المؤلفون: Jorge Calvo-Montes, Rosario Lara-Contreras, Julián Torre-Cisneros, María Eliecer Cano-García, Miquel Pujol-Rojo, José Antonio Lepe, Fernando Rodríguez-López, Luis Martínez-Martínez, Fe Tubau-Quintano, Rocío Álvarez-Marín, Manuel E. Jiménez-Mejías, Jesús Rodríguez-Baño, Álvaro Pascual-Hernández, Cecilia Martín-Gandul, José-Manuel Rodríguez-Martínez, Oriol Gasch-Blasi

المساهمون: Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación (España), Ministerio de Ciencia, Innovación y Universidades (España), Red Española de Investigación en Patología Infecciosa, European Commission, Spanish Network for Research in Infectious Diseases/Enterobacter spp. Bacteriemia Project Group, [Álvarez-Marín,R, Lepe,JA, Martín-Gandul,C, Jiménez-Mejías,ME] Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/Virgen del Rocío University Hospital, Seville, Spain. [Gasch-Blasi,O] Infectious Diseases Service, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (l3PT), Sabadell, Spain, Spanish Network for Research in Infectious Diseases. [Rodríguez-Martínez,JM, Pascual-Hernández,Á] Department of Microbiology, Virgen Macarena University Hospital, Seville, Spain, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC, Seville, Spain. [Calvo-Montes,J, Cano-García,ME, Martínez-Martínez,L] Department of Microbiology, Marqués de Valdecilla University Hospital – IDIVAL, Santander, Spain. [Lara-Contreras,R, Torre-Cisneros,J] Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Clinical Unit of Infectious Diseases, Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain. [Tubau-Quintano,F] Department of Microbiology, University Hospital of Bellvitge, Barcelona, Spain, CIBER of Respiratory Diseases (CIBERes), Instituto de Salud Carlos III, Madrid, Spain. [Rodríguez-López,F] Department of Microbiology, Reina Sofía University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba, Córdoba, Spain. [Rodríguez-Baño,J] Department of Medicine, Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Virgen Macarena University Hospital, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC, Seville, Spain. [Pujol-Rojo,M] Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut Català de la Salut (ICS-HUB), Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III (ISCIII), Madrid, Spain, Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Barcelona, Spain. [Martínez-Martínez,L] Department of Molecular Biology, University of Cantabria, Santander, Spain. [Martínez-Martínez,L] Department of Microbiology, Reina Sofía University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba, Córdoba, Spain., This work was supported by the Instituto Carlos III [grant PS09/00916], Ministerio de Ciencia e Innovación, the Plan Nacional I+D+i 2013–2016 and Instituto Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases [REIPI, RD16/0016/0001, RD16/0016/0005, RD16/0016/0007, RD16/0016/0008, RD16/0016/0009], co-financed by the European Regional Development Fund ‘A way to achieve Europe’, Operative program Intelligent Growth 2014–2020.

المصدر: Journal of Global Antimicrobial Resistance, Vol 25, Iss, Pp 351-358 (2021)
Digital.CSIC. Repositorio Institucional del CSIC
instname

مصطلحات موضوعية: Quinolone resistance mechanism, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Case–control study, medicine.drug_class, 030106 microbiology, Immunology, Antibiotics, Bacteremia, Enterobacter aerogenes, Microbiology, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Klebsiella aerogenes, Genotype, Enterobacter cloacae, medicine, Immunology and Allergy, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Enterobacter::Enterobacter aerogenes [Medical Subject Headings], Estudios de casos y controles, biology, business.industry, Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia [Medical Subject Headings], Incidence (epidemiology), Case-control study, Enterobacteriaceae Infections, bacterial infections and mycoses, biology.organism_classification, QR1-502, Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Enterobacteriaceae Infections [Medical Subject Headings], Multiple drug resistance, Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Enterobacter::Enterobacter cloacae [Medical Subject Headings], Bacteriemia, Bacteraemia, business

الوصف: Spanish Network for Research in Infectious Diseases/Enterobacter spp. Bacteriemia Project Group.
[Objectives] The genus Enterobacter is a common cause of nosocomial infections. Historically, the most frequent Enterobacter species were those of Enterobacter cloacae complex and Enterobacter aerogenes. In 2019, E. aerogenes was re-classified as Klebsiella aerogenes owing to its higher genotypic similarity with the genus Klebsiella. Our objective was to characterise and compare the clinical profiles of bacteraemia caused by E. cloacae and K. aerogenes.
[Methods] This 3-year multicentre, prospective cohort study enrolled consecutive patients with bacteraemia by E. cloacae or K. aerogenes. Baseline characteristics, bacteraemia features (source, severity, treatment), antibiotic susceptibility, resistance mechanisms and mortality were analysed. bacteraemia had received more antibiotics.
[Results] The study included 285 patients with bacteraemia [196 (68.8%) E. cloacae and 89 (31.2%) K. aerogenes]. The groups showed no differences in age, sex, previous use of invasive devices, place of acquisition, sources or severity at onset. The Charlson score was higher among patients with E. cloacae bacteraemia [2 (1–4) vs. 1 (0.5–3); P = 0.018], and previous antibiotic therapy was more common in patients with K. aerogenes bacteraemia (57.3% vs. 41.3%; P = 0.01). Mortality was 19.4% for E. cloacae and 20.2% for K. aerogenes (P = 0.869). Antibiotic susceptibility was similar for both species, and the incidence of multidrug resistance or ESBL production was low (6% and 5.3%, respectively), with no differences between species.
[Conclusion] Bacteraemias caused by E. cloacae and K. aerogenes share similar patient profiles, presentation and prognosis. Patients with E. cloacae bacteraemia had more co-morbidities and those with K. aerogenes bacteraemia had received more antibiotics.
This work was supported by the Instituto Carlos III [grant PS09/00916], Ministerio de Ciencia e Innovación, the Plan Nacional I+D+i 2013–2016 and Instituto Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases [REIPI, RD16/0016/0001; RD16/0016/0005; RD16/0016/0007; RD16/0016/0008; RD16/0016/0009], co-financed by the European Regional Development Fund ‘A way to achieve Europe’, Operative program Intelligent Growth 2014–2020.

وصف الملف: application/pdf; application/vnd.openxmlformats-officedocument.wordprocessingml.document

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::34e9ed1441d5f6bd0cec0b6d6d8d5ba8Test
https://pubmed.ncbi.nlm.nih.gov/33964492Test

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

المساهمون: Instituto de Salud Carlos III, Ministerio de Ciencia, Innovación y Universidades (España), Red Española de Investigación en Patología Infecciosa, European Commission

المصدر: Digital.CSIC. Repositorio Institucional del CSIC
instname

مصطلحات موضوعية: 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, medicine.medical_treatment, 030106 microbiology, Enterobacter, Bacteremia, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Risk factor, Prospective cohort study, biology, Septic shock, business.industry, Case-control study, Enterobacteriaceae Infections, biology.organism_classification, medicine.disease, Anti-Bacterial Agents, Infectious Diseases, Spain, Case-Control Studies, Etiology, Hemodialysis, business

الوصف: Spanish Network for Research in Infectious Diseases/Enterobacter spp. Bacteriemia Project group.
[Background] Enterobacter is among the main etiologies of hospital-acquired infections. This study aims to identify the risk factors of acquisition and attributable mortality of Enterobacter bacteremia.
[Results] The study included 285 cases and 570 controls. E. cloacae was isolated in 198(68.8%) cases and E. aerogenes in 89(31.2%). Invasive procedures (hemodialysis, nasogastric tube, mechanical ventilation, surgical drainage tube) and previous antibiotics or corticosteroids were independently associated with Enterobacter bacteremia. Its attributable mortality was 7.8%(CI95%2.7–13.4%), being dissimilar according to a McCabe index: non-fatal=3.2%, ultimately fatal=12.9% and rapidly fatal=0.12%. Enterobacter bacteremia remained an independent risk factor for mortality among cases with severe sepsis or septic shock (OR 5.75 [CI95%2.57–12.87], p
[Conclusions] Invasive procedures, previous antibiotics and corticosteroids predispose to acquire Enterobacter bacteremia. This entity increases mortality among fragile patients and those with severe infections. Antibiotic resistances did not affect the outcome.
This study was supported by the Instituto Carlos III, grant PS09/00916, Ministerio de Ciencia e Innovación, and the Plan Nacional I+D+i 2013-2016 and Instituto Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases (REIPI, RD 16/0016/0001; RD 16/0016/0005; RD 16/0016/0007; RD 16/0016/0008; RD 16/0016/0009) – co – financed by European Development Regional Fund “A way to achieve Europe”, Operative program Intelligent Growth 2014-2020.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3af45e1932ca30e10e5aa00ab04a0952Test
http://hdl.handle.net/10261/232373Test

المؤلفون: Ilias Karaiskos, Mitchell J. Schwaber, Julián Torre-Cisneros, Belén Gutiérrez-Gutiérrez, Isabel Machuca, Jesús Rodríguez-Baño, David L. Paterson, Pierluigi Viale, Zaira R. Palacios-Baena, Núria Prim, C. I. Marinescu, Elias Iosifidis, Jorge Galvez, Yohei Doi, Beatriz Mirelis, Enrico Maria Trecarichi, Felipe Francisco Tuon, José Antonio Martínez, José Molina Gil-Bermejo, N. Larrosa, José Ramón Paño-Pardo, Vicente Pintado, Manel Almela, Maria Souli, Mario Venditti, Spyros Pournaras, Fe Tubau, Michele Bartoletti, M.C. Fariñas, Yehuda Carmeli, Angela Raffaella Losito, Luis Martínez-Martínez, M. E. Cano, Oriol Gasch, Johann D. D. Pitout, Federico Perez, Silvia Gómez-Zorrilla, Benito Almirante, V. Rucci, E. Jové, Mario Tumbarello, José Molina, Germán Bou, Carmen Peña, A. O. Sahin, S. Peter, Mónica Gozalo, Evelina Tacconelli, Warren Lowman, D. Fontanals, R. San Juan, Po-Ren Hsueh, Joaquín Bermejo, Garyphallia Poulakou, Esther Calbo, Robert A. Bonomo, M. Xercavins, Murat Akova, Álvaro Pascual, Athanassios Tsakris, Anastasia Antoniadou, Alessandro Russo, C. de la Calle, Helvaci, Cristina Badia, L. Morata, Cano, Maddalena Giannella, Antonio Oliver, J. Gómez, Axel Hamprecht, O. Zarkotou, V. González, D. Virmani, M. Mora-Rillo, M. Fernández-Ruiz, Ferran Navarro, E. Ruiz de Gopegui, Alicia Hernandez, George L. Daikos, Helen Giamarellou, Emmanuel Roilides, Marco Falcone, Mireia Puig, K. Azap, Patricia Ruiz-Garbajosa

المساهمون: İç Hastalıkları, Palacios-Baena ZR, Gutiérrez-Gutiérrez B, Calbo E, Almirante B, Viale P, Oliver A, Pintado V, Gasch O, Martínez-Martínez L, Pitout J, Akova M, Peña C, Molina Gil-Bermejo J, Hernández A, Venditti M, Prim N, Bou G, Tacconelli E, Tumbarello M, Hamprecht A, Giamarellou H, Almela M, Pérez F, Schwaber MJ, Bermejo J, Lowman W, Hsueh PR, Paño-Pardo JR, Torre-Cisneros J, Souli M, Bonomo RA, Carmeli Y, Paterson DL, Pascual Á, Rodríguez-Baño J

المصدر: CLINICAL INFECTIOUS DISEASES
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname

مصطلحات موضوعية: Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Carbapenem, bloodstream infections, Immunology, 030106 microbiology, Bacteremia, bloodstream infection, Kaplan-Meier Estimate, Microbiology, beta-Lactam Resistance, beta-Lactamases, 03 medical and health sciences, Antibiotic resistance, Enterobacteriaceae, Internal medicine, polycyclic compounds, medicine, Humans, antimicrobial resistance, Articles and Commentaries, Retrospective Studies, extended-spectrum beta-lactamase-producing Enterobacteriaceae, aminoglycosides, therapy, biology, business.industry, Enterobacteriaceae Infections, extended-spectrum β-lactamase–producing Enterobacteriaceae, Middle Aged, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, Anti-Bacterial Agents, Infectious Diseases, Carbapenems, Cohort, aminoglycoside, bacteria, Female, business, Empiric therapy, medicine.drug

الوصف: Background. There is little information about the efficacy of active alternative drugs to carbapenems except beta-lactam/beta-lactamase inhibitors for the treatment of bloodstream infections (BSIs) due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). The objective of this study was to assess the outcomes of patients with BSI due to ESBL-E who received empiric therapy with such drugs (other active drugs [OADs]) or carbapenems. Methods. A multinational retrospective cohort study of patients with BSI due to ESBL-E who received empiric treatment with OADs or carbapenems was performed. Cox regression including a propensity score for receiving OADs was performed to analyze 30-day all-cause mortality as main outcome. Clinical failure and length of stay were also analyzed. Results. Overall, 335 patients were included; 249 received empiric carbapenems and 86 OADs. The most frequent OADs were aminoglycosides (43 patients) and fluoroquinolones (20 patients). Empiric therapy with OADs was not associated with mortality (hazard ratio [HR], 0.75; 95% confidence interval [CI],.38-1.48) in the Cox regression analysis. Propensity score-matched pairs, subgroups, and sensitivity analyses did not show different trends; specifically, the adjusted HR for aminoglycosides was 1.05 (95% CI,.51-2.16). OADs were neither associated with 14-day clinical failure (adjusted odds ratio, 0.62; 95% CI,.29-1.36) nor length of hospital stay. Conclusions. We were unable to show that empiric treatment with OAD was associated with a worse outcome compared with carbapenems. This information allows more options to be considered for empiric therapy, at least for some patients, depending on local susceptibility patterns of ESBL-E.

وصف الملف: text/plain; application/pdf; STAMPA

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a5882073c85590db18a5902bc87d7bdaTest
https://doi.org/10.1093/cid/cix606Test

المؤلفون: Robert A. Bonomo, Mónica Gozalo, Evelina Tacconelli, Axel Hamprecht, Julia Origüen, Benito Almirante, Increment investigators, Warren Lowman, Marco Falcone, Po-Ren Hsueh, Germán Bou, C. de la Calle, Belén Gutiérrez-Gutiérrez, Pierluigi Viale, Alessandro Russo, Yehuda Carmeli, Marta Mora-Rillo, Maria Souli, Mario Tumbarello, Reipi, Alessio Farcomeni, Mitchell J. Schwaber, José Miguel Cisneros, Esgbis, Alicia Hernandez-Torres, Murat Akova, Jesús Rodríguez-Baño, David L. Paterson, Federico Perez, Jorge Rodriguez-Gómez, Mario Venditti, Patricia Ruiz-Garbajosa, Esther Calbo, Antonio Oliver, Oriol Gasch, Johann D. D. Pitout, N. Prim, Ilias Karaiskos, Álvaro Pascual, Carmen Peña, Joaquín Bermejo

المساهمون: Russo, A., Falcone, M., Gutiérrez-Gutiérrez, B., Calbo, E., Almirante, B., Viale, P.L., Oliver, A., Ruiz-Garbajosa, P., Gasch, O., Gozalo, M., Pitout, J., Akova, M., Peña, C., Cisneros, J.M., Hernández-Torres, A., Farcomeni, A., Prim, N., Origüen, J., Bou, G., Tacconelli, E., Tumbarello, M., Hamprecht, A., Karaiskos, I., de la Calle, C., Pérez, F., Schwaber, M.J., Bermejo, J., Lowman, W., Hsueh, P.-R., Mora-Rillo, M., Rodriguez-Gomez, J., Souli, M., Bonomo, R.A., Paterson, D.L., Carmeli, Y., Pascual, A., Rodríguez-Baño, J., Venditti, M.

مصطلحات موضوعية: 0301 basic medicine, Male, Klebsiella pneumoniae, ß-lactam/ß-lactamase inhibitor, extended-spectrum ß-lactamases, sepsis, carbapenems, septic shock, ß-lactam/ß-lactamase inhibitors, Aged, Aged, 80 and over, Anti-Bacterial Agents, Drug Therapy, Combination, Enterobacteriaceae, Enterobacteriaceae Infections, Female, Humans, Middle Aged, Prognosis, Retrospective Studies, Sepsis, Survival Analysis, Treatment Outcome, beta-Lactamase Inhibitors, beta-Lactamases, beta-Lactams, Decision Support Techniques, 0302 clinical medicine, Clinical endpoint, 80 and over, Medicine, Pharmacology (medical), 030212 general & internal medicine, biology, extended-spectrum ß-lactamase, General Medicine, Infectious Diseases, Combination, sepsi, Settore SECS-S/01 - Statistica, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, Infectious Disease, carbapenem, 03 medical and health sciences, Drug Therapy, Internal medicine, In patient, business.industry, Proportional hazards model, Septic shock, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Bacteremia, business

الوصف: Purpose There are few data in the literature regarding sepsis or septic shock due to extended-spectrum β-lactamases (ESBL)-producing Enterobacteriaceae (E). The aim of this study was to assess predictors of outcome in septic patients with bloodstream infection (BSI) caused by ESBL-E. Methods Patients with severe sepsis or septic shock and BSI due to ESBL-E were selected from the INCREMENT database. The primary endpoint of the study was the evaluation of predictors of outcome after 30 days from development of severe sepsis or septic shock due to ESBL-E infection. Three cohorts were created for analysis: global, empirical-therapy and targeted-therapy cohorts. Results 367 septic patients were analysed. Overall mortality was 43.9% at 30 days. Escherichia coli (62.4%) and Klebsiella pneumoniae (27.2%) were the most frequent isolates. β-lactam/β-lactamase inhibitor (BLBLI) combinations were the most empirically used drug (43.6%), followed by carbapenems (29.4%). Empirical therapy was active in vitro in 249 (67.8%) patients, and escalation of antibiotic therapy was reported in 287 (78.2%) patients. Cox regression analysis showed that age, Charlson Comorbidity Index, McCabe classification, Pitt bacteremia score, abdominal source of infection and escalation of antibiotic therapy were independently associated with 30-day mortality. No differences in survival were reported in patients treated with BLBLI combinations or carbapenems in empirical or definitive therapy. Conclusions BSI due to ESBL-E in patients who developed severe sepsis or septic shock was associated with high 30-day mortality. Comorbidities, severity scores, source of infection and antibiotic therapy escalation were important determinants of unfavorable outcome.

وصف الملف: STAMPA

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::31c18d72506d4fa984413807d1ab4ae8Test
http://hdl.handle.net/2108/222373Test

المؤلفون: Mitchell J. Schwaber, Jesús Rodríguez-Baño, David L. Paterson, Pierluigi Viale, Belén Gutiérrez-Gutiérrez, Julián Torre-Cisneros, Axel Hamprecht, Núria Prim, Helen Giamarellou, Federico Perez, Alicia Hernandez-Torres, Marina de Cueto, Mario Tumbarello, Mario Venditti, Luis Martínez-Martínez, Evelina Tacconelli, José Antonio Lepe, Po-Ren Hsueh, Manuel Almela, Carolina Navarro-San Francisco, Warren Lowman, Antonio Oliver, Germán Bou, Oriol Gasch, Johann D. D. Pitout, Vicente Pintado, Zaira R. Palacios-Baena, Julia Origüen, Carmen Peña-Miralles, Benito Almirante, Murat Akova, Robert A. Bonomo, Álvaro Pascual, Yehuda Carmeli, Joaquín Bermejo, Esther Calbo

المساهمون: Ministerio de Economía y Competitividad (España), European Commission, Instituto de Salud Carlos III, Red Española de Investigación en Patología Infecciosa, European Federation of Pharmaceutical Industries and Associations, Cuyahoga County Veterans Service Commission, Geriatric Research Education and Clinical Center (US), National Institute of Allergy and Infectious Diseases (US), İç Hastalıkları, Palacios-Baena, Zaira Raquel, Gutiérrez-Gutiérrez, Belén, De Cueto, Marina, Viale, Pierluigi, Venditti, Mario, Hernández-Torres, Alicia, Oliver, Antonio, Martínez-Martínez, Lui, Calbo, Esther, Pintado, Vicente, Gasch, Oriol, Almirante, Benito, Antonio Lepe, José, Pitout, Johann, Akova, Murat, Peña-Miralles, Carmen, Schwaber, Mitchell J., Tumbarello, Mario, Tacconelli, Evelina, Origüen, Julia, Prim, Nuria, Bou, German, Giamarellou, Helen, Bermejo, Joaquín, Hamprecht, Axel, Pérez, Federico, Almela, Manuel, Lowman, Warren, Hsueh, Po-Ren, Navarro-San Francisco, Carolina, Torre-Cisneros, Julián, Carmeli, Yehuda, Bonomo, Robert A., Paterson, David L., Pascual, Álvaro, Rodríguez-Baño, Jesús

المصدر: Digital.CSIC. Repositorio Institucional del CSIC
instname
Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid
Consejería de Sanidad de la Comunidad de Madrid
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
Instituto de Salud Carlos III (ISCIII)

مصطلحات موضوعية: 0301 basic medicine, Male, Predictive Value of Test, Bacteremia, Logistic regression, beta-Lactamase, 0302 clinical medicine, Retrospective Studie, Klebsiella, Risk of mortality, polycyclic compounds, Pharmacology (medical), 030212 general & internal medicine, Pharmacology & Pharmacy, Original Research, Framingham Risk Score, Mortality rate, Enterobacteriaceae Infections, Middle Aged, Prognosis, 3. Good health, Anti-Bacterial Agents, Infectious Diseases, Predictive value of tests, Female, Human, Microbiology (medical), medicine.medical_specialty, Logistic Model, Prognosi, Sepsi, 030106 microbiology, Microbiology, beta-Lactamases, 03 medical and health sciences, Enterobacteriaceae, Predictive Value of Tests, Internal medicine, Sepsis, Anti-Bacterial Agent, medicine, Humans, Aged, Klebsiella Infections, Logistic Models, Retrospective Studies, Pharmacology, Receiver operating characteristic, business.industry, Retrospective cohort study, biochemical phenomena, metabolism, and nutrition, medicine.disease, bacterial infections and mycoses, Enterobacteriaceae Infection, Surgery, bacteria, business, Klebsiella Infection

الوصف: [Background] Bloodstream infections (BSIs) due to ESBL-producing Enterobacteriaceae (ESBL-E) are frequent yet outcome prediction rules for clinical use have not been developed. The objective was to define and validate a predictive risk score for 30 day mortality.
[Methods] A multinational retrospective cohort study including consecutive episodes of BSI due to ESBL-E was performed; cases were randomly assigned to a derivation cohort (DC) or a validation cohort (VC). The main outcome variable was all-cause 30 day mortality. A predictive score was developed using logistic regression coefficients for the DC, then tested in the VC.
[Results] The DC and VC included 622 and 328 episodes, respectively. The final multivariate logistic regression model for mortality in the DC included age >50 years (OR = 2.63; 95% CI: 1.18–5.85; 3 points), infection due to Klebsiella spp. (OR = 2.08; 95% CI: 1.21–3.58; 2 points), source other than urinary tract (OR = 3.6; 95% CI: 2.02–6.44; 3 points), fatal underlying disease (OR = 3.91; 95% CI: 2.24–6.80; 4 points), Pitt score >3 (OR = 3.04; 95 CI: 1.69–5.47; 3 points), severe sepsis or septic shock at presentation (OR = 4.8; 95% CI: 2.72–8.46; 4 points) and inappropriate early targeted therapy (OR = 2.47; 95% CI: 1.58–4.63; 2 points). The score showed an area under the receiver operating curve (AUROC) of 0.85 in the DC and 0.82 in the VC. Mortality rates for patients with scores of
[Conclusions] We developed and validated an easy-to-collect predictive scoring model for all-cause 30 day mortality useful for identifying patients at high and low risk of mortality.
This study was funded by: the Ministerio de Economía y Competitividad, Instituto de Salud Carlos III co-financed by the European Development Regional Fund ‘A way to achieve Europe’ ERDF, the Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), FIS grant PI10/02021 and FIS grant PI14/01832. B. G. G., J. R. B., A. P. and Y. C. also received funds from the COMBACTE-CARE project, Innovative Medicines Initiative (IMI), the European Union’s Seventh Framework Programme (FP7/2007-2013) and in-kind contributions from EFPIA companies. R. A. B. was also supported in part by funds and/or facilities provided by the Cleveland Department of Veterans Affairs, the Veterans Affairs Merit Review Program and the Geriatric Research Education and Clinical Center VISN 10 (VISN 10 GRECC), and the NIAID of the NIH under award numbers R01AI072219 and R01AI063517.

وصف الملف: application/pdf; text/plain; STAMPA

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::51b24ab96930711605cbfa5acaccd67bTest
http://hdl.handle.net/10261/191691Test

المؤلفون: Patrick N.A. Harris, M. Diletta Pezzani, Belén Gutiérrez-Gutiérrez, Pierluigi Viale, Po-Ren Hsueh, Patricia Ruiz-Garbajosa, Mario Venditti, Mario Tumbarello, Carolina Navarro-Francisco, Esther Calbo, Murat Akova, Helen Giamarellou, Antonio Oliver, Benito Almirante, Oriol Gasch, Luis Martínez-Martínez, Mitchell J. Schwaber, George Daikos, Johann Pitout, Carmen Peña, Alicia Hernández-Torres, Yohei Doi, Federico Pérez, Felipe Francisco Tuon, Evelina Tacconelli, Yehuda Carmeli, Robert A. Bonomo, Álvaro Pascual, David L. Paterson, Jesús Rodríguez-Baño, M.D. del Toro, J. Gálvez, M. Falcone, A. Russob, I. Karaiskos, E.M. Trecarichi, A.R. Losito, E. García-Vázquez, J. Gómez, E. Roilides, E. Iosifidis, S. Pournaras, N. Prim, F. Navarro, B. Mirelis, J. Origüen, R. San Juan, M. Fernández-Ruiz, M. Almela, C. de la Calle, J.A. Martínez, L. Morata, N. Larrosa, M. Puig-Asensio, G. Bou, J. Molina, V. González, J. Bermejo, V. Rucci, E. Ruiz de Gopegui, C.I. Marinescu, M.C. Fariñas, M.E. Cano, M. Gozalo, J.R. Paño-Pardo, Marta Mora-Rillo, S. Gómez-Zorrilla, F. Tubau, A. Tsakris, O. Zarkotou, A. Antoniadou, G. Poulakou, M. Souli, W. Lowman, D. Virmani, Julian Torre-Cisneros, I. Machuca, Irene Gracia-Ahufinger, Ö.K. Azap, Ö. Helvaci, A.O. Sahin, R. Cantón, V. Pintado, M. Bartoletti, M. Giannella, S. Peter, A. Hamprecht, C. Badia, M. Xercavins, D. Fontanals, E. Jové

المساهمون: Universidad de Cantabria, Harris, Patrick N.A., Pezzani, M. Diletta, Gutiérrez-Gutiérrez, Belén, Viale, Pierluigi, Hsueh, Po-Ren, Ruiz-Garbajosa, Patricia, Venditti, Mario, Tumbarello, Mario, Navarro-Francisco, Carolina, Calbo, Esther, Akova, Murat, Giamarellou, Helen, Oliver, Antonio, Almirante, Benito, Gasch, Oriol, Martínez-Martínez, Lui, Schwaber, Mitchell J., Daikos, George, Pitout, Johann, Peña, Carmen, Hernández-Torres, Alicia, Doi, Yohei, Pérez, Federico, Tuon, Felipe Francisco, Tacconelli, Evelina, Carmeli, Yehuda, Bonomo, Robert A., Pascual, Álvaro, Paterson, David L., Rodríguez-Baño, Jesú, del Toro, M.D., Gálvez, J., Falcone, M., Russo, A., Karaiskos, I., Trecarichi, E.M., Losito, A.R., García-Vázquez, E., Gómez, J., Roilides, E., Iosifidis, E., Pournaras, S., Prim, N., Navarro, F., Mirelis, B., Origüen, J., Juan, R. San, Fernández-Ruiz, M., Almela, M., de la Calle, C., Martínez, J.A., Morata, L., Larrosa, N., Puig-Asensio, M., Bou, G., Molina, J., González, V., Bermejo, J., Rucci, V., de Gopegui, E. Ruiz, Marinescu, C.I., Fariñas, M.C., Cano, M.E., Gozalo, M., Paño-Pardo, J.R., Mora-Rillo, Marta, Gómez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Antoniadou, A., Poulakou, G., Souli, M., Lowman, W., Virmani, D., Torre-Cisneros, Julian, Machuca, I., Gracia-Ahufinger, Irene, Azap, Ã .K., Helvaci, Ã ., Sahin, A.O., Cantón, R., Pintado, V., Bartoletti, M., Giannella, M., Peter, S., Hamprecht, A., Badia, C., Xercavins, M., Fontanals, D., Jové, E.

المصدر: Int J Antimicrob Agents. 2017 Nov;50(5):664-672
UCrea Repositorio Abierto de la Universidad de Cantabria
Universidad de Cantabria (UC)

مصطلحات موضوعية: Male, 0301 basic medicine, Carbapenem, Global Health, Logistic regression, 0302 clinical medicine, Drug Resistance, Multiple, Bacterial, Antimicrobial stewardship, Pharmacology (medical), 030212 general & internal medicine, Aged, 80 and over, Enterobacteriaceae Infections, General Medicine, Middle Aged, Extended-spectrum beta-lactamase, Klebsiella pneumoniae, Infectious Diseases, Beta-lactam/beta-lactamase inhibitors, Female, beta-Lactamase Inhibitors, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, Combination therapy, β-Lactam/β-lactamase inhibitor, 030106 microbiology, Infectious Disease, Biology, beta-Lactams, Carbapenemase, 03 medical and health sciences, Extended-spectrum β-lactamase, Enterobacteriaceae, Sepsis, Post-hoc analysis, medicine, Escherichia coli, Humans, Aged, Retrospective Studies, Carbapenems, β-Lactam/β-lactamase inhibitor, Odds ratio, biochemical phenomena, metabolism, and nutrition, Extended-spectrum β-lactamase, Surgery, Multiple drug resistance, Observational study, Demography

الوصف: We aimed to describe regional differences in therapy for bloodstream infection (BSI) caused by extended-spectrum ?-lactamase-producing Enterobacteriaceae (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE). 1,482 patients in 12 countries were included from an observational study of BSI caused by ESBL-E or CPE. Multivariate logistic regression was used to calculate adjusted odds ratios (aORs) for the influence of country of recruitment on empirical use of ?-lactam/?-lactamase inhibitors (BLBLI) or carbapenems, targeted use of BLBLI for ESBL-E and use of targeted combination therapy for CPE. The use of BLBLI for empirical therapy was least likely in sites from Israel (aOR 0.34, 95% CI 0.14-0.81), Greece (aOR 0.49, 95% CI 0.26-0.94) and Canada (aOR 0.31, 95% CI 0.11-0.88) but more likely in Italy (aOR 1.58, 95% CI 1.11-2.2) and Turkey (aOR 2.09, 95% CI 1.14-3.81), compared to Spain as a reference. Empirical carbapenems were more likely to be used in sites from Taiwan (aOR 1.73, 95% CI 1.03-2.92) and USA (aOR 1.89; 95% CI 1.05-3.39), and less likely in Italy (aOR 0.44, 95% CI 0.28-0.69) and Canada (aOR 0.10, 95% CI 0.01-0.74). Targeted BLBLI for ESBL-E was more likely in sites from Italy. Treatment at sites within Israel, Taiwan, Turkey and Brazil was associated with less combination therapy for CPE. Although this study does not provide precise data on the relative prevalence of ESBL-E or CPE, significant variation in therapy exists across countries even after adjustment for patient factors. A better understanding of what influences therapeutic choices for these infections will aid antimicrobial stewardship efforts. PH is supported by an Australian Postgraduate Award from the University of Queensland. The study was funded by the Ministerio de Economía y Competitividad, Instituto de Salud Carlos III - co-financed by European Development Regional Fund "A way to achieve Europe" ERDF, Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015). BGG, JRB, APH and YC also received funds from the COMBACTE-CARE project (grant agreement 115620), Innovative Medicines Initiative (IMI), the European Union's Seventh Framework Programme (FP7/2007-2013) and in-kind contributions from EFPIA companies.

وصف الملف: STAMPA

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::634852c840d39c70d001361ea2a480b5Test
http://hdl.handle.net/10902/11854Test