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Permuy C, Ruiz-Azcárate J, Sampedro M, Jiménez C, Baquero-Artigao F, Calvo C, Méndez-Echevarría A. Usefulness of daptomycin lock therapy in children with catheter-related bacteremia after failed vancomycin lock therapy. Ann Clin Microbiol Antimicrob 2023; 22:48. [PMID: 37349770 DOI: 10.1186/s12941-023-00604-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/16/2023] [Indexed: 06/24/2023] Open
Abstract
PURPOSE Catheter-related bacteremia (CRB) is a significant cause of morbidity, resource expenditure and prolonged hospital stays in patients with long-term catheters, whose numbers have increased considerably in recent years. Antibiotic lock therapy reaches high concentrations in the catheter, allowing good penetration into the biofilm, being vancomycin the most commonly used one in gram-positive infections. Several authors have recently reported the superior in vitro efficacy of daptomycin compared with vancomycin, especially for eradicating biofilms. Although there is some data on the use of daptomycin for antibiotic lock in animal models and adults, there are no data on its use in children. METHODS A descriptive study was conducted in a tertiary hospital, including patients younger than 16 years in whom daptomycin lock therapy was employed between 2018 and 2022. RESULTS We report three pediatric patients in whom CRB was confirmed on admission by paired blood cultures positive for CoNS sensitive to vancomycin, daptomycin and linezolid. All patients started vancomycin lock therapy and systemic antibiotic therapy with proven sensitivity for the isolated bacteria, without achieving negative blood cultures. Due to the persistence of positive cultures, vancomycin lock therapy was replaced by daptomycin, and blood cultures turned negative, with no relapses or need for catheter removal. CONCLUSION The use of daptomycin lock therapy could be considered in children with CoNS catheter infection, especially when other antibiotic lock therapy had failed.
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Affiliation(s)
- Celia Permuy
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain
| | - Jone Ruiz-Azcárate
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain
| | - Mercedes Sampedro
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain
| | - Cristina Jiménez
- Department of Pharmacology, Hospital Universitario La Paz, Madrid, Spain
| | - Fernando Baquero-Artigao
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Institute for Health Research IdiPAZ. CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Calvo
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Institute for Health Research IdiPAZ. CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Méndez-Echevarría
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain.
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Institute for Health Research IdiPAZ. CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain.
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Simón E, Permuy C, Sacristán L, Zamoro-Lorenci MJ, Villalaín C, Galindo A, Herraiz I. sFlt-1/PlGF ratio for the prediction of delivery within 48 hours and adverse outcomes in expectantly managed early-onset preeclampsia. Pregnancy Hypertens 2020; 22:17-23. [PMID: 32707515 DOI: 10.1016/j.preghy.2020.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 05/19/2020] [Revised: 06/15/2020] [Accepted: 07/10/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To analyze if sFlt-1/PlGF ratio is more useful than other parameters at diagnosis of early-onset (<34 weeks) preeclampsia (PE) in the prediction of delivery within 48 h and adverse maternal and perinatal outcomes. METHOD Observational retrospective study of a cohort of 76 singleton pregnancies with early-onset PE and expectant management. The predictive value of sFlt-1/PlGF ratio, blood pressure, proteinuria, creatinine, liver enzymes and platelets at diagnosis for delivery < 48 h and adverse outcomes was determined. RESULTS Maternal and perinatal adverse outcomes occurred in 25/76 (32.9%) cases and 13/69 (18.8%) livebirths, respectively. Areas under the curve (AUC) for sFlt-1/PlGF ratio were 0.59 (95%CI 0.42-0.75) and 0.75 (95%CI 0.62-0.88) for maternal and perinatal complications, respectively. Mean (standard deviation) time to delivery for a sFlt-1/PlGF ratio > 655 vs. ≤ 655 was of 4.4 (7.5) vs. 12.1 (9.3) days, p < 0.01. Relative risk for delivery within 48 h for a sFlt-1/PlGF ratio > 655 was 5.3 (95% confidence interval 2.7-10.6), p < 0.01. CONCLUSIONS sFlt-1/PlGF ratio > 655 at diagnosis was associated with a 5-fold increased risk of delivery in ≤ 48 h. None of the parameters were good predictors of adverse maternal or perinatal outcomes.
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Affiliation(s)
- Elisa Simón
- Fetal Medicine Unit, Maternal and Child Health and Development Network (Red SAMID-RD12/0026/0016), Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital, 12 de Octubre (imas12). Av. de Córdoba, s/n, 28041 Madrid, Spain; Universidad Complutense de Madrid, Av. Séneca, 2, 28040 Madrid, Spain
| | - Celia Permuy
- Fetal Medicine Unit, Maternal and Child Health and Development Network (Red SAMID-RD12/0026/0016), Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital, 12 de Octubre (imas12). Av. de Córdoba, s/n, 28041 Madrid, Spain; Universidad Complutense de Madrid, Av. Séneca, 2, 28040 Madrid, Spain.
| | - Laura Sacristán
- Fetal Medicine Unit, Maternal and Child Health and Development Network (Red SAMID-RD12/0026/0016), Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital, 12 de Octubre (imas12). Av. de Córdoba, s/n, 28041 Madrid, Spain; Universidad Complutense de Madrid, Av. Séneca, 2, 28040 Madrid, Spain.
| | - María José Zamoro-Lorenci
- Fetal Medicine Unit, Maternal and Child Health and Development Network (Red SAMID-RD12/0026/0016), Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital, 12 de Octubre (imas12). Av. de Córdoba, s/n, 28041 Madrid, Spain; Universidad Complutense de Madrid, Av. Séneca, 2, 28040 Madrid, Spain.
| | - Cecilia Villalaín
- Fetal Medicine Unit, Maternal and Child Health and Development Network (Red SAMID-RD12/0026/0016), Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital, 12 de Octubre (imas12). Av. de Córdoba, s/n, 28041 Madrid, Spain; Universidad Complutense de Madrid, Av. Séneca, 2, 28040 Madrid, Spain
| | - Alberto Galindo
- Fetal Medicine Unit, Maternal and Child Health and Development Network (Red SAMID-RD12/0026/0016), Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital, 12 de Octubre (imas12). Av. de Córdoba, s/n, 28041 Madrid, Spain; Universidad Complutense de Madrid, Av. Séneca, 2, 28040 Madrid, Spain.
| | - Ignacio Herraiz
- Fetal Medicine Unit, Maternal and Child Health and Development Network (Red SAMID-RD12/0026/0016), Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital, 12 de Octubre (imas12). Av. de Córdoba, s/n, 28041 Madrid, Spain; Universidad Complutense de Madrid, Av. Séneca, 2, 28040 Madrid, Spain.
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