds a research contract “Miguel Servet” (CP 18/00073) from the Spanish Ministry of Science, Innovation and Universities, Instituto de Salud Carlos III.

Published
2019

3. Experiencia de uso de antimicrobianos en un servicio de hematología en el contexto de un programa de optimización de antibióticos

Author

Gamarra Calvo, S., Martinez Fernandez, R., Sanchez Quinones, B., De Poo Rodriguez, M., V, Auria Caballero, C., Pano Pardo, J. R., Olave Rubio, M. T., and Arenere Mendoza, M.

Abstract

Poster [PC-356] Introducción: Se implanta un Programa de Optimización de Antibióticos (PROA) en el Servicio de Hematología (SH) de un hospital de tercer nivel, compuesto por un equipo multidisciplinar (Hematología, Farmacia, Infecciosas). Para entender la situación inicial y detectar posibles acciones de mejora, se realizó un análisis del consumo de antimicrobianos (AM). Material y Métodos: Estudio descriptivo, observacional y retrospectivo de utilización de AM en el SH durante el período de 2014 a 2017. Variables recogidas: número de ingresos, número de estancias, dosis diaria definida (DDD)/100 estancias de antimicrobianos (antibióticos y antifúngicos) y DDD/100 estancias por grupo clínico (G1: antibióticos de espectro reducido, G2: empírico en infecciones comunitarias, G3: bacterias Gram (-) resistentes, G4: bacterias gram (+) resistentes, G5: antifúngicos de espectro reducido, G6: antifúngicos de amplio espectro, G7: otros). Fuente de datos: Programa de Gestión Económica. Resultados: El número de ingresos en el SH en los años 2014, 2015, 2016 y 2017 fue de 765, 662, 756 y 572 respectivamente. Las estancias de 6839, 6280, 6547 y 5841, respectivamente. La evolución de las DDD/ 100 estancias de AM fue: 114.73, 100.91, 122.31, 133.04, de las DDD/100 estancias de antibióticos fue: 86, 38, 75, 04, 88, 05, 89, 01 y de las DDD/100 estancias de antifúngicos fue: 28.35, 25.87, 34.27 y 44.03. El G3 es el que más consumo presenta, el meropenem el principio activo más prescrito: 42.38, 33.02, 39.08 y 32.92 (DDD/100 estancias en los cuatro años del estudio). En el grupo G4 el uso de la vancomicina se ha incrementado (DDD/100 estancias 0.22, 0.04, 0.97 y 5.37) y el consumo de daptomicina ha disminuido (DDD/100 estancias 6.95, 7.42, 12.96, 8.69). El G6 ha sido el que más incremento ha presentado en 2017, siendo posaconazol (DDD/100 estancias 6.14, 7.25, 5.33 y 12.49) y anfotericina B liposomal (DDD/100 estancias 3.35, 3.22, 12.82 y 12.49) los más prescritos. Cabe destacar en el Grupo G1 el incremento del uso de sulfametoxazol-trimetroprim con DDD/100 estancias de 1.51, 2.46, 4.33, 6.00. Conclusiones: Se observa un incremento en DDD/100 estancias de los AM en el año 2017, sin embargo, los ingresos han disminuido. Puede ser que el paciente que ingresa sea más complejo. Meropenem es el principio activo más prescrito en el SH. La vancomicina ha incrementado su uso debido a la monitorización de niveles con recomendación posológica por parte del Servicio de Farmacia y como consecuencia, daptomicina ha disminuido. En los antifúngicos, aumenta el consumo de los de amplio espectro. Sulfametoxazol-trimetroprim ha aumentado su consumo como profilaxis en nuevos tratamientos. Se ha detectado variabilidad en sus dosis prescritas, por lo que se desarrollarán protocolos para su homogeneización.

Published
2018

4. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study

Author

Gutierrez-Gutierrez, B., Salamanca, E., de Cueto, M., Hsueh, P. -R., Viale, P., Pano-Pardo, J. R., Venditti, M., Tumbarello, M., Daikos, G., Canton, R., Doi, Y., Tuon, F. F., Karaiskos, I., Perez-Nadales, E., Schwaber, M. J., Azap, O. K., Souli, M., Roilides, E., Pournaras, S., Akova, M., Perez, F., Bermejo, J., Oliver, A., Almela, M., Lowman, W., Almirante, B., Bonomo, R. A., Carmeli, Y., Paterson, D. L., Pascual, A., Rodriguez-Bano, J., del Toro, M. D., Galvez, J., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, E. M., Losito, A. R., Garcia-Vazquez, E., Hernandez, A., Gomez, J., Bou, G., Iosifidis, E., Prim, N., Navarro, F., Mirelis, B., Skiada, A., Origuen, J., Juan, R. S., Fernandez-Ruiz, M., Larrosa, N., Puig-Asensio, M., Cisneros, J. M., Molina, J., Gonzalez, V., Rucci, V., de Gopegui, E. R., Marinescu, C. I., Martinez-Martinez, L., Farinas, M. C., Cano, M. E., Gozalo, M., Mora-Rillo, M., Francisco, C. N. -S., Pena, C., Gomez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Antoniadou, A., Poulakou, G., Pitout, J., Virmani, D., Torre-Cisneros, J., Guzman-Puche, J., Helvaci, O., Sahin, A. O., Pintado, V., Ruiz, P., Bartoletti, M., Giannella, M., Tacconelli, E., Riemenschneider, F., Calbo, E., Badia, C., Xercavins, M., Gasch, O., Fontanals, D., Jove, E., Venditti M., Tumbarello M. (ORCID:0000-0002-9519-8552), Trecarichi E. M., Losito A. R., Tacconelli E. (ORCID:0000-0001-8722-5824), Gutierrez-Gutierrez, B., Salamanca, E., de Cueto, M., Hsueh, P. -R., Viale, P., Pano-Pardo, J. R., Venditti, M., Tumbarello, M., Daikos, G., Canton, R., Doi, Y., Tuon, F. F., Karaiskos, I., Perez-Nadales, E., Schwaber, M. J., Azap, O. K., Souli, M., Roilides, E., Pournaras, S., Akova, M., Perez, F., Bermejo, J., Oliver, A., Almela, M., Lowman, W., Almirante, B., Bonomo, R. A., Carmeli, Y., Paterson, D. L., Pascual, A., Rodriguez-Bano, J., del Toro, M. D., Galvez, J., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, E. M., Losito, A. R., Garcia-Vazquez, E., Hernandez, A., Gomez, J., Bou, G., Iosifidis, E., Prim, N., Navarro, F., Mirelis, B., Skiada, A., Origuen, J., Juan, R. S., Fernandez-Ruiz, M., Larrosa, N., Puig-Asensio, M., Cisneros, J. M., Molina, J., Gonzalez, V., Rucci, V., de Gopegui, E. R., Marinescu, C. I., Martinez-Martinez, L., Farinas, M. C., Cano, M. E., Gozalo, M., Mora-Rillo, M., Francisco, C. N. -S., Pena, C., Gomez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Antoniadou, A., Poulakou, G., Pitout, J., Virmani, D., Torre-Cisneros, J., Guzman-Puche, J., Helvaci, O., Sahin, A. O., Pintado, V., Ruiz, P., Bartoletti, M., Giannella, M., Tacconelli, E., Riemenschneider, F., Calbo, E., Badia, C., Xercavins, M., Gasch, O., Fontanals, D., Jove, E., Venditti M., Tumbarello M. (ORCID:0000-0002-9519-8552), Trecarichi E. M., Losito A. R., and Tacconelli E. (ORCID:0000-0001-8722-5824)

Abstract

Background The best available treatment against carbapenemase-producing Enterobacteriaceae (CPE) is unknown. The objective of this study was to investigate the effect of appropriate therapy and of appropriate combination therapy on mortality of patients with bloodstream infections (BSIs) due to CPE. Methods In this retrospective cohort study, we included patients with clinically significant monomicrobial BSIs due to CPE from the INCREMENT cohort, recruited from 26 tertiary hospitals in ten countries. Exclusion criteria were missing key data, death sooner than 24 h after the index date, therapy with an active antibiotic for at least 2 days when blood cultures were taken, and subsequent episodes in the same patient. We compared 30 day all-cause mortality between patients receiving appropriate (including an active drug against the blood isolate and started in the first 5 days after infection) or inappropriate therapy, and for patients receiving appropriate therapy, between those receiving active monotherapy (only one active drug) or combination therapy (more than one). We used a propensity score for receiving combination therapy and a validated mortality score (INCREMENT-CPE mortality score) to control for confounders in Cox regression analyses. We stratified analyses of combination therapy according to INCREMENT-CPE mortality score (0–7 [low mortality score] vs 8–15 [high mortality score]). INCREMENT is registered with ClinicalTrials.gov, number NCT01764490. Findings Between Jan 1, 2004, and Dec 31, 2013, 480 patients with BSIs due to CPE were enrolled in the INCREMENT cohort, of whom we included 437 (91%) in this study. 343 (78%) patients received appropriate therapy compared with 94 (22%) who received inappropriate therapy. The most frequent organism was Klebsiella pneumoniae (375 [86%] of 437; 291 [85%] of 343 patients receiving appropriate therapy vs 84 [89%] of 94 receiving inappropriate therapy) and the most frequent carbapenemase was K pneumoniae carbapenemase

Published
2017

5. Infections caused by OXA-48-producing Klebsiella pneumoniae in a tertiary hospital in Spain in the setting of a prolonged, hospital-wide outbreak

Author

Pano-Pardo, J. R., primary, Ruiz-Carrascoso, G., additional, Navarro-San Francisco, C., additional, Gomez-Gil, R., additional, Mora-Rillo, M., additional, Romero-Gomez, M. P., additional, Fernandez-Romero, N., additional, Garcia-Rodriguez, J., additional, Perez-Blanco, V., additional, Moreno-Ramos, F., additional, and Mingorance, J., additional

Published
2012
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7. Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals

Author

Papst, Lea, Beović, Bojana, Pulcini, Céline, Durante-Mangoni, Emanuele, Rodríguez-Baño, Jesús, Kaye, Keith S, Daikos, George L, Raka, Lul, Paul, Mical, Esgap, Esgbis, ESGIE and the CRGNB treatment survey study group collaborators: Abbo, L, Abgueguen, P, Almirante, B, Azzini, Am, Bani-Sadr, F, Bassetti, M, Ben-Ami, R, Beović, B, Béraud, G, Botelho-Nevers, E, Bou, G, Boutoille, D, Cabié, A, Cacopardo, B, Cascio, A, Cassir, N, Castelli, F, Cecala, M, Charmillon, A, Chirouze, C, Cisneros, Jm, Colmenero, Jd, Coppola, N, Corcione, S, Daikos, Gl, Dalla Gasperina, D, De la Calle Cabrera, C, Delobel, P, Di Caprio, D, Durante Mangoni, E, Dupon, M, Ettahar, N, Falagas, Me, Falcone, M, Fariñas, Mc, Faure, E, Forestier, E, Foti, G, Gallagher, J, Gattuso, G, Gendrin, V, Gentile, I, Giacobbe, Dr, Gogos, Ca, Grandiere Perez, L, Hansmann, Y, Horcajada, Jp, Iacobello, C, Jacob, Jt, Justo, Ja, Kernéis, S, Komnos, A, Kotnik Kevorkijan, B, Lebeaux, D, Le Berre, R, Lechiche, C, Le Moing, V, Lescure, Fx, Libanore, M, Martinot, M, Merino de Lucas, E, Mondain, V, Mondello, P, Montejo, M, Mootien, J, Muñoz, P, Nir-Paz, R, Pan, A, Paño-Pardo, Jr, Patel, G, Paul, M, Pérez Rodríguez MT, Piroth, L, Pogue, J, Potoski, Ba, Pourcher, V, Pyrpasopoulou, A, Rahav, G, Rizzi, M, Rodríguez-Baño, J, Salavert, M, Scheetz, M, Sims, M, Spahija, G, Stefani, S, Stefos, A, Tamma, Pd, Tattevin, P, Tedesco, A, Torre-Cisneros, J, Tripolitsioti, P, Tsiodras, S, Uomo, G, Verdon, R, Viale, P, Vitrat, V, Weinberger, M, Wiener-Well, Y, Papst L., Beovic B., Pulcini C., Durante-Mangoni E., Rodriguez-Bano J., Kaye K.S., Daikos G.L., Raka L., Paul M., Abbo L., Abgueguen P., Almirante B., Azzini A.M., Bani-Sadr F., Bassetti M., Ben-Ami R., Beraud G., Botelho-Nevers E., Bou G., Boutoille D., Cabie A., Cacopardo B., Cascio A., Cassir N., Castelli F., Cecala M., Charmillon A., Chirouze C., Cisneros J.M., Colmenero J.D., Coppola N., Corcione S., Dalla Gasperina D., De la Calle Cabrera C., Delobel P., Di Caprio D., Durante Mangoni E., Dupon M., Ettahar N., Falagas M.E., Falcone M., Farinas M.C., Faure E., Forestier E., Foti G., Gallagher J., Gattuso G., Gendrin V., Gentile I., Giacobbe D.R., Gogos C.A., Grandiere Perez L., Hansmann Y., Horcajada J.P., Iacobello C., Jacob J.T., Justo J.A., Kerneis S., Komnos A., Kotnik Kevorkijan B., Lebeaux D., Le Berre R., Lechiche C., Le Moxing V., Lescure F.X., Libanore M., Martinot M., Merino de Lucas E., Mondain V., Mondello P., Montejo M., Mootien J., Munoz P., Nir-Paz R., Pan A., Pano-Pardo J.R., Patel G., Perez Rodriguez M.T., Piroth L., Pogue J., Potoski B.A., Pourcher V., Pyrpasopoulou A., Rahav G., Rizzi M., Salavert M., Scheetz M., Sims M., Spahija G., Stefani S., Stefos A., Tamma P.D., Tattevin P., Tedesco A., Torre-Cisneros J., Tripolitsioti P., Tsiodras S., Uomo G., Verdon R., Viale P., Vitrat V., Weinberger M., Wiener-Well Y., University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Monaldi Hospital, Hospital Virgen Macarena, University of Michigan Medical School [Ann Arbor], University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, National and Kapodistrian University of Athens (NKUA), University Clinical Center of Kosova, Rambam Health Care Campus, Jackson Memorial Hospital, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Vall d'Hebron University Hospital [Barcelona], University of Verona (UNIVR), Centre Hospitalier Universitaire de Reims (CHU Reims), Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', Tel Aviv Sourasky Medical Centre, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Hospital Universitario, A Coruña, Centre hospitalier universitaire de Nantes (CHU Nantes), CHU de la Martinique [Fort de France], ARNAS 'Garibaldi, S. Luigi-Currò, Ascoli-Tomaselli', Università degli studi di Palermo - University of Palermo, Assistance Publique-Hôpitaux de Marseille (AP-HM), ASST Spedali Civili of Brescia, ARNAS Civico Palermo, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hospital Universitario Virgen del Rocío [Sevilla], Hospital Regional Universitario de Málaga [Spain], Università degli studi della Campania 'Luigi Vanvitelli', University of Turin, University of Insubria, Varese, Hospital Clínic de Barcelona, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], AO San Sebastiano, CHU Bordeaux [Bordeaux], CH Valenciennes, Henry Dunant Hospital, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Hospital Marques de Valdecillas, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Métropole Savoie [Chambéry], Ospedale di Reggio Calabria, Children’s Hospital of Philadelphia (CHOP ), Carlo Poma Hospital Mantova (ASST Mantova ), CH Belfort-Montbéliard, University of Naples Federico II, AUO San Martino IST Ist Nazl Ric Canc, I-16132 Genoa, Italy, University of Patras [Patras], Centre Hospitalier Le Mans (CH Le Mans), CHU Strasbourg, IMIM-Hospital del Mar, Generalitat de Catalunya, Cannizzaro Hospital, Emory University School of Medicine, Emory University [Atlanta, GA], University of South Carolina [Columbia], AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), General Hospital of Larissa, University medical centre Maribor (UKC Maribor), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), AP-HP - Hôpital Bichat - Claude Bernard [Paris], University of Ferrara at St. Anna Hospital, CH Colmar, Hospital General Universitario de Alicante, CHU Nice [Cimiez], Hôpital Cimiez [Nice] (CHU), AOU Policlinico 'G. Martino', Messina, Italy, Hospital Universitario Cruces = Cruces University Hospital, Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Hospital General Universitario 'Gregorio Marañón' [Madrid], Hadassah Hebrew University Medical Center [Jerusalem], Azienda Istituti Ospitalieri di Cremona, Lozano Blesa Clinical Hospital [Zaragoza, Spain], Mount Sinai Hospital [Toronto, Canada] (MSH), Complejo Hospitalario de Vigo, CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Detroit Medical Center, University of Pittsburgh Medical Center [Pittsburgh, PA, États-Unis] (UPMC), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hippokration General Hospital, Sheba Medical Centre, Ramat Gan, Israel, ASST Papa Giovanni XXIII [Bergamo, Italy], Hospital Universitario La Fe, Valencia, Northwestern Hospital Chicago, Beaumont Hospital, Lagjia e Universitetit, Rruga 1, nr.32, 10000 Prishtina, Kosovo, parent, Università degli studi di Catania [Catania], Larissa University Hospital, Johns Hopkins University School of Medicine [Baltimore], CHU Pontchaillou [Rennes], Ospedale Fracastoro San Bonifacio [Verona], Hospital Reina Sofia, Cordoba, Agioi Anargiroi Hospital, Attikon University Hospital, Ospedale Cardarelli, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO), CH Annecy Genevois, Assah Harofeh Medical Centre, Zerifin, Israel, Shaare Zedek Medical Centre, Jerusalem, Israel, National Institutes of Health (US), Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), Red Española de Investigación en Patología Infecciosa, European Commission, Papst, Lea, Beović, Bojana, Pulcini, Céline, Durante-Mangoni, Emanuele, Rodríguez-Baño, Jesú, Kaye, Keith S, Daikos, George L, Raka, Lul, Paul, Mical, Papst, L., Beovic, B., Pulcini, C., Durante-Mangoni, E., Rodriguez-Bano, J., Kaye, K. S., Daikos, G. L., Raka, L., Paul, M., Abbo, L., Abgueguen, P., Almirante, B., Azzini, A. M., Bani-Sadr, F., Bassetti, M., Ben-Ami, R., Beraud, G., Botelho-Nevers, E., Bou, G., Boutoille, D., Cabie, A., Cacopardo, B., Cascio, A., Cassir, N., Castelli, F., Cecala, M., Charmillon, A., Chirouze, C., Cisneros, J. M., Colmenero, J. D., Coppola, N., Corcione, S., Dalla Gasperina, D., De la Calle Cabrera, C., Delobel, P., Di Caprio, D., Dupon, M., Ettahar, N., Falagas, M. E., Falcone, M., Farinas, M. C., Faure, E., Forestier, E., Foti, G., Gallagher, J., Gattuso, G., Gendrin, V., Gentile, I., Giacobbe, D. R., Gogos, C. A., Grandiere Perez, L., Hansmann, Y., Horcajada, J. P., Iacobello, C., Jacob, J. T., Justo, J. A., Kerneis, S., Komnos, A., Kotnik Kevorkijan, B., Lebeaux, D., Le Berre, R., Lechiche, C., Le Moxing, V., Lescure, F. X., Libanore, M., Martinot, M., Merino de Lucas, E., Mondain, V., Mondello, P., Montejo, M., Mootien, J., Munoz, P., Nir-Paz, R., Pan, A., Pano-Pardo, J. R., Patel, G., Perez Rodriguez, M. T., Piroth, L., Pogue, J., Potoski, B. A., Pourcher, V., Pyrpasopoulou, A., Rahav, G., Rizzi, M., Salavert, M., Scheetz, M., Sims, M., Spahija, G., Stefani, S., Stefos, A., Tamma, P. D., Tattevin, P., Tedesco, A., Torre-Cisneros, J., Tripolitsioti, P., Tsiodras, S., Uomo, G., Verdon, R., Viale, P., Vitrat, V., Weinberger, M., Wiener-Well, Y., Università degli studi di Verona = University of Verona (UNIVR), Assistance Publique - Hôpitaux de Marseille (APHM), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], and Università degli studi di Torino = University of Turin (UNITO)

Subjects
0301 basic medicine, Acinetobacter baumannii, Carbapenem, Antibiotics, Drug Resistance, Drug resistance, Tigecycline, Carbapenem-resistant Gram-negative bacilli, Combination therapy, Enterobacteriaceae, Polymyxin, Pseudomonas aeruginosa, Survey, 0302 clinical medicine, Surveys and Questionnaires, polycyclic compounds, 030212 general & internal medicine, Anti-Bacterial Agents, Carbapenems, Cross Infection, Cross-Sectional Studies, Drug Resistance, Bacterial, Gram-Negative Bacteria, Gram-Negative Bacterial Infections, Hospitals, Humans, Microbial Sensitivity Tests, Microbiology (medical), Infectious Diseases, biology, Microbial Sensitivity Test, Bacterial, antibiotic management, carbapenem-resistant Gram-negative bacteria, General Medicine, 3. Good health, medicine.drug, Human, medicine.medical_specialty, medicine.drug_class, 030106 microbiology, Fosfomycin, carbapenem-resistant Gram-negative bacteria, 03 medical and health sciences, Hospital, Internal medicine, Anti-Bacterial Agent, medicine, Gram-Negative Bacterial Infection, Cross-Sectional Studie, business.industry, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, bacterial infections and mycoses, Infectious disease (medical specialty), Carbapenem-resistant gram-negative bacilli, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, antibiotic management, business, Rifampicin
Abstract

ESGAP, ESGBIS, ESGIE and the CRGNB treatment survey study group., [Objectives] To explore contemporary antibiotic management of infections caused by carbapenem-resistant Gram-negative bacteria in hospitals., [Methods] Cross-sectional, internet-based questionnaire survey. We contacted representatives of all hospitals with more than 800 acute-care hospital beds in France, Greece, Israel, Italy, Kosovo, Slovenia, Spain and selected hospitals in the USA. We asked respondents to describe the most common actual practice at their hospital regarding management of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa through close-ended questions., [Results] Between January and June 2017, 115 of 141 eligible hospitals participated (overall response rate 81.6%, country-specific rates 66.7%–100%). Most were tertiary-care (99/114, 86.8%), university-affiliated (110/115, 89.1%) hospitals and most representatives were infectious disease specialists (99/115, 86.1%). Combination therapy was prescribed in 114/115 (99.1%) hospitals at least occasionally. Respondents were more likely to consider combination therapy when treating bacteraemia, pneumonia and central nervous system infections and for Enterobacteriaceae, P. aeruginosa and A. baumannii similarly. Combination of a polymyxin with a carbapenem was used in most cases, whereas combinations of a polymyxin with tigecycline, an aminoglycoside, fosfomycin or rifampicin were also common. Monotherapy was used for treatment of complicated urinary tract infections, usually with an aminoglycoside or a polymyxin. The intended goal of combination therapy was to improve the effectiveness of the treatment and to prevent development of resistance. In general, respondents shared the misconception that combination therapy is supported by strong scientific evidence., [Conclusions] Combination therapy was the preferred treatment strategy for infections caused by carbapenem-resistant Gram-negative bacteria among hospital representatives, even though high-quality evidence for carbapenem-based combination therapy is lacking., EDM received funding by NIH for project HHSN272201000039C. JRB received funding for research from Plan Nacional de I + D + i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001)—co-financed by European Development Regional Fund A way to achieve Europe, Operative Programme Intelligent Growth 2014–2020.

Published
2018
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8. COVID-19: don't neglect antimicrobial stewardship principles!

Author

Huttner BD, Catho G, Pano-Pardo JR, Pulcini C, and Schouten J

Subjects
Bacteria classification, Bacteria isolation & purification, Betacoronavirus, COVID-19, Coronavirus Infections epidemiology, Critical Care methods, Humans, Pandemics, Pneumonia, Viral epidemiology, Primary Prevention methods, SARS-CoV-2, Anti-Bacterial Agents therapeutic use, Antimicrobial Stewardship methods, Coronavirus Infections drug therapy, Pneumonia, Viral drug therapy, Superinfection drug therapy
Abstract

Competing Interests: Transparency declaration The authors declare no conflicts of interest. No external funding was received for this communication.

Published
2020
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