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Salmanton-García J, Bruns C, Rutz J, Albertsmeier M, Ankert J, Bernard L, Bataille C, Couvé-Deacon E, Fernández-Ferrer M, Fortún J, Galar A, Grill E, Guimard T, Classen AY, Vehreschild JJ, Stemler J, Naendrup JH, Hampl J, Tallon B, Sprute R, Horcajada JP, Mollar-Maseres J, Muñoz P, Pletz MW, Serracino-Inglott F, Soriano A, Vilz TO, Seifert H, Cornely OA, Mellinghoff SC, Liss BJ, Wingen-Heimann SM. Costs and resource utilization patterns in surgical site infections: a pre-COVID-19 perspective from France, Germany, Spain, and the UK. J Hosp Infect 2024; 147:123-132. [PMID: 38467251 DOI: 10.1016/j.jhin.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/30/2024] [Accepted: 02/06/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Surgical site infections (SSIs), mainly caused by Staphylococcus aureus, pose a significant economic burden in Europe, leading to increased hospitalization duration, mortality, and treatment costs, particularly with drug-resistant strains such as meticillin-resistant S. aureus. AIM To conduct a case-control study on the economic impact of S. aureus SSI in adult surgical patients across high-volume centres in France, Germany, Spain, and the UK, aiming to assess the overall and procedure-specific burden across Europe. METHODS The SALT study is a multinational, retrospective cohort study with a nested case-control analysis focused on S. aureus SSI in Europe. The study included participants from France, Germany, Italy, Spain, and the UK who underwent invasive surgery in 2016 and employed a micro-costing approach to evaluate health economic factors, matching S. aureus SSI cases with controls. FINDINGS In 2016, among 178,904 surgical patients in five European countries, 764 developed S. aureus SSI. Matching 744 cases to controls, the study revealed that S. aureus SSI cases incurred higher immediate hospitalization costs (€8,810), compared to controls (€6,032). Additionally, S. aureus SSI cases exhibited increased costs for readmissions within the first year post surgery (€7,961.6 versus €5,298.6), with significant differences observed. Factors associated with increased surgery-related costs included the cost of hospitalization immediately after surgery, first intensive care unit (ICU) admission within 12 months, and hospital readmission within 12 months, as identified through multivariable analysis. CONCLUSION The higher rates of hospitalization, ICU admissions, and readmissions among S. aureus SSI cases highlight the severity of these infections and their impact on healthcare costs, emphasizing the potential benefits of evidence-based infection control measures and improved patient care to mitigate the economic burden.
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Affiliation(s)
- J Salmanton-García
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - C Bruns
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J Rutz
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany
| | - M Albertsmeier
- Department of General, Visceral and Transplantation Surgery, LMU University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - J Ankert
- Institute of Infectious Diseases and Infection Control, University Hospital Jena, Jena, Germany
| | - L Bernard
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - C Bataille
- INSERM, CHU Limoges, UMR 1092, Université Limoges, Limoges, France
| | - E Couvé-Deacon
- INSERM, CHU Limoges, UMR 1092, Université Limoges, Limoges, France
| | - M Fernández-Ferrer
- Hospital del Mar-IMIM, Universitat Pompeu Fabra, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, CIBERINFEC, Madrid, Spain
| | - J Fortún
- Ramón y Cajal University Hospital, CIBERINFEC, IRYCIS, Madrid, Spain
| | - A Galar
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - E Grill
- Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München (LMU), Munich, Germany
| | - T Guimard
- Service de Médecine Post-Urgence, CH Départemental de Vendée, La Roche Sur Yon, France
| | - A Y Classen
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J J Vehreschild
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J Stemler
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J-H Naendrup
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J Hampl
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - B Tallon
- Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - R Sprute
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J P Horcajada
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, CIBERINFEC, Madrid, Spain; Hospital del Mar-IMIM, Universitat Pompeu Fabra, Barcelona, Spain
| | - J Mollar-Maseres
- Preventive Medicine Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - P Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - M W Pletz
- Institute of Infectious Diseases and Infection Control, University Hospital Jena, Jena, Germany
| | | | - A Soriano
- Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, CIBERINFEC, Barcelona, Spain
| | - T O Vilz
- Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Venusberg Campus 1, Bonn, Germany
| | - H Seifert
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - O A Cornely
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - S C Mellinghoff
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - B J Liss
- Department I of Internal Medicine, Helios University Hospital Wuppertal, Wuppertal, Germany; School of Medi-Cine, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - S M Wingen-Heimann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; FOM University of Applied Sciences, Essen, Germany
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2
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Bellair M, Amaral E, Ouren M, Roark C, Kim J, O'Connor A, Soriano A, Schindler ML, Wapner RJ, Stone JL, Tavella N, Merriam A, Perley L, Breman AM, Beaudet AL. Noninvasive single-cell-based prenatal genetic testing: A proof of concept clinical study. Prenat Diagn 2024; 44:304-316. [PMID: 38411249 DOI: 10.1002/pd.6529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/11/2024] [Accepted: 01/18/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVE To clinically assess a cell-based noninvasive prenatal genetic test using sequence-based copy number analysis of single trophoblasts from maternal blood. METHODS Blood was obtained from 401 (243 + 158) individuals (8-22 weeks) and shipped overnight. Red cells were lysed, and nucleated cells stained for cytokeratin (CK) and CD45 and enriched for positive CK staining. Automated scanning was used to identify and pick single CK+ /CD45- trophoblasts which were subjected to next-generation sequencing. RESULTS Blood was obtained from 243 pregnancies scheduled for CVS or amniocentesis. Luna results were normal for 160 singletons while 15 cases were abnormal (14 aneuploidy and one monozygotic twin with Williams syndrome deletion). The deletion was confirmed in both fetuses. Placental mosaicism occurred in 7 of 236 (3.0%) Luna cases and in 3 of 188 (1.6%) CVS cases (total 4.6%). No scorable trophoblasts were recovered in 32 of 236 usable samples. Additionally, 158 low-risk pregnancies not undergoing CVS/amniocentesis showed normal results in 133 cases. Seven had aneuploidy results, and there were three likely pathogenic deletions/duplications, including one15q11-q13 deletion. CONCLUSION Although the sample size is modest and statistically accurate measures of test performance are not possible, the Luna test detected aneuploidy and deletions/duplications based on concordance with CVS/amniocentesis.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ronald J Wapner
- Columbia University Irving Medical Center, New York, New York, USA
| | - Joanne L Stone
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nicola Tavella
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Lauren Perley
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Amy M Breman
- Indiana University School of Medicine, Indianapolis, Indiana, USA
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3
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Pitart C, Santillana G, Narváez S, Sellarés A, Campo I, Casals-Pascual C, Soriano A. Inoculum effect of CTX-M-15, OXA-48, and KPC-2 producing Klebsiella pneumoniae on meropenem and ceftazidime-avibactam efficacy. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04749-3. [PMID: 38216844 DOI: 10.1007/s10096-024-04749-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/04/2024] [Indexed: 01/14/2024]
Abstract
The inoculum effect, characterized by diminished antibacterial activity at high bacterial inocula, is studied in the context of beta-lactam and beta-lactamase inhibitor combinations against beta-lactamase-producing Enterobacterales. The inhibition of ESBL + OXA-48 and KPC enzymes, in combination with ceftazidime, demonstrates encouraging results. In this study, 20 Klebsiella pneumoniae isolates were tested with different inocula (1-5 × 105 and 1-5 × 107 cfu/ml) using broth microdilution methods. The inoculum effect was observed in meropenem against OXA-48 + CTX-M-15- and KPC-2-producing isolates but not with ceftazidime/avibactam. Notably, meropenem exhibited inoculum effect against carbapenemase-producing strains, whereas ceftazidime-avibactam remained effective. We conclude that ceftazidime-avibactam is recommended for high-inoculum infections.
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Affiliation(s)
- C Pitart
- Microbiology Department, Hospital Clínic de Barcelona, Barcelona, Spain.
- Institut de Salut Global, Barcelona, Spain.
- Universitat de Barcelona, Barcelona, Spain.
| | - G Santillana
- Microbiology Department, Hospital de Terrassa (CATLAB), Barcelona, Spain
| | - S Narváez
- Microbiology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Sellarés
- Microbiology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - I Campo
- Microbiology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - C Casals-Pascual
- Microbiology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut de Salut Global, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - A Soriano
- Universitat de Barcelona, Barcelona, Spain
- Infectious Diseases Department, Hospital Clínic de Barcelona, Barcelona, Spain
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4
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Saibeni S, Bezzio C, Bossa F, Privitera AC, Marchi S, Roselli J, Mazzuoli S, Geccherle A, Soriano A, Principi MB, Viola A, Sarpi L, Cappello M, D'Incà R, Mastronardi M, Bodini G, Guerra M, Benedetti A, Romano M, Cicala M, Di Sabatino A, Scaldaferri F, De Rosa T, Giardino AM, Germano V, Orlando A, Armuzzi A. Golimumab improves health-related quality of life of patients with moderate-to-severe ulcerative colitis: Results of the go-care study. Dig Liver Dis 2024; 56:83-91. [PMID: 37574431 DOI: 10.1016/j.dld.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND In recent years, improvement of Health-Related Quality of Life (HRQoL) in Ulcerative colitis (UC) has become a relevant measure for treatment efficacy. METHODS We report results from a multicenter prospective study in Italy investigating HRQoL in adult patients with UC treated with golimumab (GLM). Patients who had shown clinical response after a 6-week induction phase (w0), were followed for an additional 48 weeks (w48) (total 54-week treatment). RESULTS Of the 159 patients enrolled 90 completed the study. Compared to values at the beginning of treatment (n = 137), significant improvements were observed for mean total Inflammatory Bowel Disease Questionnaire (IBDQ) scores at w0 (168.5) and w48 (181.7). Patients with baseline PMS above the median tended to have greater improvements in IBDQ at w0 (OR 2.037, p = 0.033) and w48 (OR 3.292, p = 0.027). Compared to beginning of GLM treatment, the mean Full Mayo Score (FMS) decreased by 5.9 points at w48, while mean Partial Mayo Score (PMS) decreased by 3.9 points at w0 and by 4.9 points at w48. CONCLUSIONS GLM improved HRQoL, disease activity and inflammatory biomarkers in UC patients with moderate-to-severely active disease. The greater the burden of disease activity at baseline, the greater the improvement of HRQoL after 24 and 48 weeks of treatment.
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Affiliation(s)
- S Saibeni
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Milan, Italy
| | - C Bezzio
- IBD Unit, Gastroenterology IBD Unit, Rho Hospital, ASST Rhodense, Milan, Italy
| | - F Bossa
- Foudation Casa della Sofferenza, UOC Gastroenterology and Digestive Endoscopy, San Giovanni Rotondo, Foggia, Italy
| | | | - S Marchi
- Department of Translational Research, University of Pisa, Italy
| | - J Roselli
- Gastroenterology, Biomedical and Experimental and Clinical Sciences, "Mario Serio" University of Florence, Italy
| | - S Mazzuoli
- IBD Unit U.O.C. of Gastroenterology "Monsignor Raffaele Dimiccoli" Hospital, ASL Barletta, Italy
| | - A Geccherle
- IBD Unit IRCCS "Sacro Cuore-Don Calabria" Negrar di Valpolicella, Verona, Italy
| | - A Soriano
- Department of Internal Medicine, Gastroenterology Division and IBD Center, Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia Arcispedale S. Maria Nuova, 42121 Reggio Emilia, Italy
| | - M B Principi
- U.O.C. of Gastroenterology, "Azienda Policlinico- Universitaria", Bari, Italy
| | - A Viola
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - L Sarpi
- Gastroenterology and Digestive Endoscpy, Hospital "Media Valle del Tevere" Pantalla -Todi, Perugia, Italy
| | - M Cappello
- Gastroenterology and Hepatology Section, Promise, University of Palermo, Italy
| | - R D'Incà
- U.O.C of Gastroenterology, "University Azienda", Padua, Italy
| | - M Mastronardi
- U.O.S IBD IRCCS "S. De Bellis" Castellana Grotte, Bari Italy
| | - G Bodini
- Policlinico San Martino, University of Genoa, Italy
| | - M Guerra
- Foudation Casa della Sofferenza, UOC Gastroenterology and Digestive Endoscopy, San Giovanni Rotondo, Foggia, Italy
| | - A Benedetti
- Clinic of Gastroenterology, Hepatology and Digestive Endoscopy, Università Politecnica delle Marche-Ospedali Riuniti, Ancona, Italy
| | - M Romano
- Precision Medicine Department, University "l. Vanvitelli" Naples, Italy
| | - M Cicala
- U.O.C. of Gastroenterology and Digestive Endoscopy, "Campus Bio Medico" University, Rome, Italy
| | - A Di Sabatino
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia Italy; First Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - F Scaldaferri
- CEMAD (Digestive Disease Center) - UOS IBD UNIT, Fondazione Policlinico Universitario ‟A Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - T De Rosa
- Medical Affairs MSD Italy, Rome, Italy
| | | | - V Germano
- Medical Affairs MSD Italy, Rome, Italy
| | - A Orlando
- IBD Unit A.O. Ospedali Riuniti "Villa Sofia Cervello", Palermo, Italy
| | - A Armuzzi
- IBD Center, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy.
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5
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Téllez Santoyo A, Lopera C, Ladino Vásquez A, Seguí Fernández F, Grafiá Pérez I, Chumbita M, Aiello TF, Monzó P, Peyrony O, Puerta-Alcalde P, Cardozo C, Garcia-Pouton N, Castro P, Fernández Méndez S, Nicolas Arfelis JM, Soriano A, Garcia-Vidal C. Identifying the most important data for research in the field of infectious diseases: thinking on the basis of artificial intelligence. Rev Esp Quimioter 2023; 36:592-596. [PMID: 37575020 DOI: 10.37201/req/032.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
OBJECTIVE Clinical data on which artificial intelligence (AI) algorithms are trained and tested provide the basis to improve diagnosis or treatment of infectious diseases (ID). We aimed to identify important data for ID research to prioritise efforts being undertaken in AI programmes. METHODS We searched for 1,000 articlesfrom high-impact ID journals on PubMed, selecting 288 of the latest articles from 10 top journals. We classified them into structured or unstructured data. Variables were homogenised and grouped into the following categories: epidemiology, admission, demographics, comorbidities, clinical manifestations, laboratory, microbiology, other diagnoses, treatment, outcomes and other non-categorizable variables. RESULTS 4,488 individual variables were collected, from the 288 articles. 3,670 (81.8%) variables were classified as structured data whilst 818 (18.2%) as unstructured data. From the structured data, 2,319 (63.2%) variables were classified as direct-retrievable from electronic health records-whilst 1,351 (36.8%) were indirect. The most frequent unstructured data were related to clinical manifestations and were repeated across articles. Data on demographics, comorbidities and microbiology constituted the most frequent group of variables. CONCLUSIONS This article identified that structured variables have comprised the most important data in research to generate knowledge in the field of ID. Extracting these data should be a priority when a medical centre intends to start an AI programme for ID. We also documented that the most important unstructured data in this field are those related to clinical manifestations. Such data could easily undergo some structuring with the use of semi-structured medical records focusing on a few symptoms.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - C Garcia-Vidal
- Carolina Garcia-Vidal, MD, PhD. Infectious Diseases Department, Hospital Clínic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain. and
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6
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Herrera S, Torralbo B, Herranz S, Bernal-Maurandi J, Rubio E, Pitart C, Fortes I, Valls S, Rodríguez L, Santana G, Bodro M, Garcia-Vidal C, Hernández-Meneses M, Puerta P, Morata L, Villella A, Bertran MJ, Brey M, Soriano A, Del Río A, Martinez JA. Carriage of multidrug-resistant Gram-negative bacilli: duration and risk factors. Eur J Clin Microbiol Infect Dis 2023; 42:631-638. [PMID: 36964885 DOI: 10.1007/s10096-023-04581-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/24/2023] [Indexed: 03/26/2023]
Abstract
Identification of risk factors influencing the duration of carriage of multidrug-resistant Gram-negative bacilli (MDR-GNB) may be useful for infection control. The aim of this study is to estimate the impact of several factors collected for routine hospital surveillance on the duration of carriage of selected MDR-GNB. From January 2015 to July 2021, patients with at least two clinical/surveillance samples positive for MDR-GNB different from ESBL-producing E. coli or AmpC - exclusively producing Enterobacterales were assessed. Microorganisms, age, number of admissions, clinical or rectal sample, sex, and admission service were evaluated as risk factors. Multivariate analysis was performed by a Cox proportional hazard model. A total of 1981 episodes of colonization were included. Involved microorganisms were ESBL-Klebsiella pneumoniae (KP) in 1057 cases (53.4%), other ESBL-non-E. coli Enterobacterales in 91 (4.6%), OXA-48-KP in 263 (13.3%), KPC-KP in 90 (4.5%), VIM-KP in 29 (1.5%), carbapenemase-producing non-KP Enterobacterales (CP-non-KP) in 124 (6.3%), and MDR Pseudomonas aeruginosa (MDR-PAER) in 327 (16.5%). No differences in duration of colonization were observed among ESBL-KP (median colonization time 320 days), ESBL-non-E. coli Enterobacterales (226 days), OXA48-KP (305 days), and MDR-PAER (321 days). For each group, duration of colonization was significantly longer than that of KPC-KP (median colonization time 60 days), VIM-KP (138 days), and CP-non-KP (71 days). Male sex (HR = 0.88; 95% CI 0.78-0.99), detection in Hepatology-Gastroenterology (HR = 0.71; 95% CI 0.54-0.93), clinical sample (HR = 0.61; 95% CI 0.53-0.69), and > 2 admissions after first detection (HR = 0.47; 95% CI 0.42-0.52) were independent predictors of longer carriage, whereas VIM-KP (HR = 1.61; 95% CI 1.04-2.48), KPC-KP (HR = 1.85; 95% CI 1.49-2.3), and CP-non-KP (HR = 1.92; 95% CI 1.49-2.47) were associated with shorter colonization time. Duration of colonization was significantly longer for ESBL-KP, other ESBL-non-E. coli Enterobacterales, OXA-48-KP, and MDR-PAER. For these microorganisms, prolonging surveillance up to 2.5-3 years should be considered. Male sex, clinical sample, multiple readmissions, admission service, and type of microorganism are independent predictors of the duration of carriage.
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Affiliation(s)
- S Herrera
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - B Torralbo
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - S Herranz
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - J Bernal-Maurandi
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - E Rubio
- Department of Microbiology, Hospital Clinic, University of Barcelona, ISGLOBAL, Barcelona, Spain
| | - C Pitart
- Department of Microbiology, Hospital Clinic, University of Barcelona, ISGLOBAL, Barcelona, Spain
| | - I Fortes
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - S Valls
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - L Rodríguez
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - G Santana
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - M Bodro
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - C Garcia-Vidal
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - M Hernández-Meneses
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - P Puerta
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - L Morata
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - A Villella
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - M J Bertran
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - M Brey
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - A Soriano
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - A Del Río
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - J A Martinez
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
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Soriano A, Petit C, Ryan S, Jemc JC. Tracking Follicle Cell Development. Methods Mol Biol 2023; 2626:151-177. [PMID: 36715904 DOI: 10.1007/978-1-0716-2970-3_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Somatic follicle cells are critical support cells for Drosophila oogenesis, as they provide signals and molecules needed to produce a mature egg. Throughout this process, the follicle cells differentiate into multiple subpopulations and transition between three different cell cycle programs to support nurse cell and oocyte development. The follicle cells are mitotic in early egg chamber development, as they cover the germline cyst. In mid-oogenesis, follicle cells switch from mitosis to endocycling, increasing their ploidy from 2C to 16C. Finally, in late oogenesis, cells transition from endocycling to gene amplification, increasing the copy number of a small subset of genes, including the genes encoding proteins required for egg maturation. In order to explore the genetic regulation of these cell cycle switches and follicle cell development and specification, clonal analysis and the GAL4/UAS system are used frequently to reduce or increase expression of genes of interest. These genetic approaches combined with immunohistochemistry and in situ hybridization are powerful tools for characterizing the mechanisms regulating follicle cell development and the mitosis/endocycle and endocycle/gene amplification transitions. This chapter describes the genetic tools available to manipulate gene expression in follicle cells, as well as the methods and reagents that can be utilized to explore gene expression throughout follicle cell development.
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Affiliation(s)
- Adrianna Soriano
- Department of Biology, Loyola University Chicago, Chicago, IL, USA.,Houston Baptist University, Houston, TX, USA
| | | | - Savannah Ryan
- Department of Biology, Loyola University Chicago, Chicago, IL, USA
| | - Jennifer C Jemc
- Department of Biology, Loyola University Chicago, Chicago, IL, USA.
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Soriano A, Thompson GR, Cornely OA, Kullberg BJ, Kollef M, Vazquez J, Honore PM, Bassetti M, Pullman J, Dignani C, Das AF, Sandison T, Pappas PG. P22 Patient-level meta-analysis of efficacy and safety from STRIVE and ReSTORE: randomized, double-blinded, multicentre Phase 2 and Phase 3 trials of rezafungin in the treatment of candidaemia and/or invasive candidiasis. JAC Antimicrob Resist 2023. [DOI: 10.1093/jacamr/dlac133.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Abstract
Background
Rezafungin is a next-generation echinocandin in development for treatment of candidaemia and invasive candidiasis (IC) and for prevention of invasive fungal disease caused by Candida, Aspergillus and Pneumocystis spp. in blood and marrow transplantation. Rezafungin once-weekly (QWk) was compared to caspofungin once-daily (QD) in two double-blind, randomized, controlled trials in patients with candidaemia and/or IC: STRIVE (Phase 2; NCT02734862) and the recently completed ReSTORE (Phase 3; NCT03667690). STRIVE demonstrated the efficacy and safety profile of rezafungin. ReSTORE showed rezafungin noninferiority to caspofungin for 30 day all-cause mortality (ACM) and global response at Day 14 with comparable safety. Patient-level meta-analyses of efficacy and safety from both trials are presented.
Methods
Details of STRIVE and ReSTORE were previously described. In this analysis of data from both trials, patients who received rezafungin QWk (400 mg in Week 1, then 200 mg) were compared with those who received caspofungin QD (70 mg on Day 1 followed by 50 mg) for ≥14 days (up to 4 weeks). Efficacy endpoints included 30 day ACM (primary US FDA), mycological response at Day 5 (secondary), and time to first negative blood culture (TTNBC) (exploratory). Safety was evaluated by adverse events (AEs).
Results
Groups were well matched (Table 1). Figure 1 shows 30 day ACM (overall and by final diagnosis). Mycological response at Day 5 was 73.4% (102/139) and 64.5% (100/155) in rezafungin and caspofungin groups, respectively (difference=9.5, 95% CI=−0.9, 19.9). In patients with positive blood culture before randomization, median TTNBC was 22.3 h in rezafungin-treated versus 26.3 h in caspofungin-treated patients (stratified log rank p=0.0034, not adjusted for multiplicity). The summary of AEs (Table 2) demonstrates similar outcomes for rezafungin and caspofungin groups.
Conclusions
In the Phase 2/3 patient-level meta-analysis, rezafungin QWk demonstrated efficacy with a similar 30 day ACM rate and safety comparable to that of caspofungin QD. Data for mycological eradication at Day 5 and TTNBC support results from the primary efficacy endpoint and provide initial evidence for the theory that high, front-loaded drug exposure leads to faster fungal clearance. Further analysis of this integrated dataset may provide additional insights on rezafungin efficacy and safety.
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Affiliation(s)
- A Soriano
- Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona , Spain
| | - G R Thompson
- University of California Davis Medical Center , Davis, CA , USA
| | - O A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM) , Cologne , Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) , Cologne , Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln) , Cologne , Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne , Cologne , Germany
| | - B J Kullberg
- Radboud University Medical Center , Nijmegen , The Netherlands
| | - M Kollef
- Washington University , St Louis, MO , USA
| | - J Vazquez
- Augusta University , Augusta, GA , USA
| | - P M Honore
- Brugman University Hospital , Brussels , Belgium
| | | | - J Pullman
- Mercury Street Medical , Butte, MT , USA
| | | | - A F Das
- Cidara Therapeutics Inc. , San Diego, CA , USA
| | - T Sandison
- Cidara Therapeutics Inc. , San Diego, CA , USA
| | - P G Pappas
- University of Alabama at Birmingham , Birmingham, AL , USA
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Gabara C, Solarat B, Castro P, Fernández S, Badia JR, Toapanta D, Schulman S, Reverter JC, Soriano A, Moisés J, Aibar J. Anticoagulation strategies and risk of bleeding events in critically ill COVID-19 patients. Med Intensiva 2023; 47:1-8. [PMID: 34345092 PMCID: PMC8321771 DOI: 10.1016/j.medin.2021.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 01/04/2023]
Abstract
Objective To evaluate the rate of thrombosis, bleeding and mortality comparing anticoagulant doses in critically ill COVID-19 patients. Design Retrospective observational and analytical cohort study. Setting COVID-19 patients admitted to the intensive care unit of a tertiary hospital between March and April 2020. Patients 201 critically ill COVID-19 patients were included. Patients were categorized into three groups according to the highest anticoagulant dose received during hospitalization: prophylactic, intermediate and therapeutic. Interventions The incidence of venous thromboembolism (VTE), bleeding and mortality was compared between groups. We performed two logistic multivariable regressions to test the association between VTE and bleeding and the anticoagulant regimen. Main variables of interest VTE, bleeding and mortality. Results 78 patients received prophylactic, 94 intermediate and 29 therapeutic doses. No differences in VTE and mortality were found, while bleeding events were more frequent in the therapeutic (31%) and intermediate (15%) dose group than in the prophylactic group (5%) (p < 0.001 and p < 0.05 respectively). The anticoagulant dose was the strongest determinant for bleeding (odds ratio 2.4, 95% confidence interval 1.26-4.58, p = 0.008) but had no impact on VTE. Conclusions Intermediate and therapeutic doses appear to have a higher risk of bleeding without a decrease of VTE events and mortality in critically ill COVID-19 patients.
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Affiliation(s)
- C Gabara
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
| | - B Solarat
- Pneumology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
| | - P Castro
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
- Medical Intensive Care Unit, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
| | - S Fernández
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
- Medical Intensive Care Unit, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
| | - J R Badia
- Pneumology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
| | - D Toapanta
- Liver ICU, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
| | - S Schulman
- Department of Medicine, Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - J C Reverter
- Hematology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
| | - A Soriano
- Infectious Disease Department, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
| | - J Moisés
- Pneumology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
| | - J Aibar
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Spain
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Ferrer R, Soriano A, Cantón R, Del Pozo JL, García-Vidal C, Garnacho-Montero J, Larrosa N, Rascado P, Salavert M, Pintado V, Giró-Perafita N, Badia X. A systematic literature review and expert consensus on risk factors associated to infection progression in adult patients with respiratory tract or rectal colonisation by carbapenem-resistant Gram-negative bacteria. Rev Esp Quimioter 2022; 35:455-467. [PMID: 35859521 DOI: 10.37201/req/062.2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Risk factors (RFs) associated with infection progression in patients already colonised by carbapenem-resistant Gram-negative bacteria (CRGNB) have been addressed in few and disperse works. The aim of this study is to identify the relevant RFs associated to infection progression in patients with respiratory tract or rectal colonisation. METHODS A systematic literature review was developed to identify RFs associated with infection progression in patients with CRGNB respiratory tract or rectal colonisation. Identified RFs were then evaluated and discussed by the expert panel to identify those that are relevant according to the evidence and expert's experience. RESULTS A total of 8 articles were included for the CRGNB respiratory tract colonisation and 21 for CRGNB rectal colonisation, identifying 19 RFs associated with pneumonia development and 44 RFs associated with infection progression, respectively. After discussion, the experts agreed on 13 RFs to be associated with pneumonia development after respiratory tract CRGNB colonisation and 33 RFs to be associated with infection progression after rectal CRGNB colonisation. Respiratory tract and rectal colonisation, previous stay in the ICU and longer stay in the ICU were classified as relevant RF independently of the pathogen and site of colonisation. Previous exposure to antibiotic therapy or previous carbapenem use were also common relevant RF for patients with CRGNB respiratory tract and rectal colonisation. CONCLUSIONS The results of this study may contribute to the early identification of CRGNB colonized patients at higher risk of infection development, favouring time-to-effective therapy and improving health outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - X Badia
- Xavier Badia, Omakase Consulting S.L., Barcelona, Spain.
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Moreno-García E, Puerta-Alcalde P, Gariup G, Fernández-Ruiz M, López Cortés LE, Cuervo G, Salavert M, Merino P, Machado M, Guinea J, García-Rodríguez J, Garnacho-Montero J, Cardozo C, Peman J, Montejo M, Fortún J, Almirante B, Castro C, Rodríguez-Baño J, Aguado JM, Martínez JA, Carratalà J, Soriano A, Garcia-Vidal C. Correction to: Early Stepdown From Echinocandin to Fluconazole Treatment in Candidemia: A Post Hoc Analysis of Three Cohort Studies. Open Forum Infect Dis 2022; 9:ofac180. [PMID: 35615301 PMCID: PMC9126489 DOI: 10.1093/ofid/ofac180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | | | - G Gariup
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - M Fernández-Ruiz
- Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (imas+12), Universidad Complutense, Madrid, Spain
| | - L E López Cortés
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, CSIC, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - G Cuervo
- Hospital Universitari de Bellvitge, IDIBELL (Institut D'Investigació Biomèdica de Bellvitge), Universitat de Barcelona, Barcelona, Spain
| | - M Salavert
- Hospital Universitari i Politecnic "La Fe", Valencia, Spain
| | - P Merino
- Hospital Universitario Clínico "San Carlos", Madrid, Spain
| | - M Machado
- Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - J Guinea
- Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | | | - J Garnacho-Montero
- Unidad Clínica de Cuidados Intensivos, Hospital Universitario "Virgen Macarena", Sevilla, Spain
| | - C Cardozo
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - J Peman
- Hospital Universitari i Politecnic "La Fe", Valencia, Spain
| | - M Montejo
- Hospital Universitario "Cruces", Bilbao, Spain
| | - J Fortún
- Hospital Universitario "Ramón y Cajal", Madrid, Spain
| | - B Almirante
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Castro
- Hospital Universitario de Valme, Sevilla, Spain
| | - J Rodríguez-Baño
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, CSIC, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - J M Aguado
- Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (imas+12), Universidad Complutense, Madrid, Spain
| | - J A Martínez
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - J Carratalà
- Hospital Universitari de Bellvitge, IDIBELL (Institut D'Investigació Biomèdica de Bellvitge), Universitat de Barcelona, Barcelona, Spain
| | - A Soriano
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - C Garcia-Vidal
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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Mensa J, Barberán J, Ferrer R, Borges M, Rascado P, Maseda E, Oliver A, Marco F, Adalia R, Aguilar G, Estella A, León López R, Robles Marcos MS, González de Molina FJ, Serrano García R, Salavert M, Fernández Gómez J, Poliakova Y, Pasquau J, Azanza JR, Bou Arévalo G, LLinares Mondéjar P, Cardinal-Fernández P, Soriano A. Recommendations for antibiotic selection for severe nosocomial infections. Rev Esp Quimioter 2021; 34:511-524. [PMID: 34693705 PMCID: PMC8638841 DOI: 10.37201/req/126.2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Severe infection and its evolution to sepsis are becoming more prevalent every day and are among the leading causes of critical illness and mortality. Proper management is crucial to improve prognosis. This document addresses three essential points that have a significant impact on this objective: a) early recognition of patients with sepsis criteria, b) identification of those patients who suffer from an infection and have a high risk of progressing to sepsis, and c) adequate selection and optimization of the initial antimicrobial treatment.
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Affiliation(s)
| | - J Barberán
- José Barberán, Servicio de Medicina Interna - Enfermedades Infecciosas. Hospital Universitario HM Montepríncipe. Universidad San Pablo CEU. Spain.
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Abstract
Community-acquired pneumonia (CAP) is one of the leading causes of admission to emergency departments. Ceftaroline is a fifth-generation cephalosporin with a potent In vitro activity against Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus, the three most important pathogens causing CAP. Three randomized and double-blind clinical trials compared the efficacy of ceftaroline versus ceftriaxone in patients with CAP and the results of each trial and a meta-analysis, concluded the superiority of ceftaroline in terms of clinical success. In particular, the major difference was observed among patients with CAP caused by S. aureus. Accordingly, ceftaroline has been included as a first-line option in the recent clinical guidelines for the management of CAP.
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Affiliation(s)
- A Soriano
- Alex Soriano, Servicio de Enfermedades Infecciosas, Hospital Clínic de Barcelona, Spain.
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Meira F, Albiach L, Carbonell C, Martín-Oterino JA, Martín-Ordiales M, Linares L, Macaya I, Agüero D, Ambrosioni J, Bodro M, Cardozo C, Chumbita M, De la Mora M, García-Pouton N, Garcia-Vidal C, González-Cordón A, Hernández-Meneses M, Inciarte A, Laguno M, Leal L, Morata L, Puerta-Alcalde P, Rico V, Letona L, Cózar-Llistó A, Dueñas G, Solá M, Torres B, Rojas J, Moreno A, Moreno-García E, Torres M, Martínez JA, Soriano A, García F. Experience with the use of siltuximab in patients with SARS-CoV-2 infection. Rev Esp Quimioter 2021; 34:337-341. [PMID: 33982984 PMCID: PMC8329576 DOI: 10.37201/req/045.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/04/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The study aims to describe characteristics and clinical outcome of patients with SARS-CoV-2 infection that received siltuximab according to a protocol that aimed to early block the activity of IL-6 to avoid the progression of the inflammatory flare. METHODS Retrospective review of the first 31 patients with SARS-CoV-2 treated with siltuximab, in Hospital Clinic of Barcelona or Hospital Universitario Salamanca, from March to April 2020 with positive polymerase-chain reaction (PCR) from a nasopharyngeal swab. RESULTS The cohort included 31 cases that received siltuximab with a median (IQR) age of 62 (56-71) and 71% were males. The most frequent comorbidity was hypertension (48%). The median dose of siltuximab was 800 mg ranging between 785 and 900 mg. 7 patients received siltuximab as a salvage therapy after one dose of tocilizumab. At the end of the study, a total of 26 (83.9) patients had been discharged alive and the mortality rate was 16.1% but only 1 out of 24 that received siltuximab as a first line option (4%). CONCLUSIONS Siltuximab is a well-tolerated alternative to tocilizumab when administered as a first line option in patients with COVID-19 pneumonia within the first 10 days from symptoms onset and high C-reactive protein.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Soriano
- Alex Soriano, Department of Infectious Diseases, Hospital Clínic of Barcelona. Carrer de Villarroel 170, 08036, Barcelona, Spain.
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Ferrer R, Soriano A, Cantón R, Del Pozo JL, García-Vidal C, Garnacho-Montero J, Larrosa N, Rascado P, Salavert M, Pintado V, Pellicer B, Badía X. [A systematic review and expert's analysis of risk factors of infections in adults due to carbapenem-resistant Pseudomonas aeruginosa or Acinetobacter baumannii in Spain]. Rev Esp Quimioter 2021; 34:298-307. [PMID: 33913312 PMCID: PMC8329577 DOI: 10.37201/req/034.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The aim of the study is to identify risk factors associated to infections caused by carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Acinetobacter baumannii (CRAB) in adult patients through a systematic literature review, classify them according to their importance and provide recommendations by experts in the Spanish context. METHODS We developed a systematic literature review to identify risk factors associated to CRPA or CRAB infections and they were evaluated and discussed by a multidisciplinary panel of experts. RESULTS There were included 29 studies for P. aeruginosa and 23 for A. baumannii out of 593 identified through systematic literature review. We identified 38 risk factors for P. aeruginosa and 36 for A. baumannii. After risk factor evaluation by the panel of experts, results for CRPA were: 11 important, 10 slightly important and 15 unimportant risk factors; and for CRAB were: 9 important, 5 slightly important and 19 unimportant risk factors. For both pathogens, previous use of antibiotics and hospitalization were important risk factors. CONCLUSIONS We could identify the main risk factors associated to CRPA and CRAB through literature review. There is a need for developing additional studies with higher levels of evidence to identify sooner and better infected patients through associated risk factors.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - X Badía
- Xavier Badia, Omakase Consulting, Barcelona, Spain.
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Citriniti G, Soriano A, Bertolini E, Sandri G, Bertani A, Tinazzi I, Martinis F, Girolimetto N, Salvarani C, Beltrami M, Macchioni P. POS0265 CLINICAL AND ULTRASONOGRAPHIC ENTHESITIS IN INFLAMMATORY BOWEL DISEASE WITH AND WITHOUT PSORIASIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Previous studies have reported an association between psoriasis (PsO) and inflammatory bowel disease (IBD). Coexistence of IBD and PsO has been associated with significant higher prevalence of enthesitis and dactylitis1.Objectives:To compare the prevalence of clinical and ultrasonographic peripheral enthesis abnormalities in a consecutive series of patients with IBD and psoriasis (PsO) as compared to a group of IBD patients without psoriasis (IBD).Methods:One-hundred seventy-four IBD consecutive patients [36 PsO and 138 IBD, M/F 91/83, mean age 42.6±14.7 years, mean disease duration 110 ±12.3 months] entered the study. A complete clinical examination, including rheumatological history, 66/68 peripheral joint count, MASES and LEI scores, BASDAI, and dactylitis count, was performed at study entry. Laboratory test (ESR, CRP, Hb, fecal calprotectin) were collected. Axial or peripheral SpA diagnosis was made using ASAS criteria 2.US examination was executed by a rheumatologist blind to clinical data, using an Esaote MyLabClass, 18-6MHz linear multifrequence transducer both in B-mode and PD-mode. The following sites were examined bilaterally: lateral epicondyle of the humerus, distal quadriceps femoris insertion into the patella, inferior pole of the patella, tibial distal insertion of the patellar tendon, calcaneal insertion of the Achilles tendon, and plantar aponeurosis insertion. Knee and ankle joints were evaluated for synovial hypertrophy, PD signal and fluid effusion. Enthesitis was defined according to OMERACT 3 and scored as 0-36 for GUESS and 0-136 for MASEI.Results:PsO patients had later IBD onset (mean age 39±14.7 vs 33 ± 13.2 in IBD group, p=0.02). There weren’t observed any significant differences in IBD duration and Crohn/UC prevalence.No significant difference between the two groups in rheumatological history and clinical examination was detected, except for familiar history of psoriasis (PsO 44% vs IBD 16%, p <0.001). Prevalence of SpA was 33,3% in PsO group and 37% in IBD group (p = 0.687).146 patients (83.4%) showed structural damage at ≥ 1 enthesis, 44 patients (25%) had at least 1 active enthesitis, with no significant difference between the two groups. PsO group showcased a significantly increased prevalence of patients having ≥ 1 thickened enthesis (86.1% vs 63.9%, p=0.009) and of PD signal at knee examination (11.1% vs 2.2%, p= 0.034). Higher values of GUESS score were observed in PsO (8.1±5.1 vs 5.8±3.9, p=0.017). Enthesis hypoechogenicity was more prevalent in IBD group (27.5% vs 11.1%, p=0.049).Enthesis thickness was significantly increased in PsO, in every examined site. Enthesophyte length was significantly increased in PsO group at quadriceps tendon, patellar distal insertion and Achilles tendon.Conclusion:No differences in clinical manifestation and rheumatological history between IBD and PsO patients were observed. Subclinical (US) abnormalities were significantly increased in IBD patients with associated PsO, as compared to patients affected by IBD.References:[1]Cantini, F. et al. J. Rheumatol.44, 1341–1346 (2017).[2]Rudwaleit, M. et al. Ann. Rheum. Dis.68, 777–783 (2009).[3]Balint, P. V. et al. Ann. Rheum. Dis.77, 1730–1735 (2018).Acknowledgements:Abbvie provided funding for medical writingDisclosure of Interests:Giorgia Citriniti: None declared, Alessandra Soriano: None declared, Elena Bertolini: None declared, Gilda Sandri: None declared, Angela Bertani: None declared, Ilaria Tinazzi: None declared, Federica Martinis: None declared, Nicolò Girolimetto: None declared, Carlo Salvarani: None declared, Marina Beltrami Grant/research support from: Abbvie provided funding for medical writing, Pierluigi Macchioni: None declared
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Moreno-García E, Puerta-Alcalde P, Gariup G, Fernández-Ruiz M, López Cortés LE, Cuervo G, Salavert M, Merino P, Machado M, Guinea J, García-Rodríguez J, Garnacho-Montero J, Cardozo C, Peman J, Montejo M, Fortún J, Almirante B, Castro C, Rodríguez-Baño J, Aguado JM, Martínez JA, Carratalà J, Soriano A, Garcia-Vidal C. Early Stepdown From Echinocandin to Fluconazole Treatment in Candidemia: A Post Hoc Analysis of Three Cohort Studies. Open Forum Infect Dis 2021; 8:ofab250. [PMID: 34104670 PMCID: PMC8180243 DOI: 10.1093/ofid/ofab250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/13/2021] [Indexed: 11/17/2022] Open
Abstract
Background There are no clear criteria for antifungal de-escalation after initial empirical treatments. We hypothesized that early de-escalation (ED) (within 5 days) to fluconazole is safe in fluconazole-susceptible candidemia with controlled source of infection. Methods This is a multicenter post hoc study that included consecutive patients from 3 prospective candidemia cohorts (2007–2016). The impact of ED and factors associated with mortality were assessed. Results Of 1023 candidemia episodes, 235 met inclusion criteria. Of these, 54 (23%) were classified as the ED group and 181 (77%) were classified as the non-ED group. ED was more common in catheter-related candidemia (51.9% vs 31.5%; P = .006) and episodes caused by Candida parapsilosis, yet it was less frequent in patients in the intensive care unit (24.1% vs 39.2%; P = .043), infections caused by Nakaseomyces glabrata (0% vs 9.9%; P = .016), and candidemia from an unknown source (24.1% vs 47%; P = .003). In the ED and non-ED groups, 30-day mortality was 11.1% and 29.8% (P = .006), respectively. Chronic obstructive pulmonary disease (odds ratio [OR], 3.97; 95% confidence interval [CI], 1.48–10.61), Pitt score > 2 (OR, 4.39; 95% CI, 1.94–9.20), unknown source of candidemia (OR, 2.59; 95% CI, 1.14–5.86), candidemia caused by Candida albicans (OR, 3.92; 95% CI, 1.48–10.61), and prior surgery (OR, 0.29; 95% CI, 0.08–0.97) were independent predictors of mortality. Similar results were found when a propensity score for receiving ED was incorporated into the model. ED had no significant impact on mortality (OR, 0.50; 95% CI, 0.16–1.53). Conclusions Early de-escalation is a safe strategy in patients with candidemia caused by fluconazole-susceptible strains with controlled source of bloodstream infection and hemodynamic stability. These results are important to apply antifungal stewardship strategies.
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Affiliation(s)
| | | | - G Gariup
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - M Fernández-Ruiz
- Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (imas+12), Universidad Complutense, Madrid, Spain
| | - L E López Cortés
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, CSIC, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - G Cuervo
- Hospital Universitari de Bellvitge, IDIBELL (Institut D'Investigació Biomèdica de Bellvitge), Universitat de Barcelona, Barcelona, Spain
| | - M Salavert
- Hospital Universitari i Politecnic "La Fe", Valencia, Spain
| | - P Merino
- Hospital Universitario Clínico "San Carlos", Madrid, Spain
| | - M Machado
- Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - J Guinea
- Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | | | - J Garnacho-Montero
- Unidad Clínica de Cuidados Intensivos, Hospital Universitario "Virgen Macarena", Sevilla, Spain
| | - C Cardozo
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - J Peman
- Hospital Universitari i Politecnic "La Fe", Valencia, Spain
| | - M Montejo
- Hospital Universitario "Cruces", Bilbao, Spain
| | - J Fortún
- Hospital Universitario "Ramón y Cajal", Madrid, Spain
| | - B Almirante
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Castro
- Hospital Universitario de Valme, Sevilla, Spain
| | - J Rodríguez-Baño
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, CSIC, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - J M Aguado
- Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (imas+12), Universidad Complutense, Madrid, Spain
| | - J A Martínez
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - J Carratalà
- Hospital Universitari de Bellvitge, IDIBELL (Institut D'Investigació Biomèdica de Bellvitge), Universitat de Barcelona, Barcelona, Spain
| | - A Soriano
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - C Garcia-Vidal
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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18
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Moreno-García E, Rico E, Albiach L, Agüero D, Ambrosioni J, Bodro M, Cardozo C, Chumbita M, De la Mora M, García-Pouton N, Garcia-Vidal C, González-Cordón A, Hernández-Meneses M, Inciarte A, Laguno M, Leal L, Linares L, Macay I, Meira F, Mensa J, Moreno A, Morata L, Puerta-Alcalde P, Rojas J, Solá M, Torres B, Torres M, Tomé A, Tuset M, Castro P, Fernández S, Nicolás JM, Almuedo-Riera A, Muñoz J, Fernandez-Pittol M, Marcos MA, Soy D, Martínez JA, García F, Soriano A. Tocilizumab reduces the risk of ICU admission and mortality in patients with SARS-CoV-2 infection. Rev Esp Quimioter 2021; 34:238-244. [PMID: 33829722 PMCID: PMC8179941 DOI: 10.37201/req/037.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objectives In some patients the immune response triggered by SARS-CoV-2 is unbalanced, presenting an acute respiratory distress syndrome which in many cases requires intensive care unit (ICU) admission. The limitation of ICU beds has been one of the major burdens in the management around the world; therefore, clinical strategies to avoid ICU admission are needed. We aimed to describe the influence of tocilizumab on the need of transfer to ICU or death in non-critically ill patients. Material and methods A retrospective study of 171 patients with SARS-CoV-2 infection that did not qualify as requiring transfer to ICU during the first 24h after admission to a conventional ward, were included. The criteria to receive tocilizumab was radiological impairment, oxygen demand or an increasing of inflammatory parameters, however, the ultimate decision was left to the attending physician judgement. The primary outcome was the need of ICU admission or death whichever came first. Results A total of 77 patients received tocilizumab and 94 did not. The tocilizumab group had less ICU admissions (10.3% vs. 27.6%, P=0.005) and need of invasive ventilation (0 vs 13.8%, P=0.001). In the multivariable analysis, tocilizumab remained as a protective variable (OR: 0.03, CI 95%: 0.007-0.1, P=0.0001) of ICU admission or death. Conclusions Tocilizumab in early stages of the inflammatory flare could reduce an important number of ICU admissions and mechanical ventilation. The mortality rate of 10.3% among patients receiving tocilizumab appears to be lower than other reports. This is a non-randomized study and the results should be interpreted with caution.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Soriano
- Alex Soriano, Department of Infectious Diseases, Hospital Clínic of Barcelona. Carrer de Villarroel 170, 08036, Barcelona, Spain.
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19
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Garcia-Vidal C, Meira F, Cózar-Llistó A, Dueñas G, Puerta-Alcalde P, Garcia-Pouton N, Chumbita M, Cardozo C, Hernandez-Meneses M, Alonso-Navarro R, Rico V, Agüero D, Bodro M, Morata L, Jordan C, Lopera C, Ambrosioni J, Segui F, Grafia N, Castro P, García F, Mensa J, Martínez JA, Sanjuan G, Soriano A. Real-life use of remdesivir in hospitalized patients with COVID-19. Rev Esp Quimioter 2021; 34:136-140. [PMID: 33675220 PMCID: PMC8019465 DOI: 10.37201/req/018.2021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective Controversial results on remdesivir efficacy have been reported. We aimed to report our real-life experience with the use of remdesivir from its availability in Spain. Methods We performed a descriptive study of all patients admitted for ≥48 hours with confirmed COVID-19 who received remdesivir between the 1st of July and the 30th of September 2020. Results A total of 123 patients out of 242 admitted with COVID-19 at our hospital (50.8%) received remdesivir. Median age was 58 years, 61% were males and 56.9 % received at least one anti-inflammatory treatment. No adverse events requiring remdesivir discontinuation were reported. The need of intensive care unit admission, mechanical ventilation and 30-days mortality were 19.5%, 7.3% and 4.1%, respectively. Conclusion In our real-life experience, the use of remdesivir in hospitalized patients with COVID-19 was associated with a low mortality rate and good safety profile.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Soriano
- Dr. Alex Soriano, Department of Infectious Diseases, Hospital Clinic of Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain.
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20
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Affiliation(s)
- M McNally
- The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK
| | - R Sousa
- Porto Bone Infection Group (GRIP), Orthopaedic Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - M Wouthuyzen-Bakker
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - A F Chen
- Arthroplasty Services, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - A Soriano
- Head of Infectious Diseases Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - H C Vogely
- Orthopaedic Surgeon, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, Netherlands
| | - M Clauss
- Head of the Center for Musculoskeletal Infections, Department of Orthopaedics and Trauma Surgery, University Hospital Basel, Basel, Switzerland
| | - C A Higuera
- Levitetz Department of Orthopaedic Surgery, Cleveland Clinic, Florida, USA
| | - R Trebše
- Head of Bone Infection, Orthopaedic Hospital Valdoltra, Ankaran, Slovenia
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21
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Bonacini M, Cimino L, De Simone L, Bolletta E, Gozzi F, Soriano A, Muratore F, Zerbini A, Fontana L, Salvarani C, Croci S. Vogt-Koyanagi-Harada patients show higher frequencies of circulating NKG2D pos NK and NK T cells. Clin Exp Immunol 2020; 204:41-48. [PMID: 33314028 DOI: 10.1111/cei.13563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 11/27/2022] Open
Abstract
Vogt-Koyanagi-Harada (VKH) is an autoimmune disease characterized by inflammation in tissues that contain melanocytes. We aimed to increase the knowledge regarding immunological pathways deregulated in VKH disease. We compared the percentages of circulating natural killer (NK), NK T and T cells expressing the activatory markers: CD16, CD69, NK group 2D (NKG2D), natural cytotoxicity triggering receptor 3 (Nkp30), natural cytotoxicity triggering receptor 1 (Nkp46) and the inhibitory marker: NK group 2 member A (NKG2A) in 10 active VKH patients, 20 control subjects (CTR) and seven patients with Behçet disease (BD) by flow cytometry. Cytotoxic potential of NK cells was determined through the degranulation marker CD107a expression after contact with K562 cells by flow cytometry. Moreover, plasmatic levels of 27 cytokines were determined with a multiplex bead-based assay. VKH patients showed higher percentages of NKG2Dpos NK and NK T cells versus CTR. The cytotoxic potential of NK cells induced by K562 cells was comparable between VKH patients and CTR. Finally, higher concentrations of interleukin (IL)-4, IL-5, IL-7, IL-17 and platelet-derived growth factor-subunits B (PDGF-bb) were detected in plasma of VKH patients versus CTR. The immune profile of VKH patients was similar to that of BD patients.
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Affiliation(s)
- M Bonacini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - L Cimino
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - L De Simone
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - E Bolletta
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - F Gozzi
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A Soriano
- Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - F Muratore
- Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A Zerbini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - L Fontana
- Ophtalmology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - C Salvarani
- Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - S Croci
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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22
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Izquierdo-Domínguez A, Rojas-Lechuga MJ, Chiesa-Estomba C, Calvo-Henríquez C, Ninchritz-Becerra E, Soriano-Reixach M, Poletti-Serafini D, Villarreal IM, Maza-Solano JM, Moreno-Luna R, Villarroel PP, Mateos-Serrano B, Agudelo D, Valcarcel F, Del Cuvillo A, Santamaría A, Mariño-Sánchez F, Aguilar J, Vergés P, Inciarte A, Soriano A, Mullol J, Alobid I. Smell and Taste Dysfunction in COVID-19 Is Associated With Younger Age in Ambulatory Settings: A Multicenter Cross-Sectional Study. J Investig Allergol Clin Immunol 2020; 30:346-357. [PMID: 32554337 DOI: 10.18176/jiaci.0595] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Since the initial anecdotal reports of coronavirus disease 2019 (COVID-19) from China, a growing number of studies have reported on smell and/or taste dysfunction (STD). Objective: The aim of our study was to investigate the frequency and severity of STD in COVID-19 patients and to evaluate the association with demographic characteristics, hospital admission, symptoms, comorbidities, and blood biomarkers. METHODS We performed a multicenter cross-sectional study on patients who were positive for SARS-CoV-2 (n=846) and controls (n=143) from 15 Spanish hospitals. Data on STD were collected prospectively using an in-person survey. The severity of STD was categorized using a visual analog scale. We analyzed time to onset, recovery rate, time to recovery, hospital admission, pneumonia, comorbidities, smoking, and symptoms. RESULTS STD was at least 2-fold more common in COVID-19-positive patients than in controls. COVID-19-positive hospitalized patients were older, with a lower frequency of STD, and recovered earlier than outpatients. Analysis stratified by severity of STD showed that more than half of COVID-19 patients presented severe loss of smell (53.7%) or taste (52.2%); both senses were impaired in >90%. In the multivariate analysis, older age (>60 years), being hospitalized, and increased C-reactive protein were associated with a better sense of smell and/or taste. COVID-19-positive patients reported improvement in smell (45.6%) and taste (46.1%) at the time of the survey; in 90.6% this was within 2 weeks of infection. CONCLUSION STD is a common symptom in COVID-19 and presents mainly in young and nonhospitalized patients. More studies are needed to evaluate follow-up of chemosensory impairment.
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Affiliation(s)
- A Izquierdo-Domínguez
- Department of Allergy, Consorci Sanitari de Terrassa, Barcelona, Spain.,Unidad Alergo Rino, Centro Médico Teknon, Barcelona, Spain.,Department of Allergy, Clínica Diagonal, Barcelona, Spain
| | - M J Rojas-Lechuga
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,CIBER of Respiratory Diseases (CIBERES), Spain
| | - C Chiesa-Estomba
- Department of Otorhinolaryngology, Donostia University Hospital, San Sebastian, Spain
| | - C Calvo-Henríquez
- Department of Otorhinolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - E Ninchritz-Becerra
- Department of Otorhinolaryngology, Donostia University Hospital, San Sebastian, Spain
| | - M Soriano-Reixach
- Department of Otorhinolaryngology, Donostia University Hospital, San Sebastian, Spain
| | - D Poletti-Serafini
- Rhinology Section, Department of Otorhinolaryngology, Hospital General Universitario Gregorio Marañón and Hospital La Milagrosa, Spain
| | - I M Villarreal
- Department of Otorhinolaryngology, Hospital Universitario de Fuenlabrada and Hospital La Milagrosa, Spain
| | - J M Maza-Solano
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, University Hospital Virgen de la Macarena, Seville, Spain
| | - R Moreno-Luna
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, University Hospital Virgen de la Macarena, Seville, Spain
| | - P P Villarroel
- Department of Otorhinolaryngology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - B Mateos-Serrano
- Department of Otolaryngology, Hospital Universitario La Paz, Spain
| | - D Agudelo
- Department of Otorhinolaryngology, Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain
| | - F Valcarcel
- Rhinology Section, Department of Otorhinolaryngology, Hospital Universitario de Cruces, Bilbao, Spain
| | - A Del Cuvillo
- Rhinology and asthma Unit, UGC ORL Hospital de Jerez, Servicio Andaluz de Salud, Cadiz, Spain
| | - A Santamaría
- Department of Otorhinolaryngology, Hospital Ramón y Cajal, Madrid, Spain
| | - F Mariño-Sánchez
- Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,CIBER of Respiratory Diseases (CIBERES), Spain.,Department of Otorhinolaryngology, Hospital Ramón y Cajal, Madrid, Spain
| | - J Aguilar
- Department of Otorhinolaryngology, Hospital Reina Sofía de Córdoba, Córdoba, Spain
| | - P Vergés
- Department of Otorhinolaryngology, Hospital Vall d´Hebron, Barcelona, Spain
| | - A Inciarte
- Department of Infectious Diseases, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - A Soriano
- Department of Infectious Diseases, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - J Mullol
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,CIBER of Respiratory Diseases (CIBERES), Spain
| | - I Alobid
- Unidad Alergo Rino, Centro Médico Teknon, Barcelona, Spain.,Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,CIBER of Respiratory Diseases (CIBERES), Spain
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23
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Zizzo M, Zanelli M, Soriano A, Annessi V. Comment on: Randomized clinical trial of intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy (IEA trial). Br J Surg 2020; 107:e230. [PMID: 32352163 DOI: 10.1002/bjs.11614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/11/2020] [Indexed: 11/07/2022]
Affiliation(s)
- M Zizzo
- Surgical Oncology Unit, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - M Zanelli
- Pathology Unit, Reggio Emilia, Italy
| | - A Soriano
- Gastroenterology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - V Annessi
- General Surgery Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Guastalla, Modena, Italy
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24
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Escudero-Sanchez R, Senneville E, Digumber M, Soriano A, Del Toro MD, Bahamonde A, Del Pozo JL, Guio L, Murillo O, Rico A, García-País MJ, Rodríguez-Pardo D, Iribarren JA, Fernández M, Benito N, Fresco G, Muriel A, Ariza J, Cobo J. Suppressive antibiotic therapy in prosthetic joint infections: a multicentre cohort study. Clin Microbiol Infect 2020; 26:499-505. [PMID: 31539638 DOI: 10.1016/j.cmi.2019.09.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/01/2019] [Accepted: 09/07/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The aim was to describe the effectiveness of suppressive antibiotic treatment (SAT) in routine clinical practice when used in situations in which removal of a prosthetic implant is considered essential for the eradication of an infection, and it cannot be performed. METHODS This was a descriptive retrospective and multicentre cohort study of prosthetic joint infection (PJI) cases managed with SAT. SAT was considered to have failed if a fistula appeared or persisted, if debridement was necessary, if the prosthesis was removed due to persistence of the infection or if uncontrolled symptoms were present. RESULTS In total, 302 patients were analysed. Two hundred and three of these patients (67.2%) received monotherapy. The most commonly used drugs were tetracyclines (39.7% of patients) (120/302) and cotrimoxazole (35.4% of patients) (107/302). SAT was considered successful in 58.6% (177/302) of the patients (median time administered, 36.5 months; IQR 20.75-59.25). Infection was controlled in 50% of patients at 5 years according to Kaplan-Meier analysis. Resistance development was documented in 15 of 65 (23.1%) of the microbiologically documented cases. SAT failure was associated with age <70 years (sub-hazard ratio (SHR) 1.61, 95% CI 1.1-2.33), aetiology other than Gram-positive cocci (SHR 1.56, 95% CI 1.09-2.27) and location of the prosthesis in the upper limb (SHR 2.4, 95% CI 1.5-3.84). SAT suspension was necessary due to adverse effects in 17 of 302 patients (5.6%). CONCLUSIONS SAT offers acceptable results for patients with PJI when surgical treatment is not performed or when it fails to eradicate the infection.
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Affiliation(s)
| | - E Senneville
- Centre Hospitalier Gustave Dron, Tourcoing, France
| | - M Digumber
- Centre Hospitalier Gustave Dron, Tourcoing, France
| | | | | | | | | | - L Guio
- Hospital Cruces, Vizcaya, Spain
| | - O Murillo
- Hospital Bellvitge, Barcelona, Spain
| | - A Rico
- Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | | | - N Benito
- Hospital Santa Creu I Sant Pau, Barcelona, Spain
| | - G Fresco
- Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - A Muriel
- Hospital Ramón y Cajal, IRYCIS, CIBER, Madrid, Spain
| | - J Ariza
- Hospital Bellvitge, Barcelona, Spain
| | - J Cobo
- Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
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25
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Molist C, Navarro N, Giralt I, Zarzosa P, Gallo-Oller G, Pons G, Magdaleno A, Moreno L, Guillén G, Hladun R, Garrido M, Soriano A, Segura MF, Sánchez de Toledo J, Gallego S, Roma J. miRNA-7 and miRNA-324-5p regulate alpha9-Integrin expression and exert anti-oncogenic effects in rhabdomyosarcoma. Cancer Lett 2020; 477:49-59. [PMID: 32142919 DOI: 10.1016/j.canlet.2020.02.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/16/2020] [Accepted: 02/27/2020] [Indexed: 11/15/2022]
Abstract
The prognosis of patients with metastatic rhabdomyosarcoma (RMS), the most common type of soft tissue sarcoma in children, is poor and no strategies have been identified to improve their dismal prognosis. Alpha-9 integrin (ITGA9) plays a particularly crucial role in cancer progression and invasiveness. Despite the consensus on the remarkable pro-oncogenic potential of this protein, the miRNA-mediated regulation of ITGA9 has barely been studied to date. In the present study, miR-7 and miR-324-5p were selected as the best candidates after a screening to find ITGA9 regulators, and their effects on cell proliferation and invasion in RMS are described and characterized for the first time. Interestingly, the overexpression of both miRNA produced a clear impairment of cell proliferation, while miR-7 also induced a remarkable drop in cell invasion. Furthermore, the stable overexpression of both miRNA was found to reduce tumor growth in orthotopic RMS models and miR-7 was able to impair metastatic lung colonization. Consequently, we conclude that miR-7 and miR-324-5p show anti-oncogenic and anti-metastatic potential, thereby opening up the possibility of being used as novel therapeutic tools to avoid RMS progression.
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Affiliation(s)
- C Molist
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Navarro
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Giralt
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Zarzosa
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Gallo-Oller
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Pons
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Magdaleno
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Moreno
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Guillén
- Pediatric Surgery Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - R Hladun
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Garrido
- Pathology Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - A Soriano
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M F Segura
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Sánchez de Toledo
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Pediatric Oncology and Hematology Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Gallego
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Pediatric Oncology and Hematology Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - J Roma
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Soriano A, Oh J, Hassani D, Andy U, Arya L. 42: What do residents want in a surgical video? Trainee perspectives on the vaginal hysterectomy. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.12.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Suyama J, Yang F, Soriano A, Rao H, Arya L. 25: Mechanisms underlying nocturia in women with bladder pain syndrome/interstitial cystitis. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.12.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hassani D, Soriano A, Arya L, Uduak A. 33: Relationship between symptoms and urinary biomarkers in women with dry overactive bladder. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.12.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Herbst R, Arkenau H, Bendell J, Arrowsmith E, Wermke M, Soriano A, Penel N, Santana-Davila R, Bischoff H, Chau I, Chao B, Ferry D, Mi G, Paz-Ares L. MA14.07 Phase I Expansion Cohort of Ramucirumab Plus Pembrolizumab in Advanced Treatment-Naïve Non-Small Cell Lung Cancer (JVDF). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Farjadian S, Bonatti F, Soriano A, Reina M, Adorni A, Graziano C, Moghtaderi M, Percesepe A, Romeo G, Martorana D. A new MEFV gene mutation in an Iranian patient with familial Mediterranean fever. Reumatismo 2019; 71:85-87. [PMID: 31309779 DOI: 10.4081/reumatismo.2019.1141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 10/28/2018] [Indexed: 11/23/2022] Open
Abstract
Familial mediterranean fever (FMF) is an inherited autoinflammatory disorder characterized by recurrent episodes of fever and painful inflammation involving the intra-abdominal organs, the lungs and the joints, which is highly prevalent in specific ethnic groups including the Iranians. We report a 12-year-old boy from Iran, with a clinical history of recurrent fever. Based on the suggestive clinical data, mutational analysis revealed the presence of the novel c.1945C>T heterozygous variant in exon 10, which leads to a leucine to phenylalanine change at position 649 of the protein. The mutation was inherited from the mother. This novel mutation lies in exon 10 of the MEFV gene, which encodes for a domain called B30.2-SPRY, located in the C-terminal region of the pyrin protein and contains the most frequent mutations associated with FMF. The present report expands the spectrum of MEFV gene mutations associated with FMF. The uniqueness of this study, compared with other published case reports, consists in the new mutation found in the MEFV gene. In fact, new mutations in this gene are of high interest, in order to better understand the role of this gene in autoinflammation.
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Affiliation(s)
- S Farjadian
- Department of Immunology, Shiraz University of Medical Sciences, Shiraz.
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Viasus D, Puerta-Alcalde P, Cardozo C, Suárez-Lledó M, Rodríguez-Núñez O, Morata L, Fehér C, Marco F, Chumbita M, Moreno-García E, Fernández-Avilés F, Gutiérrez-Garcia G, Martínez JA, Mensa J, Rovira M, Esteve J, Soriano A, Garcia-Vidal C. Predictors of multidrug-resistant Pseudomonas aeruginosa in neutropenic patients with bloodstream infection. Clin Microbiol Infect 2019; 26:345-350. [PMID: 31295551 DOI: 10.1016/j.cmi.2019.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 06/07/2019] [Accepted: 07/01/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To assess risk factors for multidrug-resistant Pseudomonas aeruginosa (MDR-PA) infection in neutropenic patients. METHODS Single-centre retrospective analysis of consecutive bloodstream infection (BSI) episodes (2004-2017, Barcelona). Two multivariate regression models were used at BSI diagnosis and P. aeruginosa detection. Significant predictors were used to establish rules for stratifying patients according to MDR-PA BSI risk. RESULTS Of 661 Gram-negative BSI episodes, 190 (28.7%) were caused by P. aeruginosa (70 MDR-PA). Independent factors associated with MDR-PA among Gram-negative organisms were haematological malignancy (OR 3.30; 95% CI 1.15-9.50), pulmonary source of infection (OR 7.85; 95% CI 3.32-18.56), nosocomial-acquired BSI (OR 3.52; 95% CI 1.74-7.09), previous antipseudomonal cephalosporin (OR 13.66; 95% CI 6.64-28.10) and piperacillin/tazobactam (OR 2.42; 95% CI 1.04-5.63), and BSI occurring during ceftriaxone (OR 4.27; 95% CI 1.15-15.83). Once P. aeruginosa was identified as the BSI aetiological pathogen, nosocomial acquisition (OR 7.13; 95% CI 2.87-17.67), haematological malignancy (OR 3.44; 95% CI 1.07-10.98), previous antipseudomonal cephalosporin (OR 3.82; 95% CI 1.42-10.22) and quinolones (OR 3.97; 95% CI 1.37-11.48), corticosteroids (OR 2.92; 95% CI 1.15-7.40), and BSI occurring during quinolone (OR 4.88; 95% CI 1.58-15.05) and β-lactam other than ertapenem (OR 4.51; 95% CI 1.45-14.04) were independently associated with MDR-PA. Per regression coefficients, 1 point was assigned to each parameter, except for nosocomial-acquired BSI (3 points). In the second analysis, a score >3 points identified 60 (86.3%) out of 70 individuals with MDR-PA BSI and discarded 100 (84.2%) out of 120 with non-MDR-PA BSI. CONCLUSIONS A simple score based on demographic and clinical factors allows stratification of individuals with bacteraemia according to their risk of MDR-PA BSI, and may help facilitate the use of rapid MDR-detection tools and improve early antibiotic appropriateness.
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Affiliation(s)
- D Viasus
- Health Sciences Division, Universidad del Norte, and Hospital Universidad del Norte, Barranquilla, Colombia
| | - P Puerta-Alcalde
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - C Cardozo
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - M Suárez-Lledó
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - O Rodríguez-Núñez
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - L Morata
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - C Fehér
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - F Marco
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Microbiology Department, Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain
| | - M Chumbita
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - E Moreno-García
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | | | - G Gutiérrez-Garcia
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - J A Martínez
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - J Mensa
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - M Rovira
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - J Esteve
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - A Soriano
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - C Garcia-Vidal
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain.
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Orihuela-Martín J, Rodríguez-Núñez O, Morata L, Cardozo C, Puerta-Alcalde P, Hernández-Meneses M, Ambrosioni J, Linares L, Bodro M, de Los Angeles Guerrero-León M, Del Río A, Garcia-Vidal C, Almela M, Pitart C, Marco F, Soriano A, Martínez JA. Performance of differential time to positivity as a routine diagnostic test for catheter-related bloodstream infections: a single-centre experience. Clin Microbiol Infect 2019; 26:383.e1-383.e7. [PMID: 31288101 DOI: 10.1016/j.cmi.2019.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 06/05/2019] [Accepted: 07/01/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the performance of differential time to positivity (DTP) for the diagnosis of catheter-related bloodstream infections (CRBSI). METHODS From all episodes of bloodstream infections (BSI) diagnosed during a 15-year period (2003-17) those in which a paired set of blood cultures drawn from a catheter and a peripheral vein were positive for the same microorganism and had a clinically and/or microbiologically defined source were selected. To assess diagnostic discrimination ability and accuracy of DTP for CRBSI, area under the receiver operating characteristic curves (AUC) and performance characteristics of a DTP ≥2 h were computed. RESULTS A total of 512 BSI were included, of which 302 (59%) were CRBSI. Discrimination ability of DTP was low for Staphylococcus aureus (AUC 0.656 ± 0.06), coagulase-negative staphylococci (AUC 0.618 ± 0.081), enterococci (AUC 0.554 ± 0.117) and non-AmpC-producing Enterobacteriaceae (AUC 0.653 ± 0.053); moderate for Pseudomonas aeruginosa (AUC 0.841 ± 0.073), and high for AmpC-producing Enterobacteriaceae (AUC 0.944 ± 0.039). For the entire sample, DTP had a low-to-moderate discrimination ability (AUC 0.698 ± 0.024). A DTP ≥2 h has a low sensitivity for coagulase-negative staphylococci (60%) and very low for S. aureus (34%), enterococci (40%) and non-AmpC-producing Enterobacteriaceae (42%). A DTP cut-off of 1 h improved sensitivity (90%) for AmpC-producing Enterobacteriaceae. CONCLUSIONS Differential time to positivity performs well for diagnosing CRBSI only when AmpC-producing Enterobacteriaceae and P. aeruginosa are involved. Performance is low for common Gram-positive organisms and non-AmpC-producing enteric bacilli; a negative test should not be used to rule out CRBSI due to these microorganisms. A DTP ≥1 h may improve accuracy for AmpC-producing Enterobacteriaceae, particularly Enterobacter spp.
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Affiliation(s)
- J Orihuela-Martín
- Service of Internal Medicine, Insular University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | - O Rodríguez-Núñez
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - L Morata
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - C Cardozo
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - P Puerta-Alcalde
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Hernández-Meneses
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - J Ambrosioni
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - L Linares
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Bodro
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M de Los Angeles Guerrero-León
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - A Del Río
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - C Garcia-Vidal
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Almela
- Service of Microbiology, ISGlobal, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - C Pitart
- Service of Microbiology, ISGlobal, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - F Marco
- Service of Microbiology, ISGlobal, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Soriano
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - J A Martínez
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Chau I, Bendell J, Soriano A, Arkenau H, Cultrera J, Santana-Davila R, Calvo E, Tourneau CL, Zender L, Mi G, Schelman W, Ferry D, Herbst R, Fuchs C. Safety and antitumor activity from the phase Ib study of ramucirumab plus pembrolizumab in treatment-naïve advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma (JVDF). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz157.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Arora E, Soriano A, Sansone S, Arya L, Andy U. 41: Contaminated mid-stream urine specimens in women with pelvic organ prolapse. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.01.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Puerta-Alcalde P, Cardozo C, Suárez-Lledó M, Rodríguez-Núñez O, Morata L, Fehér C, Marco F, Del Río A, Martínez JA, Mensa J, Rovira M, Esteve J, Soriano A, Garcia-Vidal C. Current time-to-positivity of blood cultures in febrile neutropenia: a tool to be used in stewardship de-escalation strategies. Clin Microbiol Infect 2018; 25:447-453. [PMID: 30096417 DOI: 10.1016/j.cmi.2018.07.026] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/19/2018] [Accepted: 07/21/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVES We aimed to describe the current time-to-positivity (TTP) of blood cultures in individuals with onco-haematological diseases with febrile neutropenia. We assessed the probability of having a multidrug-resistant Gram-negative bacilli (MDR-GNB) bloodstream infection (BSI) 24 h after cultures were taken, to use this information for antibiotic de-escalation strategies. METHODS BSI episodes were prospectively collected (2003-2017). When a patient experienced more than one BSI, only one episode was randomly chosen. Time elapsed from the beginning of incubation to a positive reading was observed; TTP was recorded when the first bottle had a positive result. RESULTS Of the 850 patient-unique episodes, 323 (38%) occurred in acute leukaemia, 185 (21.8%) in non-Hodgkin's lymphoma and 144 (16.9%) in solid neoplasms. Coagulase-negative staphylococci (225; 26.5%), Escherichia coli (207; 26.1%), Pseudomonas aeruginosa (136; 16%), Enterococcus spp. (81; 9.5%) and Klebsiella pneumoniae (67; 7.9%), were the most frequent microorganisms isolated. MDR-GNB were documented in 126 (14.8%) episodes. Median TTP was 12 h (interquartile range 9-16.5 h). Within the first 24 h, 92.1% of blood cultures were positive (783/850). No MDR-GNB was positive over 24 h. Of the 67 (7.9%) episodes with a TTP ≥24 h, 25 (37.3%) occurred in patients who were already receiving active antibiotics against the isolated pathogen. Most common isolations with TTP ≥24 h were coagulase-negative staphylococci, candidaemia and a group of anaerobic GNB. CONCLUSIONS Currently, the vast majority of BSI in individuals with onco-haematological diseases with febrile neutropenia have a TTP <24 h, including all episodes caused by MDR-GNB. Our results support reassessing empiric antibiotic treatment in neutropenic patients at 24 h, to apply antibiotic stewardship de-escalation strategies.
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Affiliation(s)
- P Puerta-Alcalde
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - C Cardozo
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - M Suárez-Lledó
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - O Rodríguez-Núñez
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - L Morata
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - C Fehér
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - F Marco
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Microbiology Department, Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain
| | - A Del Río
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - J A Martínez
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - J Mensa
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - M Rovira
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - J Esteve
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - A Soriano
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - C Garcia-Vidal
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain.
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Masanas M, Soriano A, Boloix A, Masiá N, Jimenez C, Roma J, Sánchez de Toledo J, Santamaria A, Gallego S, Segura M. PO-353 Functional high-throughput screening reveals multiple tumour-suppressive microRNAs in neuroblastoma. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Soriano A, Alañón ME, Alarcón M, García-Ruíz A, Díaz-Maroto MC, Pérez-Coello MS. Oak wood extracts as natural antioxidants to increase shelf life of raw pork patties in modified atmosphere packaging. Food Res Int 2018; 111:524-533. [PMID: 30007715 DOI: 10.1016/j.foodres.2018.05.055] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/02/2018] [Accepted: 05/21/2018] [Indexed: 12/31/2022]
Abstract
The use of antioxidants and refrigeration storage in modified atmosphere packaging, MAP, are the main strategies to slow down the oxidative and microbial deterioration of fresh meat. Synthetic antioxidants are commonly used for this purpose, however due to their controversial health effects, natural alternatives for their replacement are being looked for. The main aim of this work is the evaluation of pressurised aqueous extracts from oak wood as natural preservative of pork patties. The effect of different amounts of oak wood extracts (0.05, 0.5 and 1.0%) on the self-life of pork patties packed in MAP in refrigeration during 12 days were studied in comparison with the use of sodium ascorbate as synthetic preservative. Samples treated with oak wood extracts showed lower lipid oxidation, higher antioxidant capacity and an inhibitory effect on the enterobacteria growth. Furthermore, the addition of oak wood extracts resulted in a dramatically decrease of the volatile compounds coming from the lipid oxidation reactions. On the other hand, it is noteworthy that the use of oak wood extracts modified sensorial characteristics. Intensity colour was higher and new sensorial features such as oak wood and sweet spices appeared which were well appreciated.
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Affiliation(s)
- A Soriano
- Area of Food Technology, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain
| | - M E Alañón
- Regional Institute for Applied Scientific Research (IRICA), University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain.
| | - M Alarcón
- Area of Food Technology, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain
| | - A García-Ruíz
- Area of Food Technology, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain
| | - M C Díaz-Maroto
- Area of Food Technology, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain; Regional Institute for Applied Scientific Research (IRICA), University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain
| | - M S Pérez-Coello
- Area of Food Technology, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain
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Gonçalves-Ribeiro S, Sanz-Pamplona R, Vidal A, Sanjuan X, Guillen Díaz-Maroto N, Soriano A, Guardiola J, Albert N, Martínez-Villacampa M, López I, Santos C, Serra-Musach J, Salazar R, Capellà G, Villanueva A, Molleví DG. Prediction of pathological response to neoadjuvant treatment in rectal cancer with a two-protein immunohistochemical score derived from stromal gene-profiling. Ann Oncol 2018; 28:2160-2168. [PMID: 28911071 DOI: 10.1093/annonc/mdx293] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Preoperative chemoradiotherapy followed by surgical mesorectal resection is the standard of care for locally advanced rectal carcinomas. Yet, predicting that patients will respond to treatment remains an unmet clinical challenge. Experimental design Using laser-capture microdissection we isolated RNA from stroma and tumour glands from prospective pre-treatment samples (n = 15). Transcriptomic profiles were obtained hybridising PrimeView Affymetrix arrays. We modelled a carcinoma-associated fibroblast-specific genes filtering data using GSE39396. Results The analysis of differentially expressed genes of stroma/tumour glands from responder and non-responder patients shows that most changes were associated with the stromal compartment; codifying mainly for extracellular matrix and ribosomal components. We built a carcinoma-associated fibroblast (CAF) specific classifier with genes showing changes in expression according to the tumour regression grade (FN1, COL3A1, COL1A1, MMP2 and IGFBP5). We assessed these five genes at the protein level by means of immunohistochemical staining in a patient's cohort (n = 38). For predictive purposes we used a leave-one-out cross-validated model with a positive predictive value (PPV) of 83.3%. Random Forest identified FN1 and COL3A1 as the best predictors. Rebuilding the leave-one-out cross-validated regression model improved the classification performance with a PPV of 93.3%. An independent cohort was used for classifier validation (n = 36), achieving a PPV of 88.2%. In a multivariate analysis, the two-protein classifier proved to be the only independent predictor of response. Conclusion We developed a two-protein immunohistochemical classifier that performs well at predicting the non-response to neoadjuvant treatment in rectal cancer.
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Affiliation(s)
| | - R Sanz-Pamplona
- Program of Prevention and Cancer Control, Biomarkers Unit, Catalan Institute of Oncology
| | | | | | | | - A Soriano
- Department of Gastroenterology Endoscopy Unit, Hospital Universitari de Bellvitge
| | - J Guardiola
- Department of Gastroenterology Endoscopy Unit, Hospital Universitari de Bellvitge
| | - N Albert
- Program Against Cancer Therapeutic Resistance
| | | | - I López
- Department of Medical Oncology
| | | | | | | | - G Capellà
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Catalonia, Spain
| | | | - D G Molleví
- Program Against Cancer Therapeutic Resistance
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Soriano A, Allende MT, Vizoso F, Fernández García J, Vivanco J, Ruibal A. MCA and CA 15.3 Serum Levels in Non-malignant Diseases. Some Preliminary Results. Int J Biol Markers 2018; 5:46-7. [PMID: 2230351 DOI: 10.1177/172460089000500110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Seimetz M, Bellido P, García P, Mur P, Iborra A, Soriano A, Hülber T, García López J, Jiménez-Ramos MC, Lera R, Ruiz-de la Cruz A, Sánchez I, Zaffino R, Roso L, Benlloch JM. Spectral characterization of laser-accelerated protons with CR-39 nuclear track detector. Rev Sci Instrum 2018; 89:023302. [PMID: 29495831 DOI: 10.1063/1.5009587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
CR-39 nuclear track material is frequently used for the detection of protons accelerated in laser-plasma interactions. The measurement of track densities allows for determination of particle angular distributions, and information on the kinetic energy can be obtained by the use of passive absorbers. We present a precise method of measuring spectral distributions of laser-accelerated protons in a single etching and analysis process. We make use of a one-to-one relation between proton energy and track size and present a precise calibration based on monoenergetic particle beams. While this relation is limited to proton energies below 1 MeV, we show that the range of spectral measurements can be significantly extended by simultaneous use of absorbers of suitable thicknesses. Examples from laser-plasma interactions are presented, and quantitative results on proton energies and particle numbers are compared to those obtained from a time-of-flight detector. The spectrum end points of continuous energy distributions have been determined with both detector types and coincide within 50-100 keV.
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Affiliation(s)
- M Seimetz
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - P Bellido
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - P García
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - P Mur
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - A Iborra
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - A Soriano
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - T Hülber
- Radosys Kft., Vegyész u. 17-27, 1116 Budapest, Hungary
| | - J García López
- Departamento Física Atómica, Molecular y Nuclear, Universidad de Sevilla, Av. Reina Mercedes s/n, 41012 Sevilla, Spain
| | - M C Jiménez-Ramos
- Centro Nacional de Aceleradores (CNA), U. Sevilla-J. Andalucía-CSIC, Avda. Thomas Alva Edison 7, 41092 Sevilla, Spain
| | - R Lera
- Proton Laser Applications S.L. (PLA), Avda. Vilafranca del Penedès 11, 08734 Olèrdola, Spain
| | - A Ruiz-de la Cruz
- Proton Laser Applications S.L. (PLA), Avda. Vilafranca del Penedès 11, 08734 Olèrdola, Spain
| | - I Sánchez
- Proton Laser Applications S.L. (PLA), Avda. Vilafranca del Penedès 11, 08734 Olèrdola, Spain
| | - R Zaffino
- Instituto de Microelectrónica de Barcelona (IMB-CNM, CSIC), C/ dels Til.lers Campus UAB, 08193 Cerdanyola del Vallès (Barcelona), Spain
| | - L Roso
- Centro de Láseres Pulsados (CLPU), Calle del Adaja, 37185 Villamayor, Spain
| | - J M Benlloch
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
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De la Calle C, Ternavasio-de la Vega HG, Morata L, Marco F, Cardozo C, García-Vidal C, Del Rio A, Cilloniz C, Torres A, Martínez JA, Mensa J, Soriano A. Effectiveness of combination therapy versus monotherapy with a third-generation cephalosporin in bacteraemic pneumococcal pneumonia: A propensity score analysis. J Infect 2018; 76:342-347. [PMID: 29360520 DOI: 10.1016/j.jinf.2018.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Combining a macrolide or a fluoroquinolone to beta-lactam regimens in the treatment of patients with moderate to severe community-acquired pneumonia is recommended by the international guidelines. However, the information in patients with bacteraemic pneumococcal pneumonia is limited. METHODS A propensity score technique was used to analyze prospectively collected data from all patients with bacteraemic pneumococcal pneumonia admitted from 2000 to 2015 in our institution, who had received empirical treatment with third-generation cephalosporin in monotherapy or plus macrolide or fluoroquinolone. RESULTS We included 69 patients in the monotherapy group and 314 in the combination group. After adjustment by PS for receiving monotherapy, 30-day mortality (OR 2.89; 95% CI 1.07-7.84) was significantly higher in monotherapy group. A higher 30-day mortality was observed in monotherapy group in both 1:1 and 1:2 matched samples although it was statistically significant only in 1:2 sample (OR: 3.50 (95% CI 1.03-11.96), P = 0.046). CONCLUSIONS Our study suggests that in bacteraemic pneumococcal pneumonia, empirical therapy with a third-generation cephalosporin plus a macrolide or a fluoroquinolone is associated with a lower mortality rate than beta-lactams in monotherapy. These results support the recommendation of combination therapy in patients requiring admission with moderate to severe disease.
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Affiliation(s)
- C De la Calle
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain.
| | | | - L Morata
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - F Marco
- Department of Microbiology, Hospital Clínic Barcelona, Barcelona, Spain
| | - C Cardozo
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - C García-Vidal
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - A Del Rio
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - C Cilloniz
- Department of Pneumology, Hospital Clinic of Barcelona, University of Barcelona (UB), Barcelona, Spain
| | - A Torres
- Department of Pneumology, Hospital Clinic of Barcelona, University of Barcelona (UB), Barcelona, Spain
| | - J A Martínez
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - J Mensa
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - A Soriano
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
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Oliver L, Candela-Juan C, Palma J, Pujades M, Soriano A, Vilar J, Martínez J, Mestre V, Ruiz-Rodríguez J, Llorca-Domaica N. Comparison of the dosimetric response of 4-elements OSL and TL passive personal dosimeters. RADIAT MEAS 2017. [DOI: 10.1016/j.radmeas.2017.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Yahlali N, Garcia JM, Díaz J, Soriano A, Fernandes LMP. Ageing studies of TPB in noble gas detectors for dark matter and neutrinoless ββ decay searches. Spectrochim Acta A Mol Biomol Spectrosc 2017; 172:109-114. [PMID: 27160970 DOI: 10.1016/j.saa.2016.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 03/03/2016] [Accepted: 04/08/2016] [Indexed: 06/05/2023]
Abstract
Noble gases (Xe, Ar, Kr) are very attractive as detector media in Dark Matter search and neutrinoless double-beta decay experiments. However, the detection of their scintillation light (in the VUV spectral region) requires shifting the VUV light to visible light, where standard photosensors are more efficient. Tetraphenyl butadiene (TPB) is widely used as wavelength shifter, absorbing the VUV light and re-emitting in the blue region (~430nm). TPB is an organic molecule that may degrade due to exposure to environmental agents and also to ultraviolet light. In this work, we present TPB ageing studies due to exposure to VUV light, aiming at quantifying the reduction of the absolute fluorescence yield of TPB coatings of several thicknesses (130nm, 260nm, 390nm, 1600nm), exposed to various doses of VUV light at 170nm (similar to the Xe scintillation). In our setup, the VUV light is produced from a vacuum monochromator coupled to a deuterium lamp. The VUV exposure in our setup is compared to the exposure obtained in the electroluminescent gaseous Xe TPC of the NEXT-100 experiment for neutrinoless double-beta decay search.
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Affiliation(s)
- N Yahlali
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Catedrático José Beltrán 2, 46980 Paterna, Valencia, Spain.
| | - J M Garcia
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Catedrático José Beltrán 2, 46980 Paterna, Valencia, Spain
| | - J Díaz
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Catedrático José Beltrán 2, 46980 Paterna, Valencia, Spain
| | - A Soriano
- Instituto de Ciencia Molecular (ICMOL), Universitat de València, Catedrático José Beltrán 2, 46980 Paterna, Valencia, Spain
| | - L M P Fernandes
- LIBPhys, Department of Physics, University of Coimbra, 3004-516 Coimbra, Portugal
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Cobos-Triguero N, Zboromyrska Y, Morata L, Alejo I, De La Calle C, Vergara A, Cardozo C, Arcas MP, Soriano A, Marco F, Mensa J, Almela M, Martínez JA. Time-to-positivity, type of culture media and oxidase test performed on positive blood culture vials to predict Pseudomonas aeruginosa in patients with Gram-negative bacilli bacteraemia. Rev Esp Quimioter 2017; 30:9-13. [PMID: 27897434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The aim of this study was to determine the usefulness of oxidase test and time-to-positivity (TTP) in aerobic and anaerobic blood culture vials to detect the presence of Pseudomonas aeruginosa in patients with Gram-negative bacilli (GNB) bacteraemia. METHODS TTP was recorded for each aerobic and anaerobic blood culture vial of monomicrobial bacteraemia due to GNB. Oxidase test was performed in a pellet of the centrifuged content of the positive blood culture. An algorithm was developed in order to perform the oxidase test efficiently taking into account TTP and type of vial. RESULTS A total of 341 episodes of GNB bacteraemia were analysed. Sensitivity, specificity, positive predictive value and negative predictive value of the oxidase test performed on positive vials with GNB to predict P. aeruginosa were 95%, 99%, 91%, and 99%, respectively. When growth was first or exclusively detected in anaerobic vials, P. aeruginosa was never identified hence the performance of the oxidase test could be avoided. When growth was only or first detected in aerobic vials, a TTP≥8h predicted P. aeruginosa in 37% or cases (63 of 169), therefore oxidase test is highly recommended. CONCLUSIONS Oxidase test performed onto positive blood culture vials previously selected by TTP and type of vials is an easy and inexpensive way to predict P. aeruginosa. In most cases, this can lead to optimization of treatment in less than 24 hours.
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Affiliation(s)
- N Cobos-Triguero
- Nazaret Cobos-Trigueros. Department of Infectious Diseases, Hospital Clínic. Villarroel 170, 08036, Barcelona, Spain.
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Zarzosa P, Navarro N, Giralt I, Molist C, Almazán-Moga A, Vidal I, Soriano A, Segura MF, Hladun R, Villanueva A, Gallego S, Roma J. Patient-derived xenografts for childhood solid tumors: a valuable tool to test new drugs and personalize treatments. Clin Transl Oncol 2016; 19:44-50. [PMID: 27718156 DOI: 10.1007/s12094-016-1557-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 09/22/2016] [Indexed: 12/23/2022]
Abstract
The use of preclinical models is essential in translational cancer research and especially important in pediatric cancer given the low incidence of each particular type of cancer. Cell line cultures have led to significant advances in cancer biology. However, cell lines have adapted to growth in artificial culture conditions, thereby undergoing genetic and phenotypic changes which may hinder the translational application. Tumor grafts developed in mice from patient tumor tissues, generally known as patient-derived xenografts (PDXs), are interesting alternative approaches to reproducing the biology of the original tumor. This review is focused on highlighting the interest of PDX models in pediatric cancer research and supporting strategies of personalized medicine. This review provides: (1) a description of the background of PDX in cancer, (2) the particular case of PDX in pediatric cancer, (3) how PDX can improve personalized medicine strategies, (4) new methods to increase engraftment, and, finally, (5) concluding remarks.
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Affiliation(s)
- P Zarzosa
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Navarro
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Giralt
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Molist
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Almazán-Moga
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Vidal
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Soriano
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M F Segura
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Hladun
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Villanueva
- Chemoresistance and Predicitive Factors Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Xenopat S.L. Business Bioincubator Bellvitge Health Science Campus, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - S Gallego
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Roma
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain.
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Purrello SM, Garau J, Giamarellos E, Mazzei T, Pea F, Soriano A, Stefani S. Methicillin-resistant Staphylococcus aureus infections: A review of the currently available treatment options. J Glob Antimicrob Resist 2016; 7:178-186. [PMID: 27889013 DOI: 10.1016/j.jgar.2016.07.010] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 07/03/2016] [Accepted: 07/16/2016] [Indexed: 12/16/2022] Open
Abstract
This review is the result of discussions that took place at the 5th MRSA Working Group Consensus Meeting and explores the possible treatment options available for different types of infections due to methicillin-resistant Staphylococcus aureus (MRSA), focusing on those antibiotics that could represent a valid alternative to vancomycin. In fact, whilst vancomycin remains a viable option, its therapy is moving towards individualised dosing. Other drugs, such as the new lipoglycopeptides (oritavancin, dalbavancin and telavancin) and fifth-generation cephalosporins (ceftaroline and ceftobiprole), are showing good in vitro potency and in vivo efficacy, especially for patients infected with micro-organisms with higher vancomycin minimum inhibitory concentrations (MICs). Tedizolid is an attractive agent for use both in hospital and community settings, but the post-marketing data will better clarify its potential. Daptomycin and linezolid have shown non-inferiority to vancomycin in the treatment of MRSA bacteraemia and non-inferiority/superiority to vancomycin in the treatment of hospital-acquired pneumonia. Thus, several options are available, but more data from clinical practice, especially for invasive infections, are needed to assign specific roles to each antibiotic and to definitely include them in the new antibacterial armamentarium.
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Affiliation(s)
- S M Purrello
- Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMAR Lab), Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - J Garau
- Department of Medicine, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - E Giamarellos
- 4th Department of Internal Medicine, Attikon University Hospital, Athens, Greece
| | - T Mazzei
- Department of Health Sciences, Clinical Pharmacology and Oncology Section, University of Firenze, Firenze, Italy
| | - F Pea
- Institute of Clinical Pharmacology, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy; Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
| | - A Soriano
- Department of Infectious Diseases, IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain
| | - S Stefani
- Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMAR Lab), Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
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Oliver L, Candela C, Palma J, Pujades M, Soriano A, Alabau J, Martínez J, Mestre V, Ruiz J, Vilar J, Llorca N. Comparison of the dosimetric response of 4-element BeOSL and TLD-100 passive personal dosimeters. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Benito N, Franco M, Ribera A, Soriano A, Rodriguez-Pardo D, Sorlí L, Fresco G, Fernández-Sampedro M, Dolores Del Toro M, Guío L, Sánchez-Rivas E, Bahamonde A, Riera M, Esteban J, Baraia-Etxaburu JM, Martínez-Alvarez J, Jover-Sáenz A, Dueñas C, Ramos A, Sobrino B, Euba G, Morata L, Pigrau C, Coll P, Mur I, Ariza J. Time trends in the aetiology of prosthetic joint infections: a multicentre cohort study. Clin Microbiol Infect 2016; 22:732.e1-8. [PMID: 27181408 DOI: 10.1016/j.cmi.2016.05.004] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/24/2016] [Accepted: 05/03/2016] [Indexed: 02/05/2023]
Abstract
It is important to know the spectrum of the microbial aetiology of prosthetic joint infections (PJIs) to guide empiric treatment and establish antimicrobial prophylaxis in joint replacements. There are no available data based on large contemporary patient cohorts. We sought to characterize the causative pathogens of PJIs and to evaluate trends in the microbial aetiology. We hypothesized that the frequency of antimicrobial-resistant organisms in PJIs has increased in the recent years. We performed a cohort study in 19 hospitals in Spain, from 2003 to 2012. For each 2-year period (2003-2004 to 2011-2012), the incidence of microorganisms causing PJIs and multidrug-resistant bacteria was assessed. Temporal trends over the study period were evaluated. We included 2524 consecutive adult patients with a diagnosis of PJI. A microbiological diagnosis was obtained for 2288 cases (90.6%). Staphylococci were the most common cause of infection (1492, 65.2%). However, a statistically significant rising linear trend was observed for the proportion of infections caused by Gram-negative bacilli, mainly due to the increase in the last 2-year period (25% in 2003-2004, 33.3% in 2011-2012; p 0.024 for trend). No particular species contributed disproportionally to this overall increase. The percentage of multidrug-resistant bacteria PJIs increased from 9.3% in 2003-2004 to 15.8% in 2011-2012 (p 0.008), mainly because of the significant rise in multidrug-resistant Gram-negative bacilli (from 5.3% in 2003-2004 to 8.2% in 2011-2012; p 0.032). The observed trends have important implications for the management of PJIs and prophylaxis in joint replacements.
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Affiliation(s)
- N Benito
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau-Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Spain; Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain.
| | - M Franco
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau-Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Spain
| | - A Ribera
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitari Bellvitge, Barcelona, Spain
| | - A Soriano
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Clínic Universitari, Barcelona, Spain
| | - D Rodriguez-Pardo
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - L Sorlí
- Department of Infectious Diseases, Hospital del Mar, Barcelona, Spain
| | - G Fresco
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Fernández-Sampedro
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitario Valdecilla, Santander, Spain
| | - M Dolores Del Toro
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - L Guío
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitario Cruces, Bilbao, Spain
| | - E Sánchez-Rivas
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - A Bahamonde
- Department of Internal Medicine-Infectious Diseases, Hospital el Bierzo, León, Spain
| | - M Riera
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Infectious Diseases Unit, Department of Infectious Diseases, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - J Esteban
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | | | - J Martínez-Alvarez
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Jover-Sáenz
- Unit of Nosocomial Infection, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - C Dueñas
- Department of Internal Medicine, Hospital Universitario de Burgos, Burgos, Spain
| | - A Ramos
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - B Sobrino
- Department of Infectious Diseases, Hospital Regional Universitario Málaga, Málaga, Spain
| | - G Euba
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitari Bellvitge, Barcelona, Spain
| | - L Morata
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Clínic Universitari, Barcelona, Spain
| | - C Pigrau
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - P Coll
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Microbiology, Hospital de la Santa Creu i Sant Pau-Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - I Mur
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau-Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - J Ariza
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitari Bellvitge, Barcelona, Spain
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Majem B, Parrilla A, Soriano A, Gil-Moreno A, Segura M, Santamaria A. Functional characterization of a tumor suppressor micro-RNA in ovarian cancer. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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