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López-Cortés LE, Delgado-Valverde M, Moreno-Mellado E, Goikoetxea Aguirre J, Guio Carrión L, Blanco Vidal MJ, López Soria LM, Pérez-Rodríguez MT, Martínez Lamas L, Arnaiz de Las Revillas F, Armiñanzas C, Ruiz de Alegría-Puig C, Jiménez Aguilar P, Del Carmen Martínez-Rubio M, Sáez-Bejar C, de Las Cuevas C, Martín-Aspas A, Galán F, Yuste JR, Leiva-León J, Bou G, Capón González P, Boix-Palop L, Xercavins-Valls M, Goenaga-Sánchez MÁ, Anza DV, Castón JJ, Rufián MR, Merino E, Rodríguez JC, Loeches B, Cuervo G, Guerra Laso JM, Plata A, Pérez Cortés S, López Mato P, Sierra Monzón JL, Rosso-Fernández C, Bravo-Ferrer JM, Retamar-Gentil P, Rodríguez-Baño J. Efficacy and safety of a structured de-escalation from antipseudomonal β-lactams in bloodstream infections due to Enterobacterales (SIMPLIFY): an open-label, multicentre, randomised trial. Lancet Infect Dis 2024; 24:375-385. [PMID: 38215770 DOI: 10.1016/s1473-3099(23)00686-2] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND De-escalation from broad-spectrum to narrow-spectrum antibiotics is considered an important measure to reduce the selective pressure of antibiotics, but a scarcity of adequate evidence is a barrier to its implementation. We aimed to determine whether de-escalation from an antipseudomonal β-lactam to a narrower-spectrum drug was non-inferior to continuing the antipseudomonal drug in patients with Enterobacterales bacteraemia. METHODS An open-label, pragmatic, randomised trial was performed in 21 Spanish hospitals. Patients with bacteraemia caused by Enterobacterales susceptible to one of the de-escalation options and treated empirically with an antipseudomonal β-lactam were eligible. Patients were randomly assigned (1:1; stratified by urinary source) to de-escalate to ampicillin, trimethoprim-sulfamethoxazole (urinary tract infections only), cefuroxime, cefotaxime or ceftriaxone, amoxicillin-clavulanic acid, ciprofloxacin, or ertapenem in that order according to susceptibility (de-escalation group), or to continue with the empiric antipseudomonal β-lactam (control group). Oral switching was allowed in both groups. The primary outcome was clinical cure 3-5 days after end of treatment in the modified intention-to-treat (mITT) population, formed of patients who received at least one dose of study drug. Safety was assessed in all participants. Non-inferiority was declared when the lower bound of the 95% CI of the absolute difference in cure rate was above the -10% non-inferiority margin. This trial is registered with EudraCT (2015-004219-19) and ClinicalTrials.gov (NCT02795949) and is complete. FINDINGS 2030 patients were screened between Oct 5, 2016, and Jan 23, 2020, of whom 171 were randomly assigned to the de-escalation group and 173 to the control group. 164 (50%) patients in the de-escalation group and 167 (50%) in the control group were included in the mITT population. 148 (90%) patients in the de-escalation group and 148 (89%) in the control group had clinical cure (risk difference 1·6 percentage points, 95% CI -5·0 to 8·2). The number of adverse events reported was 219 in the de-escalation group and 175 in the control group, of these, 53 (24%) in the de-escalation group and 56 (32%) in the control group were considered severe. Seven (5%) of 164 patients in the de-escalation group and nine (6%) of 167 patients in the control group died during the 60-day follow-up. There were no treatment-related deaths. INTERPRETATION De-escalation from an antipseudomonal β-lactam in Enterobacterales bacteraemia following a predefined rule was non-inferior to continuing the empiric antipseudomonal drug. These results support de-escalation in this setting. FUNDING Plan Nacional de I+D+i 2013-2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases; Spanish Clinical Research and Clinical Trials Platform, co-financed by the EU; European Development Regional Fund "A way to achieve Europe", Operative Program Intelligence Growth 2014-2020.
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Affiliation(s)
- Luis Eduardo López-Cortés
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.
| | - Mercedes Delgado-Valverde
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Elisa Moreno-Mellado
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | | | - Laura Guio Carrión
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Cruces, Barakaldo, Spain
| | | | | | - María Teresa Pérez-Rodríguez
- Servicio de Medicina Interna, Complexo Hospitalario Universitario de Vigo (CHUVI), Xerencia de Xestión Integrada de Vigo, Spain
| | - Lucía Martínez Lamas
- Grupo de Investigación de Microbiología y Enfermedades Infecciosas, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), CHUVI, Vigo, Spain
| | - Francisco Arnaiz de Las Revillas
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain; Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - Carlos Armiñanzas
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain; Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - Carlos Ruiz de Alegría-Puig
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain; Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | - Carmen Sáez-Bejar
- Servicio de Medicina Interna, Hospital Universitario de la Princesa, Madrid, Spain
| | | | - Andrés Martín-Aspas
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Facultad de Medicina, Hospital Universitario Puerta del Mar, Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Fátima Galán
- Servicio de Microbiología, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - José Ramón Yuste
- Servicio de Enfermedades Infecciosas, Clínica Universitaria de Navarra, Pamplona, Spain
| | - José Leiva-León
- Servicio de Microbiología, Clínica Universitaria de Navarra, Pamplona, Spain
| | - Germán Bou
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain; Servicio de Microbiología-Instituto de Investigación Biomédica, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | - Lucía Boix-Palop
- Servicio de Enfermedades Infecciosas, Hospital Universitario Mútua de Terrassa, Barcelona, Spain
| | | | | | - Diego Vicente Anza
- Servicio de Microbiología, Hospital Universitario de Donostia, Donostia, Spain
| | - Juan José Castón
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain; Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Manuel Recio Rufián
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain; Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Esperanza Merino
- Unidad de Enfermedades Infecciosas, Hospital General Universitario Dr Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Juan Carlos Rodríguez
- Servicio de Microbiología, Hospital General Universitario Dr Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Belén Loeches
- Unidad de Enfermedades Infecciosas, Hospital Universitario La Paz, Madrid, Spain
| | - Guillermo Cuervo
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Bellvitge, Barcelona, Spain
| | | | - Antonio Plata
- Unidad de Enfermedades Infecciosas, Hospital Universitario Regional de Málaga, Málaga, Spain
| | | | - Pablo López Mato
- Unidad de Enfermedades Infecciosas, Hospital de Ourense, Ourense, Spain
| | - José Luis Sierra Monzón
- Servicio de Enfermedades Infecciosas and Servicio de Urgencias, Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - Clara Rosso-Fernández
- Unidad de Investigación Clínica y Ensayos Clínicos (UICEC-HUVR), Hospitales Universitarios Virgen del Rocío y Virgen Macarena, Sevilla, Spain
| | - José María Bravo-Ferrer
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Pilar Retamar-Gentil
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Jesús Rodríguez-Baño
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
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Toledo E, Canal G, Sánchez S, Echeverri J, Fernández R, Del Mar Achalandabaso M, Anderson EJ, Castillo F, Rodríguez JC. Comparison of abdominal adipose tissue versus Body Mass Index (BMI) as a predictor of complications and survival in liver transplantation. Cir Esp 2024:S2173-5077(24)00083-8. [PMID: 38508388 DOI: 10.1016/j.cireng.2024.02.010] [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: 10/03/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Because of the obesity epidemic, more obese patients are on liver transplant (LT) waiting lists. The diseases associated with obesity may increase complications and limit survival after LT. However, there is no established measure or cut-off point to determine this impact and aid decision making. The aim of the present study is to evaluate obesity in patients undergoing LT via BMI and CT-based measurement of adipose tissue (AAT). These parameters will be used to predict the risk of postoperative complications and 5-year survival. METHODS A retrospective, single-center study was carried out at a tertiary Spanish hospital, including all patients who received LT between January 2012 and July 2019 (n = 164). The patients were adults who underwent LT using the 'piggyback' technique, preserving the recipient vena cava. Visceral adipose tissue (VAT) and BMI were calculated to examine correlations with postoperative complications and 5-year survival. RESULTS No significant association was found between postoperative complications by Comprehensive Complication Index, BMI, AAT/height, subcutaneous fat/height and VAT/height. Kaplan-Meier curves for 5-year survival compared LT recipients with BMI < 30.45 vs ≥30.45, with an estimated survival of 58.97 months versus 43.11 months, respectively (P < .001) (Fig. 3) and for LT recipients with an AAT/height <27.35 mm versus ≥27.35 mm, with an estimated survival of 57.69 months versus 46.34 months (P = .001). CONCLUSIONS This study does not show a higher rate of postoperative complications in obese patients. There is a significantly lower long-term survival in patients with AAT/height ≥27.35 mm and BMI ≥ 30.45. BMI is a valid estimate of obesity and is predictive of survival.
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Affiliation(s)
- Enrique Toledo
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain.
| | - Gema Canal
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain
| | | | - Juan Echeverri
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain
| | - Roberto Fernández
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain
| | | | - Edward J Anderson
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain
| | - Federico Castillo
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain
| | - Juan Carlos Rodríguez
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain; Universidad de Cantabria, Cantabria, Spain
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García-Rivera C, Navarro M, Parra M, Sánchez Bautista A, Gómez I, Ventero MP, Rodríguez JC. [In vitro activity of delafloxacin against clinical isolates of carbapenem-resistant Pseudomonas aeruginosa in a stage prior to the clinical use of this drug]. Rev Esp Quimioter 2024; 37:104-105. [PMID: 38140799 PMCID: PMC10874670 DOI: 10.37201/req/080.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/25/2023] [Accepted: 11/03/2023] [Indexed: 12/24/2023]
Affiliation(s)
| | | | | | | | | | - M P Ventero
- María-Paz Ventero, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Av. Pintor Baeza 12, 03010. Alicante, Spain.
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García-Marín AM, Cancino-Muñoz I, Torres-Puente M, Villamayor LM, Borrás R, Borrás-Máñez M, Bosque M, Camarena JJ, Colomer-Roig E, Colomina J, Escribano I, Esparcia-Rodríguez O, Gil-Brusola A, Gimeno C, Gimeno-Gascón A, Gomila-Sard B, González-Granda D, Gonzalo-Jiménez N, Guna-Serrano MR, López-Hontangas JL, Martín-González C, Moreno-Muñoz R, Navarro D, Navarro M, Orta N, Pérez E, Prat J, Rodríguez JC, Ruiz-García MM, Vanaclocha H, González-Candelas F, Furió V, Comas I. Role of the first WHO mutation catalogue in the diagnosis of antibiotic resistance in Mycobacterium tuberculosis in the Valencia Region, Spain: a retrospective genomic analysis. Lancet Microbe 2024; 5:e43-e51. [PMID: 38061383 PMCID: PMC10790317 DOI: 10.1016/s2666-5247(23)00252-5] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 05/13/2023] [Accepted: 08/04/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND In June, 2021, WHO published the most complete catalogue to date of resistance-conferring mutations in Mycobacterium tuberculosis. Here, we aimed to assess the performance of genome-based antimicrobial resistance prediction using the catalogue and its potential for improving diagnostics in a real low-burden setting. METHODS In this retrospective population-based genomic study M tuberculosis isolates were collected from 25 clinical laboratories in the low-burden setting of the Valencia Region, Spain. Culture-positive tuberculosis cases reported by regional public health authorities between Jan 1, 2014, and Dec 31, 2016, were included. The drug resistance profiles of these isolates were predicted by the genomic identification, via whole-genome sequencing (WGS), of the high-confidence resistance-causing variants included in the catalogue and compared with the phenotype. We determined the minimum inhibitory concentration (MIC) of the isolates with discordant resistance profiles using the resazurin microtitre assay. FINDINGS WGS was performed on 785 M tuberculosis complex culture-positive isolates, and the WGS resistance prediction sensitivities were: 85·4% (95% CI 70·8-94·4) for isoniazid, 73·3% (44·9-92·2) for rifampicin, 50·0% (21·1-78·9) for ethambutol, and 57·1% (34·0-78·2) for pyrazinamide; all specificities were more than 99·6%. Sensitivity values were lower than previously reported, but the overall pan-susceptibility accuracy was 96·4%. Genotypic analysis revealed that four phenotypically susceptible isolates carried mutations (rpoB Leu430Pro and rpoB Ile491Phe for rifampicin and fabG1 Leu203Leu for isoniazid) known to give borderline resistance in standard phenotypic tests. Additionally, we identified three putative resistance-associated mutations (inhA Ser94Ala, katG Leu48Pro, and katG Gly273Arg for isoniazid) in samples with substantially higher MICs than those of susceptible isolates. Combining both genomic and phenotypic data, in accordance with the WHO diagnostic guidelines, we could detect two new multidrug-resistant cases. Additionally, we detected 11 (1·6%) of 706 isolates to be monoresistant to fluoroquinolone, which had been previously undetected. INTERPRETATION We showed that the WHO catalogue enables the detection of resistant cases missed in phenotypic testing in a low-burden region, thus allowing for better patient-tailored treatment. We also identified mutations not included in the catalogue, relevant at the local level. Evidence from this study, together with future updates of the catalogue, will probably lead in the future to the partial replacement of culture testing with WGS-based drug susceptibility testing in our setting. FUNDING European Research Council and the Spanish Ministerio de Ciencia.
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Affiliation(s)
- Ana María García-Marín
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Valencia, Spain; Joint Research Unit Infección y Salud Pública, FISABIO-University of Valencia, Institute for Integrative Systems Biology, Valencia, Spain
| | - Irving Cancino-Muñoz
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Valencia, Spain; Joint Research Unit Infección y Salud Pública, FISABIO-University of Valencia, Institute for Integrative Systems Biology, Valencia, Spain
| | | | | | - Rafael Borrás
- Microbiology Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - María Borrás-Máñez
- Microbiology and Parasitology Service, Hospital Universitario de La Ribera, Alzira, Spain
| | | | - Juan J Camarena
- Microbiology Service, Hospital Universitario Dr Peset, Valencia, Spain
| | - Ester Colomer-Roig
- FISABIO Public Health, Valencia, Spain; Microbiology Service, Hospital Universitario Dr Peset, Valencia, Spain
| | - Javier Colomina
- Microbiology Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Isabel Escribano
- Microbiology Laboratory, Hospital Virgen de los Lirios, Alcoy, Spain
| | | | - Ana Gil-Brusola
- Microbiology Service, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Concepción Gimeno
- Microbiology Service, Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Bárbara Gomila-Sard
- Microbiology Service, Hospital General Universitario de Castellón, Castellón, Spain
| | | | | | | | | | - Coral Martín-González
- Microbiology Service, Hospital Universitario de San Juan de Alicante, Alicante, Spain
| | - Rosario Moreno-Muñoz
- Microbiology Service, Hospital General Universitario de Castellón, Castellón, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - María Navarro
- Microbiology Service, Hospital de la Vega Baixa, Orihuela, Spain
| | - Nieves Orta
- Microbiology Service, Hospital Francesc de Borja, Gandía, Spain
| | - Elvira Pérez
- Subdirección General de Epidemiología y Vigilancia de la Salud y Sanidad Ambiental de Valencia, Valencia, Spain
| | - Josep Prat
- Microbiology Service, Hospital de Sagunto, Sagunto, Spain
| | | | | | - Hermelinda Vanaclocha
- Subdirección General de Epidemiología y Vigilancia de la Salud y Sanidad Ambiental de Valencia, Valencia, Spain
| | - Fernando González-Candelas
- Joint Research Unit Infección y Salud Pública, FISABIO-University of Valencia, Institute for Integrative Systems Biology, Valencia, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Victoria Furió
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Valencia, Spain.
| | - Iñaki Comas
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Valencia, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
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Ventero MP, Haro-Moreno JM, Molina-Pardines C, Sánchez-Bautista A, García-Rivera C, Boix V, Merino E, López-Pérez M, Rodríguez JC. Role of Relebactam in the Antibiotic Resistance Acquisition in Pseudomonas aeruginosa: In Vitro Study. Antibiotics (Basel) 2023; 12:1619. [PMID: 37998821 PMCID: PMC10668777 DOI: 10.3390/antibiotics12111619] [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: 09/26/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Pseudomonas aeruginosa shows resistance to several antibiotics and often develops such resistance during patient treatment. OBJECTIVE Develop an in vitro model, using clinical isolates of P. aeruginosa, to compare the ability of the imipenem and imipenem/relebactam to generate resistant mutants to imipenem and to other antibiotics. Perform a genotypic analysis to detect how the selective pressure changes their genomes. METHODS The antibiotics resistance was studied by microdilution assays and e-test, and the genotypic study was performed by NGS. RESULTS The isolates acquired resistance to imipenem in an average of 6 days, and to imipenem/relebactam in 12 days (p value = 0.004). After 30 days of exposure, 75% of the isolates reached a MIC > 64 mg/L for imipenem and 37.5% for imipenem/relebactam (p value = 0.077). The 37.5% and the 12.5% imipenem/relebactam mutants developed resistance to piperacillin/tazobactam and ceftazidime, respectively, while the 87.5% and 37.5% of the imipenem mutants showed resistance to these drugs (p value = 0.003, p value = 0.015). The main biological processes altered by the SNPs were the glycosylation pathway, transcriptional regulation, histidine kinase response, porins, and efflux pumps. DISCUSSION The addition of relebactam delays the generation of resistance to imipenem and limits the cross-resistance to other beta-lactams. The clinical relevance of this phenomenon, which has the limitation that it has been performed in vitro, should be evaluated by stewardship programs in clinical practice, as it could be useful in controlling multi-drug resistance in P. aeruginosa.
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Affiliation(s)
- Maria Paz Ventero
- Microbiology Department, Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (M.P.V.); (A.S.-B.); (C.G.-R.); (J.C.R.)
| | - Jose M. Haro-Moreno
- Evolutionary Genomics Group, División de Microbiología, Universidad Miguel Hernández, Apartado 18, 03550 San Juan de Alicante, Spain
- Institut de Biologie Structurale J.-P. Ebel, Université Grenoble Alpes, 38000 Grenoble, France
| | - Carmen Molina-Pardines
- Microbiology Department, Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (M.P.V.); (A.S.-B.); (C.G.-R.); (J.C.R.)
- Evolutionary Genomics Group, División de Microbiología, Universidad Miguel Hernández, Apartado 18, 03550 San Juan de Alicante, Spain
| | - Antonia Sánchez-Bautista
- Microbiology Department, Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (M.P.V.); (A.S.-B.); (C.G.-R.); (J.C.R.)
| | - Celia García-Rivera
- Microbiology Department, Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (M.P.V.); (A.S.-B.); (C.G.-R.); (J.C.R.)
| | - Vicente Boix
- Infectious Diseases Unit, Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Esperanza Merino
- Infectious Diseases Unit, Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Mario López-Pérez
- Evolutionary Genomics Group, División de Microbiología, Universidad Miguel Hernández, Apartado 18, 03550 San Juan de Alicante, Spain
| | - Juan Carlos Rodríguez
- Microbiology Department, Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (M.P.V.); (A.S.-B.); (C.G.-R.); (J.C.R.)
- Evolutionary Genomics Group, División de Microbiología, Universidad Miguel Hernández, Apartado 18, 03550 San Juan de Alicante, Spain
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Lorenzo-Rebenaque L, Casto-Rebollo C, Diretto G, Frusciante S, Rodríguez JC, Ventero MP, Molina-Pardines C, Vega S, Marin C, Marco-Jiménez F. Modulation of Caecal Microbiota and Metabolome Profile in Salmonella-Infected Broilers by Phage Therapy. Int J Mol Sci 2023; 24:15201. [PMID: 37894882 PMCID: PMC10607084 DOI: 10.3390/ijms242015201] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Bacteriophage therapy is considered one of the most promising tools to control zoonotic bacteria, such as Salmonella, in broiler production. Phages exhibit high specificity for their targeted bacterial hosts, causing minimal disruption to the niche microbiota. However, data on the gut environment's response to phage therapy in poultry are limited. This study investigated the influence of Salmonella phage on host physiology through caecal microbiota and metabolome modulation using high-throughput 16S rRNA gene sequencing and an untargeted metabolomics approach. We employed 24 caecum content samples and 24 blood serum samples from 4-, 5- and 6-week-old broilers from a previous study where Salmonella phages were administered via feed in Salmonella-infected broilers, which were individually weighed weekly. Phage therapy did not affect the alpha or beta diversity of the microbiota. Specifically, we observed changes in the relative abundance of 14 out of the 110 genera using the PLS-DA and Bayes approaches. On the other hand, we noted changes in the caecal metabolites (63 up-accumulated and 37 down-accumulated out of the 1113 caecal metabolites). Nevertheless, the minimal changes in blood serum suggest a non-significant physiological response. The application of Salmonella phages under production conditions modulates the caecal microbiome and metabolome profiles in broilers without impacting the host physiology in terms of growth performance.
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Affiliation(s)
- Laura Lorenzo-Rebenaque
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology, Biomedical Research Institute, Faculty of Veterinary Medicine, Cardenal Herrera-CEU University, CEU Universities, Calle Santiago Ramón y Cajal 20, Alfara del Patriarca, 45115 Valencia, Spain; (L.L.-R.); (S.V.); (C.M.)
| | - Cristina Casto-Rebollo
- Institute for Animal Science and Technology, Universitat Politècnica de València, 46022 Valencia, Spain;
| | - Gianfranco Diretto
- Italian Agency for New Technologies, Energy and Sustainable Development (ENEA), Biotechnology Laboratory, Centro Ricerche Casaccia, Via Anguillarese, 301, Santa Maria di Galeria, 00123 Rome, Italy; (G.D.); (S.F.)
| | - Sarah Frusciante
- Italian Agency for New Technologies, Energy and Sustainable Development (ENEA), Biotechnology Laboratory, Centro Ricerche Casaccia, Via Anguillarese, 301, Santa Maria di Galeria, 00123 Rome, Italy; (G.D.); (S.F.)
| | - Juan Carlos Rodríguez
- Microbiology Department, Dr. Balmis University General Hospital, Microbiology Division, Miguel Hernández University, ISABIAL, 03010 Alicante, Spain;
| | - María-Paz Ventero
- Microbiology Department, Dr. Balmis University General Hospital, ISABIAL, 03010 Alicante, Spain; (M.-P.V.); (C.M.-P.)
| | - Carmen Molina-Pardines
- Microbiology Department, Dr. Balmis University General Hospital, ISABIAL, 03010 Alicante, Spain; (M.-P.V.); (C.M.-P.)
| | - Santiago Vega
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology, Biomedical Research Institute, Faculty of Veterinary Medicine, Cardenal Herrera-CEU University, CEU Universities, Calle Santiago Ramón y Cajal 20, Alfara del Patriarca, 45115 Valencia, Spain; (L.L.-R.); (S.V.); (C.M.)
| | - Clara Marin
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology, Biomedical Research Institute, Faculty of Veterinary Medicine, Cardenal Herrera-CEU University, CEU Universities, Calle Santiago Ramón y Cajal 20, Alfara del Patriarca, 45115 Valencia, Spain; (L.L.-R.); (S.V.); (C.M.)
| | - Francisco Marco-Jiménez
- Institute for Animal Science and Technology, Universitat Politècnica de València, 46022 Valencia, Spain;
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Ramos-Rincón JM, Pinargote-Celorio H, Llenas-García J, Moreno-Pérez O, González-Cuello I, Gonzalez-de-la-Aleja P, Martínez-López B, Reus S, García-López M, Rodríguez JC, Boix V, Merino E. A retrospective real-world study of early short-course remdesivir in non-hospitalized COVID-19 patients at high risk for progression: low rate of hospitalization or death, regardless of immunocompetence status. Front Pharmacol 2023; 14:1218650. [PMID: 37881188 PMCID: PMC10597661 DOI: 10.3389/fphar.2023.1218650] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/25/2023] [Indexed: 10/27/2023] Open
Abstract
Introduction: The evidence for remdesivir therapy in immunocompromised patients is scarce. To evaluate remdesivir (RDV) effectiveness and safety in COVID-19 outpatients at high risk for progression in a real-world setting, we compare the outcome in immunocompromised (IC) patients with that in non-immunocompromised patients. Methods: Two hospitals conducted a retrospective study of all adult patients with mild-to-moderate SARS-CoV-2 infection at high risk for disease progression who were treated as outpatients with a 3-day course of RDV (1st January-30th September 2022). The primary effectiveness endpoint was a composite of any cause of hospitalization or death by day 30. A multiple logistic regression model was built to explore the association between immune status and clinical outcome, estimating adjusted odds ratios [aORs (95% CI)]. Results: We have included 211 patients, of which 57% were males, with a median age of 65 years (IQR 53-77), 70.1% were vaccinated (three or four doses), and 61.1% were IC. The median duration of symptoms before RDV treatment was 3 days (IQR 2-5). During follow-up, 14 (6.6%) patients were hospitalized, of which 6 (2.8%) were hospitalized for COVID-19 progression. No patient required mechanical ventilation, and two patients died (non-COVID-19-related). After accounting for potential confounders, only anti-CD20 treatment was associated with the composed outcome [aOR 5.35 (1.02-27.5, 95% CI)], whereas the immunocompetence status was not [aOR 1.94 (0.49-7.81, 95% CI)]. Conclusion: Early COVID-19 outpatient treatment with a 3-day course of remdesivir in vaccinated patients at high risk for disease progression during the Omicron surge had a good safety profile. It was associated with a low rate of all-cause hospitalization or death, regardless of immunocompetence status.
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Affiliation(s)
- José Manuel Ramos-Rincón
- Internal Medicine Department, Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
| | - Héctor Pinargote-Celorio
- Unit of Infectious Diseases Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Jara Llenas-García
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Internal Medicine Service Vega Baja Hospital—Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
| | - Oscar Moreno-Pérez
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Endocrinology Department Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Inmaculada González-Cuello
- Internal Medicine Service Vega Baja Hospital—Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
| | - Pilar Gonzalez-de-la-Aleja
- Unit of Infectious Diseases Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Belén Martínez-López
- Internal Medicine Service Vega Baja Hospital—Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
| | - Sergio Reus
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Unit of Infectious Diseases Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - María García-López
- Internal Medicine Service Vega Baja Hospital—Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
| | - Juan Carlos Rodríguez
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Microbiology Service Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Vicente Boix
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Unit of Infectious Diseases Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Esperanza Merino
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Unit of Infectious Diseases Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
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Álvarez-Martínez FJ, Rodríguez JC, Borrás-Rocher F, Barrajón-Catalán E, Micol V. Author Correction: The antimicrobial capacity of Cistus salviifolius and Punica granatum plant extracts against clinical pathogens is related to their polyphenolic composition. Sci Rep 2023; 13:13027. [PMID: 37563180 PMCID: PMC10415256 DOI: 10.1038/s41598-023-39602-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Affiliation(s)
- Francisco Javier Álvarez-Martínez
- Instituto de Biología Molecular y Celular (IBMC) and Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández (UMH), 03202, Elche, Spain
| | - Juan Carlos Rodríguez
- Microbiology Section, University General Hospital of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL Foundation, Alicante, Spain
| | - Fernando Borrás-Rocher
- Statistics and Operative Research Department, Miguel Hernández University (UMH), Avda. Universidad s/n, 03202, Elche, Spain
| | - Enrique Barrajón-Catalán
- Instituto de Biología Molecular y Celular (IBMC) and Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández (UMH), 03202, Elche, Spain.
| | - Vicente Micol
- Instituto de Biología Molecular y Celular (IBMC) and Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández (UMH), 03202, Elche, Spain
- CIBER, Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III (CB12/03/30038), Madrid, Spain
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9
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Peña-Calzada K, Olivera-Viciedo D, Calero-Hurtado A, de Mello Prado R, Habermann E, Lata Tenesaca LF, Ajila G, de Oliveira R, Rodríguez JC, Lupino Gratão P. Silicon mitigates the negative impacts of salt stress in soybean plants. J Sci Food Agric 2023; 103:4360-4370. [PMID: 36788650 DOI: 10.1002/jsfa.12503] [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] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 01/09/2023] [Accepted: 02/14/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Soybean is widely cultivated around the world, including regions with salinity conditions. Salt stress impairs plant physiology and growth, but recent evidence suggests that silicon (Si) is able to mitigate this stressful condition. Therefore, the purpose of this study was to evaluate how different strategies of Si application impact on salt stress tolerance of an intermediate Si accumulator species (soybean). Therefore, we applied four treatments: Si-untreated plants (Si 0); foliar spraying at 20 mmol L-1 (Si F); nutritive solution addition at 2.0 mol L-1 (Si R), and combined foliar spraying at 20 mmol L-1 plus nutritive solution at 2.0 mmol L-1 (Si F + R). We investigated how Si application modified growth, leaf gas exchange, photosynthetic pigments, chlorophyll fluorescence, relative water content (RWC), nutrient accumulation, and ion homeostasis of soybean plants submitted to different levels of salt stress (50 and 100 mmol L-1 NaCl). RESULTS Salinity induced an expressive reduction in ion accumulation, plant water status, and growth of soybean, while Si application promoted contrary effects and increased potassium (K+ ) accumulation, water status, photosynthetic pigment content, chlorophyll fluorescence parameters, and gas exchange attributes. Additionally, Si application enhanced Si accumulation associated with decreased Na+ uptake and improved morpho-physiological growth. CONCLUSION The use of exogenous Si can be an efficient strategy to attenuate the harmful effects of salt stress in soybean plants. The best application strategy was observed with combined foliar spraying with Si included in the nutritive solution (Si F + R). © 2023 Society of Chemical Industry.
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Affiliation(s)
- Kolima Peña-Calzada
- Department of Biology, São Paulo State University (UNESP), School of Agricultural and Veterinarian Sciences, Jaboticabal, São Paulo, Brazil
- Agronomy Department, University of Sancti Spiritus 'Jose Marti Perez' (UNISS), Sancti Spiritus, Cuba
| | - Dilier Olivera-Viciedo
- Department of Animal Science, Federal University of Maranhão (UFMA), Center of Environment and Agriculture Science, Chapadinha, Maranhão, Brazil
| | - Alexander Calero-Hurtado
- Agronomy Department, University of Sancti Spiritus 'Jose Marti Perez' (UNISS), Sancti Spiritus, Cuba
- Department of Agricultural Production Sciences, São Paulo State University (UNESP), School of Agricultural and Veterinarian Sciences, Jaboticabal, São Paulo, Brazil
| | - Renato de Mello Prado
- Department of Agricultural Production Sciences, São Paulo State University (UNESP), School of Agricultural and Veterinarian Sciences, Jaboticabal, São Paulo, Brazil
| | - Eduardo Habermann
- Department of Biology, University of São Paulo, FFCLRP, Ribeirão Preto, Brazil
| | | | - Gabriela Ajila
- Department of Biology, São Paulo State University (UNESP), School of Agricultural and Veterinarian Sciences, Jaboticabal, São Paulo, Brazil
| | - Reginaldo de Oliveira
- Department of Biology, São Paulo State University (UNESP), School of Agricultural and Veterinarian Sciences, Jaboticabal, São Paulo, Brazil
| | - Juan Carlos Rodríguez
- Agronomy Department, University of Sancti Spiritus 'Jose Marti Perez' (UNISS), Sancti Spiritus, Cuba
| | - Priscila Lupino Gratão
- Department of Biology, São Paulo State University (UNESP), School of Agricultural and Veterinarian Sciences, Jaboticabal, São Paulo, Brazil
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10
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Merchante N, Herrero R, Valverde-Fredet MD, Rodríguez-Fernández M, Pinargote H, Martínez-Marcos FJ, Gil-Anguita C, García-López M, Tasias Pitarch M, Abril López De Medrano V, Navarrete Lorite MN, Gómez-Ayerbe C, León E, González-De La Aleja P, Ruiz Castillo A, Aller AI, Rodríguez JC, Ternero Fonseca J, Corzo JE, Naranjo Pérez A, Trigo-Rodríguez M, Merino E. Role of previous systemic antibiotic therapy on the probability of recurrence after an initial episode of Clostridioides difficile infection treated with vancomycin. JAC Antimicrob Resist 2023; 5:dlad033. [PMID: 36968953 PMCID: PMC10035639 DOI: 10.1093/jacamr/dlad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/05/2023] [Indexed: 03/25/2023] Open
Abstract
Objectives To investigate the role of previous antibiotic therapy in the risk of recurrence after a Clostridioides difficile infection (CDI) treated with vancomycin. Methods Multicentre observational study. Patients with a CDI episode achieving clinical cure with oral vancomycin and followed up 8 weeks were included. Previous antibiotic exposure up to 90 days was collected. Multivariate analysis of predictors of recurrence adjusted by the propensity score (PS) of being previously treated with each non-CDI antibiotic was performed. Results Two hundred and forty-one patients were included; 216 (90%) had received systemic antibiotics. Fifty-three patients (22%) had a CDI recurrence. Rates of recurrence were lower in those treated with piperacillin/tazobactam in the last month when compared with those not receiving piperacillin/tazobactam [3 (7%) versus 50 (25%); P = 0.01], whereas higher rates were seen in those treated with cephalosporins in the last month [26/87 (30%) versus 27/154 (17%); P = 0.03]. In multivariate analysis controlled by the inverse probability of treatment weighting by PS, receiving ≥5 days of piperacillin/tazobactam in the last month as the last antibiotic regimen prior to CDI was independently associated with a lower risk of recurrence [adjusted OR (AOR) 0.13; 95% CI: 0.06-0.29; P < 0.0001] whereas exposure for ≥5 days to cephalosporins (versus piperacillin/tazobactam) was associated with an increased risk (AOR 10.9; 95% CI: 4.4-27.1; P < 0.0001). Conclusions Recent use of piperacillin/tazobactam might be associated with a lower risk of CDI recurrence, while recent use of cephalosporins might promote an increased risk. These findings should be considered when treating hospitalized patients.
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Affiliation(s)
- Nicolás Merchante
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Avenida de Bellavista s/n, 41014, Sevilla, Spain
| | - Rocío Herrero
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Avenida de Bellavista s/n, 41014, Sevilla, Spain
| | - María Dolores Valverde-Fredet
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Avenida de Bellavista s/n, 41014, Sevilla, Spain
| | - Miguel Rodríguez-Fernández
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Avenida de Bellavista s/n, 41014, Sevilla, Spain
| | - Héctor Pinargote
- Unidad de Enfermedades Infecciosas, Hospital General Universitario Dr. Balmis, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain
| | | | - Concepción Gil-Anguita
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Marina Baixa, Villajoyosa, Spain
| | | | - María Tasias Pitarch
- Unidad de Enfermedades Infecciosas, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Miguel Nicolás Navarrete Lorite
- Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena. Departamento de Medicina, Universidad de Sevilla. Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Sevilla, Spain
| | - Cristina Gómez-Ayerbe
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Enfermedades Infecciosas, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
| | - Eva León
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Avenida de Bellavista s/n, 41014, Sevilla, Spain
| | - Pilar González-De La Aleja
- Unidad de Enfermedades Infecciosas, Hospital General Universitario Dr. Balmis, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Ana Ruiz Castillo
- Servicio Microbiología, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | - Ana I Aller
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Avenida de Bellavista s/n, 41014, Sevilla, Spain
| | - Juan Carlos Rodríguez
- Servicio Microbiología, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Julia Ternero Fonseca
- Servicio de Aparato Digestivo, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | - Juan E Corzo
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Avenida de Bellavista s/n, 41014, Sevilla, Spain
| | - Alberto Naranjo Pérez
- Servicio de Aparato Digestivo, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | - Marta Trigo-Rodríguez
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Avenida de Bellavista s/n, 41014, Sevilla, Spain
| | - Esperanza Merino
- Unidad de Enfermedades Infecciosas, Hospital General Universitario Dr. Balmis, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain
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11
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Monge-García V, Gimeno-Gascón A, Ventero MP, Climent-Barberá JM, Cholbi-Llobell F, Rodríguez JC, Baño-Ruiz E, Caminero-Canas MA, Reus-Bañuls S. New contributions on chronic low back pain: disc infection or contaminated cultures? APMIS 2023; 131:277-283. [PMID: 36905320 DOI: 10.1111/apm.13307] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND There is controversy about the likely infectious origin of chronic low back pain, because it has been suggested the possibility of a relationship with infection by Cutibacterium acnes (C. acnes). HYPOTHESIS The aim of this study is to compare four methods to determine the presence of a likely infection caused by C. acnes in surgical disc samples. PATIENTS AND METHODS This work is a cross-sectional observational study in which there are included 23 patients with microdiscectomy indication. Disc samples were taken during surgery and analysis was done by culture, Sanger sequencing, Next-Generation Sequencing (NGS), and real-time PCR (qPCR). Furthermore, clinical data collection was conducted, and it was analysed the presence of the Modic-like changes on the magnetic resonance imaging. RESULTS In 5 of the samples from among the 23 patients (21.7%) C. acnes was isolated by culture. However, in none of the samples could its genome be detected through Sanger sequencing, the less sensitive method. Only the qPCR and NGS were able to detect very few copies of the genome of this microorganism in all the samples, with no significant quantitative differences being observed between the patients in whom isolation of the microorganism by culture was evident or not. Further, there were no significant relationships identified between the clinical variables, including Modic alterations and positive cultures. DISCUSSION The most sensitive methods to the detect C. acnes were NGS and qPCR. The data obtained do not suggest association between the presence of C. acnes and the clinical process and support the hypothesis that C. acnes is found in these samples only because it is a contamination from the skin microbiome.
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Affiliation(s)
- V Monge-García
- Physical Medicine and Rehabilitation Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - A Gimeno-Gascón
- Microbiology Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - M P Ventero
- Microbiology Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - J M Climent-Barberá
- Physical Medicine and Rehabilitation Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - F Cholbi-Llobell
- Physical Medicine and Rehabilitation Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - J C Rodríguez
- Microbiology Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - E Baño-Ruiz
- Neurosurgery Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - M A Caminero-Canas
- Neurosurgery Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - S Reus-Bañuls
- Infectious Diseases Unit, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
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12
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Lorenzo-Rebenaque L, Casto-Rebollo C, Diretto G, Frusciante S, Rodríguez JC, Ventero MP, Molina-Pardines C, Vega S, Marin C, Marco-Jiménez F. Examining the effects of Salmonella phage on the caecal microbiota and metabolome features in Salmonella-free broilers. Front Genet 2022; 13:1060713. [PMID: 36437955 PMCID: PMC9691336 DOI: 10.3389/fgene.2022.1060713] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/26/2022] [Indexed: 10/29/2023] Open
Abstract
Bacteriophages selectively infect and kill their target bacterial host, being a promising approach to controlling zoonotic bacteria in poultry production. To ensure confidence in its use, fundamental questions of safety and toxicity monitoring of phage therapy should be raised. Due to its high specificity, a minimal impact on the gut ecology is expected; however, more in-depth research into key parameters that influence the success of phage interventions has been needed to reach a consensus on the impact of bacteriophage therapy in the gut. In this context, this study aimed to investigate the interaction of phages with animals; more specifically, we compared the caecum microbiome and metabolome after a Salmonella phage challenge in Salmonella-free broilers, evaluating the role of the phage administration route. To this end, we employed 45 caecum content samples from a previous study where Salmonella phages were administered via drinking water or feed for 24 h from 4, 5 to 6-weeks-old broilers. High-throughput 16S rRNA gene sequencing showed a high level of similarity (beta diversity) but revealed a significant change in alpha diversity between broilers with Salmonella-phage administered in the drinking water and control. Our results showed that the phages affected only a few genera of the microbiota's structure, regardless of the administration route. Among these, we found a significant increase in Streptococcus and Sellimonas in the drinking water and Lactobacillus, Anaeroplasma and Clostridia_vadinBB60_group in the feed. Nevertheless, the LC-HRMS-based metabolomics analyses revealed that despite few genera were significantly affected, a substantial number of metabolites, especially in the phage administered in the drinking water were significantly altered (64 and 14 in the drinking water and feed groups, respectively). Overall, our study shows that preventive therapy with bacteriophages minimally alters the caecal microbiota but significantly impacts their metabolites, regardless of the route of administration.
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Affiliation(s)
- Laura Lorenzo-Rebenaque
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology, Biomedical Research Institute, Faculty of Veterinary Medicine, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain
| | - Cristina Casto-Rebollo
- Institute of Science and Animal Technology, Universitat Politècnica de València, Valencia, Spain
| | - Gianfranco Diretto
- Italian Agency for New Technologies, Energy and Sustainable Development (ENEA), Biotechnology Laboratory, Centro Ricerche Casaccia, Santa Maria di Galeria, Rome, Italy
| | - Sarah Frusciante
- Italian Agency for New Technologies, Energy and Sustainable Development (ENEA), Biotechnology Laboratory, Centro Ricerche Casaccia, Santa Maria di Galeria, Rome, Italy
| | - Juan Carlos Rodríguez
- Microbiology Department, Balmis General University Hospital, Microbiology Division, Miguel Hernández University, ISABIAL, Alicante, Spain
| | - María-Paz Ventero
- Microbiology Department, Balmis General University Hospital, ISABIAL, Alicante, Spain
| | | | - Santiago Vega
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology, Biomedical Research Institute, Faculty of Veterinary Medicine, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain
| | - Clara Marin
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology, Biomedical Research Institute, Faculty of Veterinary Medicine, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain
| | - Francisco Marco-Jiménez
- Institute of Science and Animal Technology, Universitat Politècnica de València, Valencia, Spain
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13
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de la Espriella R, Amiguet M, Miñana G, Rodríguez JC, Moyano P, Segarra D, Fernández J, Santas E, Núñez G, Lorenzo M, Bonanad C, Alania E, Valle A, Sanchis J, Bodí V, Górriz JL, Navarro J, Codina P, Voors AA, Bayés-Genís A, Núñez J. Bending oxygen saturation index and risk of worsening heart failure events in chronic heart failure. Eur J Heart Fail 2022; 24:2108-2117. [PMID: 36054502 DOI: 10.1002/ejhf.2651] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 01/18/2023] Open
Abstract
AIMS Bendopnea is a clinical symptom of advanced heart failure with uncertain prognostic value. We aimed to evaluate whether bendopnea and the change in oxygen saturation when bending forward (bending oxygen saturation index [BOSI]) are associated with adverse outcomes in ambulatory chronic heart failure (CHF) patients. METHODS AND RESULTS We prospectively evaluated 440 subjects with symptomatic CHF. BOSI was defined as the difference between sitting and bending oxygen saturation (SpO2 ). The endpoint was the total number of worsening heart failure (WHF) events (heart failure hospitalization or urgent heart failure visit requiring parenteral diuretic therapy). The mean age was 74 ± 10 years, 257 (58.6%) were male, and 226 (51.4%) had a left ventricular ejection fraction <50%. Bendopnea was present in 94 (21.4%) patients, and 120 (27.3%) patients had a BOSI ≥-3%. The agreement between BOSI ≥-3% and bendopnea was moderate (Gwet's AC 0.482, p < 0.001). At a median (p25%-p75%) follow-up of 2.17 years (0.88-3.16), we registered 441 WHF events in 148 patients. After multivariable adjustment, BOSI was independently associated with the risk for total WHF episodes (overall, p < 0.001). Compared to improvement/no change in SpO2 when bending (BOSI 0%), those with BOSI ≥-3% showed an increased risk of WHF events (incidence rate ratio [IRR] 2.16, 95% confidence interval [CI] 1.67-2.79; p < 0.001). In contrast, bendopnea was not associated with the risk of total WHF episodes (IRR 1.04, 95% CI 0.83-1.31; p = 0.705). CONCLUSIONS In ambulatory and stable CHF patients, BOSI ≥-3% and not bendopnea was independently associated with an increased risk of total (first and recurrent) WHF episodes. Awareness of SpO2 while assessing bendopnea may be a useful tool for predicting heart failure decompensations.
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Affiliation(s)
- Rafael de la Espriella
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
| | - Martina Amiguet
- Cardiology Department, Hospital General de Castellón, Castellón, Spain
| | - Gema Miñana
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
| | - Juan Carlos Rodríguez
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
| | - Patricia Moyano
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
| | - Daniel Segarra
- Hospital Politécnico Universitario La Fe, Valencia, Spain
| | - Julio Fernández
- Gestión Sanitaria, Conselleria de Sanidad, Generalitat Valenciana, Valencia, Spain.,Departamento de Enfermería, Universidad de Valencia, Valencia, Spain
| | - Enrique Santas
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
| | - Gonzalo Núñez
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
| | - Miguel Lorenzo
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
| | - Clara Bonanad
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
| | - Edgardo Alania
- Cardiology Department, Hospital de Denia, Alicante, Spain
| | - Alfonso Valle
- Cardiology Department, Hospital de Denia, Alicante, Spain
| | - Juan Sanchis
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain.,Department of Medicine, Universitat de Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red Enfermedades Cardiovascular, Madrid, Spain
| | - Vicent Bodí
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain.,Department of Medicine, Universitat de Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red Enfermedades Cardiovascular, Madrid, Spain
| | - Jose Luis Górriz
- Department of Medicine, Universitat de Valencia, Valencia, Spain.,Nephrology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
| | - Jorge Navarro
- Department of Medicine, Universitat de Valencia, Valencia, Spain
| | - Pau Codina
- Institut del Cor, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Adriaan A Voors
- Department of Cardiology University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Antoni Bayés-Genís
- Centro de Investigación Biomédica en Red Enfermedades Cardiovascular, Madrid, Spain.,Institut del Cor, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Julio Núñez
- Cardiology Department, Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain.,Department of Medicine, Universitat de Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red Enfermedades Cardiovascular, Madrid, Spain
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14
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Pastor F, Rodríguez JC, Barrera JM, Delgado García-Menocal JA, Brizuela A, Puigdollers A, Espinar E, Gil J. Effect of Fluoride Content of Mouthwashes on Superelastic Properties of NiTi Orthodontic Archwires. Materials (Basel) 2022; 15:ma15196592. [PMID: 36233934 PMCID: PMC9573170 DOI: 10.3390/ma15196592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 06/01/2023]
Abstract
The influence of sodium fluoride (NaF) concentration in mouthwashes on the properties of superelastic NiTi orthodontic wires has been studied. In this work, 55.8%Ni and 44.2%Ti (in weight) wires were introduced in commercial mouthwashes with different NaF contents (0, 130, 200 and 380 ppm). The release of Ni2+ and Ti4+ ions was by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) at 1, 4, 7 and 14 days. Superelastic orthodontic wires present at oral temperature the austenitic phase which is transformed into a plastic phase (martensite) by cooling. The temperatures at which this occurs are influenced by the chemical composition. The release of ions from the wire will produce variations in the temperatures and stresses of the stress-induced martensitic transformation. Ms, Mf, As, Af were determined by Differential Scanning Calorimeter (DSC). The transformation stresses (austenite to stress induce martensite) were determined with a servo-hydraulic testing machine at 37 °C. The surfaces for the different times and mouthwash were observed by Scanning Electron Microscope (SEM). The release of Ni2+ in mouthwashes with 380 ppm NaF concentrations reaches 230,000 ppb in 14 days and for Ti4+ 175,000 ppb. When NaF concentrations are lower than 200 ppm the release of Ni and Ti ions is around 1500 ppb after 14 days. This variation in compositions leads to variations in Ms from 27 °C to 43.5 °C in the case of higher NaF concentration. The increasing immersion time and NaF concentrations produce a decrease of Ni in the wires, increasing Ms which exceed 37 °C with the loss of superelasticity. In the same way, the stresses (tooth position corrective) decrease from 270 MPa to 0 MPa due to the martensitic phase. The degradation can produce the growth of precipitates rich in Ti (Ti2Ni). These results are of great interest in the orthodontic clinic in order to avoid the loss of the therapeutic properties of superelastic NiTi due to long immersion in fluoride mouthwashes.
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Affiliation(s)
- Francisco Pastor
- Departamento Ortodoncia, Facultad de Odontología, Universidad de Sevilla, Avicena s/n, 41009 Sevilla, Spain
| | - Juan Carlos Rodríguez
- Departamento Ortodoncia, Facultad de Odontología, Universidad de Sevilla, Avicena s/n, 41009 Sevilla, Spain
| | - José María Barrera
- Departamento Ortodoncia, Facultad de Odontología, Universidad de Sevilla, Avicena s/n, 41009 Sevilla, Spain
| | - José Angel Delgado García-Menocal
- Bioengineering Institute of Technology, Facultad de Medicina y Ciencias de la Salud, Universidad Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallés, 08195 Barcelona, Spain
| | - Aritza Brizuela
- Facultad de Odontología, Universidad Europea Miguel de Cervantes, C/del Padre Julio Chevalier 2, 47012 Valladolid, Spain
| | - Andreu Puigdollers
- Departamento Ortodoncia, Facultad de Odontología, Universidad Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallés, 08195 Barcelona, Spain
| | - Eduardo Espinar
- Departamento Ortodoncia, Facultad de Odontología, Universidad de Sevilla, Avicena s/n, 41009 Sevilla, Spain
| | - Javier Gil
- Bioengineering Institute of Technology, Facultad de Medicina y Ciencias de la Salud, Universidad Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallés, 08195 Barcelona, Spain
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15
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García-Rivera C, Escribano I, Espinosa B, Algado-Sellés N, Sánchez-Payá J, Llorens P, Rodríguez JC. Are SARS-CoV-2 antigen tests useful in routine emergency department care? Emergencias 2022; 34:321-323. [PMID: 35833776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Celia García-Rivera
- Servicio de Microbiología, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | - Isabel Escribano
- Servicio de Microbiología, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | - Begoña Espinosa
- Servicio de Urgencias, Unidad de Corta Estancia y Hospitalización a Domicilio, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | - Natividad Algado-Sellés
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | - José Sánchez-Payá
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | - Pere Llorens
- Servicio de Urgencias, Unidad de Corta Estancia y Hospitalización a Domicilio, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | - Juan Carlos Rodríguez
- Servicio de Microbiología, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
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16
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García-Rivera C, Parra-Grande M, Merino E, Boix V, Rodríguez JC. Concordance of the Filmarray Blood Culture Identification Panel 2 and classical microbiological methods in a bacteriemia diagnostic unit. Diagn Microbiol Infect Dis 2022; 104:115787. [DOI: 10.1016/j.diagmicrobio.2022.115787] [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] [Received: 04/19/2022] [Revised: 07/20/2022] [Accepted: 08/06/2022] [Indexed: 11/24/2022]
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17
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Cancino-Muñoz I, López MG, Torres-Puente M, Villamayor LM, Borrás R, Borrás-Máñez M, Bosque M, Camarena JJ, Colijn C, Colomer-Roig E, Colomina J, Escribano I, Esparcia-Rodríguez O, García-García F, Gil-Brusola A, Gimeno C, Gimeno-Gascón A, Gomila-Sard B, Gónzales-Granda D, Gonzalo-Jiménez N, Guna-Serrano MR, López-Hontangas JL, Martín-González C, Moreno-Muñoz R, Navarro D, Navarro M, Orta N, Pérez E, Prat J, Rodríguez JC, Ruiz-García MM, Vanaclocha H, Comas I. Population-based sequencing of Mycobacterium tuberculosis reveals how current population dynamics are shaped by past epidemics. eLife 2022; 11:76605. [PMID: 35880398 PMCID: PMC9323001 DOI: 10.7554/elife.76605] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 12/22/2021] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
Transmission is a driver of tuberculosis (TB) epidemics in high-burden regions, with assumed negligible impact in low-burden areas. However, we still lack a full characterization of transmission dynamics in settings with similar and different burdens. Genomic epidemiology can greatly help to quantify transmission, but the lack of whole genome sequencing population-based studies has hampered its application. Here, we generate a population-based dataset from Valencia region and compare it with available datasets from different TB-burden settings to reveal transmission dynamics heterogeneity and its public health implications. We sequenced the whole genome of 785 Mycobacterium tuberculosis strains and linked genomes to patient epidemiological data. We use a pairwise distance clustering approach and phylodynamic methods to characterize transmission events over the last 150 years, in different TB-burden regions. Our results underscore significant differences in transmission between low-burden TB settings, i.e., clustering in Valencia region is higher (47.4%) than in Oxfordshire (27%), and similar to a high-burden area as Malawi (49.8%). By modeling times of the transmission links, we observed that settings with high transmission rate are associated with decades of uninterrupted transmission, irrespective of burden. Together, our results reveal that burden and transmission are not necessarily linked due to the role of past epidemics in the ongoing TB incidence, and highlight the need for in-depth characterization of transmission dynamics and specifically tailored TB control strategies.
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Affiliation(s)
- Irving Cancino-Muñoz
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV-CSIC), Valencia, Spain
| | - Mariana G López
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV-CSIC), Valencia, Spain
| | - Manuela Torres-Puente
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV-CSIC), Valencia, Spain
| | - Luis M Villamayor
- Unidad Mixta "Infección y Salud Pública" (FISABIO-CSISP), Valencia, Spain
| | - Rafael Borrás
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
| | - María Borrás-Máñez
- Microbiology and Parasitology Service, Hospital Universitario de La Ribera, Alzira, Spain
| | | | - Juan J Camarena
- Microbiology Service, Hospital Universitario Dr Peset, Valencia, Spain
| | - Caroline Colijn
- Department of Mathematics, Faculty of Science, Simon Fraser University, Burnaby, Canada
| | - Ester Colomer-Roig
- Unidad Mixta "Infección y Salud Pública" (FISABIO-CSISP), Valencia, Spain.,Microbiology Service, Hospital Universitario Dr Peset, Valencia, Spain
| | - Javier Colomina
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
| | - Isabel Escribano
- Microbiology Laboratory, Hospital Virgen de los Lirios, Alcoy, Spain
| | | | | | - Ana Gil-Brusola
- Microbiology Service, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Concepción Gimeno
- Microbiology Service, Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Bárbara Gomila-Sard
- Microbiology Service, Hospital General Universitario de Castellón, Castellón, Spain
| | | | | | | | | | - Coral Martín-González
- Microbiology Service, Hospital Universitario de San Juan de Alicante, Alicantes, Spain
| | - Rosario Moreno-Muñoz
- Microbiology Service, Hospital General Universitario de Castellón, Castellón, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
| | - María Navarro
- Microbiology Service, Hospital de la Vega Baixa, Orihuela, Spain
| | - Nieves Orta
- Microbiology Service, Hospital Universitario de San Juan de Alicante, Alicantes, Spain
| | - Elvira Pérez
- Subdirección General de Epidemiología y Vigilancia de la Salud y Sanidad Ambiental de Valencia (DGSP), Valencia, Spain
| | - Josep Prat
- Microbiology Service, Hospital de Sagunto, Sagunto, Spain
| | | | | | - Hermelinda Vanaclocha
- Subdirección General de Epidemiología y Vigilancia de la Salud y Sanidad Ambiental de Valencia (DGSP), Valencia, Spain
| | | | - Iñaki Comas
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV-CSIC), Valencia, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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18
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Merchante N, Chico P, Márquez-Saavedra E, Riera G, Herrero R, González-de-la-Aleja P, Aller AI, Rodríguez JC, Rodríguez-Fernández M, Ramos JM, Trigo-Rodríguez M, Merino E. Impact of COVID19 pandemic on the incidence of health-care associated Clostridioides difficile infection. Anaerobe 2022; 75:102579. [PMID: 35500744 PMCID: PMC9054722 DOI: 10.1016/j.anaerobe.2022.102579] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the impact of COVID19 pandemic on the incidence of health-care associated Clostridioides difficile infection (HA-CDI). METHODS Retrospective study conducted in the Hospital Universitario de Valme (HUV) and the Hospital General Universitario de Alicante (HGUA) in Spain between January 2019 and February 2021. The study period was divided into non-COVID19 period (2019 and months from 2020 to 2021 with ≤30 hospitalized COVID19 patients) and COVID19 period (months from 2020 to 2021 with >30 COVID19 patients). HA-CDI incidence rates (IR) were calculated as the number of new CDI cases per 10.000 occupied bed-days (OBD) and antimicrobial consumption by means of the defined daily dose (DDD) per 1000 OBD. RESULTS During the COVID19 period, HA-CDI IR in the HUV was 2.6 per 10.000 OBD, which was lower than what was observed during the non-COVID19 period (4.1 per 10.000 OBD; p = 0.1). In the HGUA, HA-CDI IR during COVID19 period was 3.9 per 10.000 OBD, which was not significantly different to the IR observed during the non-COVID19 period (3.7 per 10.000 OBD; p = 0.8). There was a slight increase in the total antibiotic consumption during COVID19 period in both hospitals, with significant increases of certain high-risk antibiotics as cephalosporins. CONCLSUSIONS HA-CDI incidence has not increased during the COVID19 pandemic in two tertiary centers in Spain, in spite of a slightly higher antibiotic consumption during the COVID19 period in both hospitals. These findings suggest that, in the presence of strict infection control measures, hospital antibiotic consumption might have a lower impact than expected on HA-CDI.
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Affiliation(s)
- Nicolás Merchante
- Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Sevilla, Spain,Corresponding author. Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario de Valme. Avenida de Bellavista s/n, 41014. Sevilla, Spain
| | - Pablo Chico
- Servicio de Medicina Preventiva, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain
| | | | - Gerónima Riera
- Servicio de Farmacia, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Rocío Herrero
- Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Sevilla, Spain
| | - Pilar González-de-la-Aleja
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Ana I. Aller
- Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Sevilla, Spain
| | - Juan Carlos Rodríguez
- Servicio Microbiología, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Miguel Rodríguez-Fernández
- Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Sevilla, Spain
| | - José Manuel Ramos
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Marta Trigo-Rodríguez
- Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Sevilla, Spain
| | - Esperanza Merino
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain
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Ruiz-Algueró M, Alejos B, García Yubero C, Riera Jaume M, Antonio Iribarren J, Asensi V, Pasquau F, Galera CE, Pascual-Carrasco M, Muñoz A, Jarrín I, Suárez-García I, Moreno S, Jarrín I, Dalmau D, Navarro ML, González MI, Blanco JL, Garcia F, Rubio R, Iribarren JA, Gutiérrez F, Vidal F, Berenguer J, González J, Alejos B, Hernando V, Moreno C, Iniesta C, Garcia Sousa LM, Perez NS, Muñoz-Fernández MÁ, García-Merino IM, Fernández IC, Rico CG, de la Fuente JG, Concejo PP, Portilla J, Merino E, Reus S, Boix V, Giner L, Gadea C, Portilla I, Pampliega M, Díez M, Rodríguez JC, Sánchez-Payá J, Gómez JL, Hernández J, Alemán MR, del Mar Alonso M, Inmaculada Hernández M, Díaz-Flores F, García D, Pelazas R, Lirola AL, Moreno JS, Caso AA, Hernández Gutiérrez C, Novella Mena M, Rubio R, Pulido F, Bisbal O, Hernando A, Domínguez L, Crestelo DR, Bermejo L, Santacreu M, Antonio Iribarren J, Arrizabalaga J, Aramburu MJ, Camino X, Rodríguez-Arrondo F, von Wichmann MÁ, Tomé LP, Goenaga MÁ, Bustinduy MJ, Azkune H, Ibarguren M, Lizardi A, Kortajarena X, Gutiérrez F, Masiá M, Padilla S, Navarro A, Montolio F, Robledano C, Gregori Colomé J, Adsuar A, Pascual R, Fernández M, García E, García JA, Barber X, Muga R, Sanvisens A, Fuster D, Berenguer J, de Quirós JCLB, Gutiérrez I, Ramírez M, Padilla B, Gijón P, Aldamiz-Echevarría T, Tejerina F, José Parras F, Balsalobre P, Diez C, Latorre LP, Vidal F, Peraire J, Viladés C, Veloso S, Vargas M, López-Dupla M, Olona M, Rull A, Rodríguez-Gallego E, Alba V, Montero Alonso M, López Aldeguer J, Blanes Juliá M, Tasias Pitarch M, Hernández IC, Calabuig Muñoz E, Cuéllar Tovar S, Salavert Lletí M, Navarro JF, González-Garcia J, Arnalich F, Arribas JR, de la Serna JIB, Castro JM, Escosa L, Herranz P, Hontañón V, García-Bujalance S, López-Hortelano MG, González-Baeza A, Martín-Carbonero ML, Mayoral M, Mellado MJ, Micán RE, Montejano R, Luisa Montes M, Moreno V, Pérez-Valero I, Rodés B, Sainz T, Sendagorta E, Stella Alcáriz N, Valencia E, Ramón Blanco J, Antonio Oteo J, Ibarra V, Metola L, Sanz M, Pérez-Martínez L, Arazo P, Sampériz G, Dalmau D, Jaén A, Sanmartí M, Cairó M, Martinez-Lacasa J, Velli P, Font R, Xercavins M, Alonso N, Repáraz J, de Alda MGR, de León Cano MT, de Galarreta BPR, Segura F, José Amengual M, Navarro G, Sala M, Cervantes M, Pineda V, Calzado S, Navarro M, de los Santos I, Sanz Sanz J, Aparicio AS, Sarriá Cepeda C, Garcia-Fraile Fraile L, Martín Gayo E, Moreno S, Luis Casado J, Dronda F, Moreno A, Jesús Pérez Elías M, Gómez Ayerbe C, Gutiérrez C, Madrid N, del Campo Terrón S, Martí P, Ansa U, Serrano S, Jesús Vivancos M, Cano A, García AA, Bravo Urbieta J, Muñoz Á, Jose Alcaraz M, Villalba MDC, García F, Hernández J, Peña A, Muñoz L, Casas P, Alvarez M, Chueca N, Vinuesa D, Martinez-Montes C, Romero JD, Rodríguez C, Puerta T, Carlos Carrió J, Vera M, Ballesteros J, Ayerdi O, Antela A, Losada E, Riera M, Peñaranda M, Leyes M, Ribas MA, Campins AA, Vidal C, Fanjul F, Murillas J, Homar F, Santos J, Ayerbe CG, Viciana I, Palacios R, González CM, Viciana P, Espinosa N, López-Cortés LF, Podzamczer D, Ferrer E, Imaz A, Tiraboschi J, Silva A, Saumoy M, Ribera E, Curran A, Olalla J, del Arco A, de la torre J, Prada JL, de Lomas Guerrero JMG, Stachowski JP, Martínez OJ, Vera FJ, Martínez L, García J, Alcaraz B, Jimeno A, Iglesias AC, Souto BP, de Cea AM, Muñoz J, Zubero MZ, Baraia-Etxaburu JM, Ugarte SI, Beneitez OLF, de Munain JL, López MMC, de la Peña M, Lopez M, Galera C, Albendin H, Pérez A, Iborra A, Moreno A, Merlos MA, Vidal A, Amador C, Pasquau F, Ena J, Benito C, Fenoll V, Anguita CG, Rabasa JTA, Suárez-García I, Malmierca E, González-Ruano P, Rodrigo DM, Seco MPR, Vidal MAG, de Zarraga MA, Pérez VE, Molina MJT, García JV, Moreno JPS, Górgolas M, Cabello A, Álvarez B, Prieto L, Sanz Moreno J, Arranz Caso A, Gutiérrez CH, Novella Mena M, Galindo Puerto MJ, Fernando Vilalta R, Ferrer Ribera A, Román AR, Brieva Herrero MT, Juárez AR, López PL, Sánchez IM, Martínez JP, Jiménez MC, Perea RT, Ruiz-Capillas JJJ, Pineda JA. Use of Generic Antiretroviral Drugs and Single-Tablet Regimen De-Simplification for the Treatment of HIV Infection in Spain. AIDS Res Hum Retroviruses 2022; 38:433-440. [PMID: 35357907 DOI: 10.1089/aid.2021.0122] [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: 11/13/2022] Open
Abstract
The present study sought to describe the use of generic drugs and single-tablet regimen (STR) de-simplification for the treatment of human immunodeficiency virus (HIV) infection among 41 hospitals from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). In June 2018, we collected information on when generic antiretroviral drugs (ARVs) were introduced in the different hospitals, how the decisions to use them were made, and how the information was provided to the patients. Most of the nine available generic ARVs in Spain by June 2018 had been introduced in at least 85% of the participating hospitals, except for zidovudine (AZT)/lamivudine (3TC) and AZT. The time difference between the effective marketing date of each generic ARV and its first dispensing date in the hospitals was much shorter for the more recently approved generic ARV since the year 2017. However, only up to 20% of the hospitals de-simplified efavirenz (EFV)/tenofovir disoproxil (TDF)/emtricitabine (FTC), dolutegravir (DTG)/abacavir (ABC)/3TC, and rilpivirine (RPV)/TDF/FTC (to generic EFV+TDF/FTC, DTG+generic ABC/3TC, and RPV+generic TDF/FTC, respectively), whereas the generic STR EFV/TDF/FTC was introduced in 87.8% of the centers. The median times between the date of effective marketing of generic TDF/FTC and the date of de-simplification of EFV/TDF/FTC and RPV/TDF/FTC were 723 [interquartile range (IQR): 369-1,119] and 234 (IQR: 142-264) days, respectively; this time was 155 (IQR: 28-287) days for de-simplification of DTG/ABC/3TC. In conclusion, despite the widespread use of generic ARVs, STRs de-simplification was only undertaken in <20% of the hospitals. There was wide variability in the timing of the introduction of each generic ARV after they were available in the market.
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Affiliation(s)
- Marta Ruiz-Algueró
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
| | - Belén Alejos
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
| | | | | | - José Antonio Iribarren
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, Instituto de Investigación BioDonostia, San Sebastián, Spain
| | - Víctor Asensi
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Mario Pascual-Carrasco
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Unidad de Investigación en Telemedicina y Salud Digital (UITes), Instituto de Salud Carlos III, Madrid, Spain
| | - Adolfo Muñoz
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Unidad de Investigación en Telemedicina y Salud Digital (UITes), Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Jarrín
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
| | - Inés Suárez-García
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain
- Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, Spain
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Moreno-Pérez O, Merino E, Ramos JM, Rodríguez JC, Diaz C, Mas P, Reus S, Sánchez-Martínez R, Boix V, Chico-Sánchez P, Sánchez-Payá J, Portilla J. [Valproic Acid Could Help in the Fight Against COVID-19: a case-control study]. Neurologia 2022:S0213-4853(22)00014-7. [PMID: 35185237 PMCID: PMC8841207 DOI: 10.1016/j.nrl.2022.01.007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/22/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE There is early evidence about Valproic acid (VPA) antiviral effect. Our aim was to investigate the incidence and severity of SARS-CoV-2 infection in VPA users as compared with the general population. MATERIAL AND METHODS A case-control study nested within a cohort, carried out between March 1 and December 17, 2020. Retrospectively, we identified confirmed SARS-CoV-2 infection patients exposed to VPA in our health department (defined as case). We ascertained VPA regimen (all the time (AT)(292 days) or at least 20% of the study period (notAT)(≥58 days) and if VPA levels were in therapeutic range (ATR) (50-100 mcg/mL) in the last 24 months. We calculated the cumulative incidence of SARS-CoV-2 infection and hospital admission in the cases, comparing it with the general unexposed VPA population (controls). RESULTS During the study period, 6183 PCR+ were detected among 281035 inhabitants, of these, 746 were hospitalized. 691 patients were on VPA notAT and 628 (90.1%) AT. The indication for VPA use was epilepsy in 54.9%. The incidence of PCR+ was 1.736 % (OR 0.785 (95%CI 0.443-1.390) and 1.910 % (OR 0.865 (95%CI 0.488-1.533), on VPA notAT and VPA AT patients, respectively vs. 2.201% in people without VPA regimen. Those patients with VPA ATR had a lower risk of PCR + (OR 0.233 (95%CI 0.057-0.951) notAT; OR 0.218 (95%CI 0.053-0.890) AT). Hospital admission incidence was lower in patient on VPA (OR was 0.543 (95% CI 0.076 to 3.871). CONCLUSION Patients with VPA within the therapeutic range had a reduction of SARS-Cov-2 infection incidence greater than 75%. There is a downward trend in the risk of COVID-19 admission by SARS-CoV-2 in patients on VPA therapy. These findings warrant further investigation.
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Affiliation(s)
- Oscar Moreno-Pérez
- Endocrinology and Nutrition department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
| | - Esperanza Merino
- Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Jose Manuel Ramos
- Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
| | - Juan Carlos Rodríguez
- Microbiology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Miguel Hernández University, Elche, Spain
| | - Carmina Diaz
- Neurology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
| | - Patricio Mas
- Pharmacy department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Sergio Reus
- Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
| | - Rosario Sánchez-Martínez
- Internal Medicine department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - Vicente Boix
- Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
| | - Pablo Chico-Sánchez
- Preventive department, Alicante General University Hospital - - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - José Sánchez-Payá
- Preventive department, Alicante General University Hospital - - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - Joaquín Portilla
- Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
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21
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Bou G, Calbo E, Crespo M, Cantón R, Álvarez de Luna FF, García Rodríguez J, Ángel Goenaga M, González-García J, Gonzàlez J, Larrosa N, Martínez-Martínez L, Navarro D, Ramón Paño J, Rivero A, Carlos Rodríguez J, Tomás M, Vilaj J. Justification for 24/7 clinical microbiology services. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2021.08.003] [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]
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22
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Bou G, Calbo E, Crespo M, Cantón R, Álvarez de Luna FF, García Rodríguez J, Ángel Goenaga M, González-García J, Gonzàlez J, Larrosa N, Martínez-Martínez L, Navarro D, Ramón Paño J, Rivero A, Carlos Rodríguez J, Tomás M, Vilaj J. Justification for 24/7 clinical microbiology services. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:1-4. [PMID: 34991847 DOI: 10.1016/j.eimce.2021.08.014] [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] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/12/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Germán Bou
- Servicio de Microbiología, Complejo Hospitalario Universitario La Coruña e Instituto Investigación Biomédica A Coruña (INIBIC), La Coruña, Spain
| | - Esther Calbo
- Unidad de Enfermedades Infecciosas, Hospital Mutua de Terrassa, Universidad Internacional de Cataluña, Barcelona, Spain
| | - Manuel Crespo
- Servicio de Medicina Interna, Instituto de Investigación Galicia Sur, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal e Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | | | - Julio García Rodríguez
- Servicio de Microbiología, Hospital Universitario La Paz, IdiPaz, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Miguel Ángel Goenaga
- Servicio Enfermedades Infecciosas, Hospital Donostia, OSI Donostialdea, Donostia, Spain
| | - Juan González-García
- Servicio de Medicina Interna, Hospital Universitario La Paz, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Instituto de Investigación Hospital Universitario La Paz (IdiPaz), Madrid, Spain
| | - Julià Gonzàlez
- Servicio de Microbiología, Hospital Clínic, Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain; Instituto de Salud Global (ISGlobal) de Barcelona, Barcelona, Spain
| | - Nieves Larrosa
- Servicio de Microbiología, Hospital Universitario Vall d'Hebron, VHIR, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luis Martínez-Martínez
- Unidad de Microbiología Clínica, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Departamento de Química Agrícola, Edafología y Microbiología, Universidad de Córdoba, Córdoba, Spain
| | - David Navarro
- Servicio de Microbiología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - José Ramón Paño
- Servicio de Enfermedades Infecciosas, Hospital Clínico Universitario "Lozano Blesa", IIS Aragón, Zaragoza, Spain
| | - Antonio Rivero
- Servicio de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Universidad de Córdoba, IMIBIC, Córdoba, Spain
| | - Juan Carlos Rodríguez
- Servicio de Microbiología, Hospital General Universitario de Alicante-ISABIAL, Universidad Miguel Hernández, Alicante, Spain
| | - María Tomás
- Servicio de Microbiología, Complejo Hospitalario Universitario La Coruña e Instituto Investigación Biomédica A Coruña (INIBIC), La Coruña, Spain
| | - Jordi Vilaj
- Instituto de Salud Global (ISGlobal) de Barcelona, Barcelona, Spain.
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Gras-Valenti P, Vidal I, Montiel-Higuero I, Escribano I, Algado-Selles N, Chico-Sánchez P, Ventero MP, Jiménez-Sepulveda N, Molina-Pardines C, Merino-Lucas E, Sánchez-Payá J, Rodríguez JC. Evaluation of the validity of Ag PANBIO-COVID19 in the diagnosis of SARS-CoV-2 infection in asymptomatic or mildly infected patients. Rev Esp Quimioter 2021; 34:618-622. [PMID: 34549577 PMCID: PMC8638769 DOI: 10.37201/req/054.2021] [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] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Objective. To assess the validity of SARS-CoV-2 Antigen (Ag) detection for the diagnosis of SARS-CoV-2 infection in mildly infected or asymptomatic patients. Material and methods. Observational study to evaluate diagnostic tests. Non-hospitalized patients with indication for diagnostic testing for SARS-CoV-2 infection were included. The diagnostic test to be evaluated was the determination of Ag and as a reference standard to determine the presence of viral RNA the RT-PCR was used. Results. A total of 494 patients were included. Of these 71.5% (353/494) had symptoms and 28.5% (141/494) were asymptomatic (presurgery screening (35/494) and confirmed case-contact (106/494). The overall sensitivity of the Ag test was 61.1% and the specificity was 99.7%. The sensitivity and specificity in the asymptomatic group were 40% and 100% respectively, and in the symptomatic group 63.5% and 99.6% respectively. In turn, the sensitivity and specificity in the group of symptomatic patients varied according to the time of symptom evolution: in patients with recent symptoms, they were 71.4% and 99.6% respectively, while in patients with symptoms of more than 5 days of evolution, they were 26.7% and 100% respectively. In all groups studied, the presence of antigen is associated with a high viral load (Ct<30 cycles). Conclusions. The use of Ag detection test is not indicated for the diagnosis of SARS-CoV-2 infection in asymptomatic patients or with symptoms of more than 5 days of evolution, but it could be useful in patients with symptoms of 1-5 days of evolution.
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Affiliation(s)
| | | | | | | | | | | | - M P Ventero
- Maria Paz Ventero Martín. Hospital General Universitario de Alicante, C/Pintor Baeza, 12. CP:03010. Spain.
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Moreno-Pérez O, Ramos JM, Gimeno A, Rodríguez JC, Andres M, Leon-Ramirez JM, Valero B, Llorens P, Boix V, Gil J, Merino E. Medium-term serostatus in Spanish case series recovered from SARS-CoV-2 infection. J Med Virol 2021; 93:6030-6039. [PMID: 34138461 PMCID: PMC8426938 DOI: 10.1002/jmv.27135] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/14/2021] [Indexed: 11/08/2022]
Abstract
The medium-term serologic response of SARS-CoV-2 infection recovered individuals is not well known. The aims were to quantify the incidence of seropositive failure in the medium term in a cohort of patients with different COVID-19 severity and to analyze its associated factors. Patients who had recovered from mild and severe forms of SARS-CoV-2 infection in an Academic Spanish hospital (March 12-May 2, 2020), were tested for total anti-SARS-CoV-2 antibodies by electrochemiluminescence immunoassay (Elecsys Anti-SARS-CoV-2 test; Roche Diagnostics GmbH). The non-seropositive status (seropositive failure) incidence (95% CI) was determined. Associations were tested by multiple logistic regression in a global cohort and severe pneumonia subpopulation. Of 435 patients with PCR-confirmed SARS-CoV-2, a serological test was carried out in 325: 210 (64.6%) had severe pneumonia (hospitalized patients), 51 (15.7%) non-severe pneumonia (managed as outpatients), and 64 (19.7%) mild cases without pneumonia. After a median (IQR) of 76 days (70-83) from symptom onset, antibody responses may not consistently develop or reach levels sufficient to be detectable by antibody tests (non-seropositive incidence) in 6.9% (95% CI, 4.4-10.6) and 20.3% (95% CI, 12.2-31.7) of patients with and without pneumonia, respectively. Baseline independent predictors of seropositive failure were higher leukocytes and fewer days of symptoms before admission, while low glomerular filtrate and fever seem associated with serologic response. Age, comorbidity or immunosuppressive therapies (corticosteroids, tocilizumab) did not influence antibody response. In the medium-term, SARS-CoV-2 seropositive failure is not infrequent in COVID-19 recovered patients. Age, comorbidity or immunosuppressive therapies did not influence antibody response.
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Affiliation(s)
- Oscar Moreno-Pérez
- Endocrinology and Nutrition Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.,Clinical Medicine Department, Miguel Hernández University, Elche, Spain
| | - Jose Manuel Ramos
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain.,Internal Medicine Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Adelina Gimeno
- Microbiology Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Juan Carlos Rodríguez
- Microbiology Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.,Miguel Hernández University, Elche, Spain
| | - Mariano Andres
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain.,Rheumatology Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Jose-Manuel Leon-Ramirez
- Pneumology Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Beatriz Valero
- Internal Medicine Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Pere Llorens
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain.,Emergency Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Vicente Boix
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain.,Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Joan Gil
- Pneumology Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Esperanza Merino
- Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
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Merino E, Gimeno A, Alcalde M, Coy J, Boix V, Molina-Pardines C, Ventero MP, Galiana A, Caro E, Rodríguez JC. Impact of Sepsis Flow Chip, a novelty fast microbiology method, in the treatment of bacteremia caused by Gram-negative bacilli. Rev Esp Quimioter 2021; 34:193-199. [PMID: 33764003 PMCID: PMC8179947 DOI: 10.37201/req/109.2020] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective The aim of this study was to assess the impact of the information provided by the new Sepsis Chip Flow system (SFC) and other fast microbiological techniques on the selection of the appropriate antimicrobial treatment by the clinical researchers of an antimicrobial stewardship team. Methods Two experienced clinical researchers performed the theoretical exercise of independently selecting the treatment for patients diagnosed by bacteremia due to bacilli gram negative (BGN). At first, the clinicians had only available the clinical characteristics of 74 real patients. Sequentially, information regarding the Gram stain, MALDI-TOF, and SFC from Vitro were provided. Initially, the researchers prescribed an antimicrobial therapy based on the clinical data, later these data were complementing with information from microbiological techniques, and the clinicians made their decisions again. Results The data provided by the Gram stain reduced the number of patients prescribed with combined treatments (for clinician 1, from 23 to 7, and for clinician 2, from 28 to 12), but the use of carbapenems remained constant. In line with this, the data obtained by the MALDI-TOF also decreased the combined treatment, and the use of carbapenems remained unchanged. By contrast, the data on antimicrobial resistance provided by the SFC reduced the carbapenems treatment. Conclusions From the theoretical model the Gram stain and the MALDI-TOF results achieved a reduction in the combined treatment. However, the new system tested (SFC), due to the resistance mechanism data provided, not only reduced the combined treatment, it also decreased the prescription of the carbapenems.
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Affiliation(s)
| | | | | | | | | | - C Molina-Pardines
- Carmen Molina Pardines, Department of Microbiology, General University Hospital of Alicante-ISABIAL, Spain.
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Ventero MP, Cuadrat RRC, Vidal I, Andrade BGN, Molina-Pardines C, Haro-Moreno JM, Coutinho FH, Merino E, Regitano LCA, Silveira CB, Afli H, López-Pérez M, Rodríguez JC. Nasopharyngeal Microbial Communities of Patients Infected With SARS-CoV-2 That Developed COVID-19. Front Microbiol 2021; 12:637430. [PMID: 33815323 PMCID: PMC8010661 DOI: 10.3389/fmicb.2021.637430] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 12/03/2020] [Accepted: 02/23/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND SARS-CoV-2 is an RNA virus causing COVID-19. The clinical characteristics and epidemiology of COVID-19 have been extensively investigated, however, only one study so far focused on the patient's nasopharynx microbiota. In this study we investigated the nasopharynx microbial community of patients that developed different severity levels of COVID-19. We performed 16S ribosomal DNA sequencing from nasopharyngeal swab samples obtained from SARS-CoV-2 positive (56) and negative (18) patients in the province of Alicante (Spain) in their first visit to the hospital. Positive SARS-CoV-2 patients were observed and later categorized in mild (symptomatic without hospitalization), moderate (hospitalization), and severe (admission to ICU). We compared the microbiota diversity and OTU composition among severity groups and built bacterial co-abundance networks for each group. RESULTS Statistical analysis indicated differences in the nasopharyngeal microbiome of COVID19 patients. 62 OTUs were found exclusively in SARS-CoV-2 positive patients, mostly classified as members of the phylum Bacteroidota (18) and Firmicutes (25). OTUs classified as Prevotella were found to be significantly more abundant in patients that developed more severe COVID-19. Furthermore, co-abundance analysis indicated a loss of network complexity among samples from patients that later developed more severe symptoms. CONCLUSION Our study shows that the nasopharyngeal microbiome of COVID-19 patients showed differences in the composition of specific OTUs and complexity of co-abundance networks. Taxa with differential abundances among groups could serve as biomarkers for COVID-19 severity. Nevertheless, further studies with larger sample sizes should be conducted to validate these results.
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Affiliation(s)
- Maria Paz Ventero
- Microbiology Department, Alicante University General Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - Rafael R. C. Cuadrat
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Inmaculada Vidal
- Microbiology Department, Alicante University General Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - Bruno G. N. Andrade
- Embrapa Pecuária Sudeste, São Carlos, Brazil
- Department of Computer Science, Munster Technological University (MTU), Cork, Ireland
| | - Carmen Molina-Pardines
- Microbiology Department, Alicante University General Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - Jose M. Haro-Moreno
- Evolutionary Genomics Group, División de Microbiología, Universidad Miguel Hernández, San Juan de Alicante, Spain
| | - Felipe H. Coutinho
- Evolutionary Genomics Group, División de Microbiología, Universidad Miguel Hernández, San Juan de Alicante, Spain
| | - Esperanza Merino
- Infectious Diseases Unit, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | | | | | - Haithem Afli
- Department of Computer Science, Munster Technological University (MTU), Cork, Ireland
| | - Mario López-Pérez
- Microbiology Department, Alicante University General Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
- Evolutionary Genomics Group, División de Microbiología, Universidad Miguel Hernández, San Juan de Alicante, Spain
| | - Juan Carlos Rodríguez
- Microbiology Department, Alicante University General Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
- Evolutionary Genomics Group, División de Microbiología, Universidad Miguel Hernández, San Juan de Alicante, Spain
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Álvarez-Martínez FJ, Rodríguez JC, Borrás-Rocher F, Barrajón-Catalán E, Micol V. The antimicrobial capacity of Cistus salviifolius and Punica granatum plant extracts against clinical pathogens is related to their polyphenolic composition. Sci Rep 2021; 11:588. [PMID: 33436818 PMCID: PMC7803989 DOI: 10.1038/s41598-020-80003-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/16/2020] [Indexed: 11/08/2022] Open
Abstract
Antimicrobial resistance poses a serious threat to human health worldwide. Plant compounds may help to overcome antibiotic resistance due to their potential resistance modifying capacity. Several botanical extracts and pure polyphenolic compounds were screened against a panel of eleven bacterial isolates with clinical relevance. The two best performing agents, Cistus salviifolius (CS) and Punica granatum (GP) extracts, were tested against 100 Staphylococcus aureus clinical isolates, which resulted in average MIC50 values ranging between 50-80 µg/mL. CS extract, containing hydrolyzable tannins and flavonoids such as myricetin and quercetin derivatives, demonstrated higher activity against methicillin-resistant S. aureus isolates. GP extract, which contained mostly hydrolyzable tannins, such as punicalin and punicalagin, was more effective against methicillin-sensitive S. aureus isolates. Generalized linear model regression and multiple correspondence statistical analysis revealed a correlation between a higher susceptibility to CS extract with bacterial resistance to beta-lactam antibiotics and quinolones. On the contrary, susceptibility to GP extract was related with bacteria sensitive to quinolones and oxacillin. Bacterial susceptibility to GP and CS extracts was linked to a resistance profile based on cell wall disruption mechanism. In conclusion, a differential antibacterial activity against S. aureus isolates was observed depending on antibiotic resistance profile of isolates and extract polyphenolic composition, which may lead to development of combinatorial therapies including antibiotics and botanical extracts.
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Affiliation(s)
- Francisco Javier Álvarez-Martínez
- Instituto de Biología Molecular y Celular (IBMC) and Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández (UMH), 03202, Elche, Spain
| | - Juan Carlos Rodríguez
- Microbiology Section, University General Hospital of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL Foundation, Alicante, Spain
| | - Fernando Borrás-Rocher
- Statistics and Operative Research Department, Miguel Hernández University (UMH), Avda. Universidad s/n, 03202, Elche, Spain
| | - Enrique Barrajón-Catalán
- Instituto de Biología Molecular y Celular (IBMC) and Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández (UMH), 03202, Elche, Spain.
| | - Vicente Micol
- Instituto de Biología Molecular y Celular (IBMC) and Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández (UMH), 03202, Elche, Spain
- CIBER, Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III (CB12/03/30038), Madrid, Spain
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Gil R, Bitar P, Deza C, Dreyse J, Florenzano M, Ibarra C, Jorquera J, Melo J, Olivi H, Parada MT, Rodríguez JC, Undurraga Á. CUADRO CLÍNICO DEL COVID-19. Revista Médica Clínica Las Condes 2021. [PMCID: PMC7849538 DOI: 10.1016/j.rmclc.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
El Coronavirus SARS-CoV-2 produce la enfermedad COVID-19, cuya manifestación más grave y potencialmente letal es la neumonía. En este artículo revisaremos las manifestaciones clínicas del COVID-19, la fisiopatología de la neumonía, el manejo intrahospitalario previo al ingreso a Unidades de Cuidados Intensivos, la embolia pulmonar que es una complicación muy frecuente de esta enfermedad y el seguimiento de los pacientes posterior al alta. Para esta publicación nos hemos basado en publicaciones médicas y en estudios que hemos hecho durante esta pandemia en nuestro Centro de Enfermedades Respiratorias.
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Suárez-García I, Moreno C, Ruiz-Algueró M, Pérez-Elías MJ, Navarro M, Díez Martínez M, Viciana P, Pérez-Martínez L, Górgolas M, Amador C, de Zárraga MA, Jarrín I, Moreno S, Jarrín I, Dalmau D, Navarro ML, González MI, Garcia F, Poveda E, Iribarren JA, Gutiérrez F, Rubio R, Vidal F, Berenguer J, González J, Muñoz-Fernández MÁ, Jarrin I, Alejos B, Moreno C, Iniesta C, Sousa LMG, Perez NS, Rava M, Muñoz-Fernández MÁ, Fernández IC, Merino E, García G, Portilla I, Agea I, Portilla J, Sánchez-Payá J, Rodríguez JC, Gimeno L, Giner L, Díez M, Carreres M, Reus S, Boix V, Torrús D, Lirola AL, García D, Díaz-Flores F, Gómez JL, del Mar Alonso M, Pelazas R, Hernández J, Alemán MR, Hernández MI, Asensi V, Valle E, Carmenado MER, Secades TSZ, Is LP, Rubio R, Pulido F, Bisbal O, Hernando A, Domínguez L, Crestelo DR, Bermejo L, Santacreu M, Iribarren JA, Arrizabalaga J, Aramburu MJ, Camino X, Rodríguez-Arrondo F, von Wichmann MÁ, Tomé LP, Goenaga MÁ, Bustinduy MJ, Azkune H, Ibarguren M, Lizardi A, Kortajarena X, Oyaga MPC, Igartua MU, Gutiérrez F, Masiá M, Padilla S, Navarro A, Montolio F, Robledano C, Colomé JG, Adsuar A, Pascual R, Fernández M, García E, García JA, Barber X, Muga R, Sanvisens A, Fuster D, Berenguer J, de Quirós JCLB, Gutiérrez I, Ramírez M, Padilla B, Gijón P, Aldamiz-Echevarría T, Tejerina F, Parras FJ, Balsalobre P, Diez C, Latorre LP, Fanciulli C, Vidal F, Peraire J, Viladés C, Veloso S, Vargas M, Olona M, Rull A, Rodríguez-Gallego E, Alba V, Castellanos AJ, López-Dupla M, Alonso MM, Aldeguer JL, Juliá MB, Pitarch MT, Hernández IC, Muñoz EC, Tovar SC, Lletí MS, Navarro JF, González-Garcia J, Arnalich F, Arribas JR, de la Serna JIB, Castro JM, Escosa L, Herranz P, Hontañón V, García-Bujalance S, López-Hortelano MG, González-Baeza A, Martín-Carbonero ML, Mayoral M, Mellado MJ, Micán RE, Montejano R, Montes ML, Moreno V, Pérez-Valero I, Rodés B, Sainz T, Sendagorta E, Alcáriz NS, Valencia E, Blanco JR, Oteo JA, Ibarra V, Metola L, Sanz M, Pérez-Martínez L, Arazo P, Sampériz G, Dalmau D, Jaén A, Sanmartí M, Cairó M, Martinez-Lacasa J, Velli P, Font R, Xercavins M, Alonso N, Marcotegui MR, Repáraz J, de Alda MGR, de León Cano MT, de Galarreta BPR, Amengual MJ, Navarro G, Garcia MC, Isbert SC, Vilasaro MN, de los Santos I, Sanz JS, Aparicio AS, Cepeda CS, Fraile LGF, Gayo EM, Moreno S, Osorio JLC, Nuñez FD, Zamora AM, Elías MJP, Gutiérrez C, Madrid N, del Campo Terrón S, Villar SS, Gallego MJV, Sanz JM, Urroz UA, Velasco T, Bernal E, Sanchez AC, García AA, Urbieta JB, Perez AM, Alcaraz MJ, del Carmen Villalba M, García F, Quero JH, Medina LM, Alvarez M, Chueca N, García DV, Martinez-Montes C, Beltran CG, de Salazar Gonzalerz A, Lopez AF, Utrilla MR, Del Romero J, Rodríguez C, Puerta T, Carrió JC, Vera M, Ballesteros J, Ayerdi O, Antela A, Losada E, Riera M, Peñaranda M, Leyes M, Ribas MA, Campins AA, Vidal C, Fanjul F, Murillas J, Homar F, Santos J, Ayerbe CG, Viciana I, Palacios R, López CP, Gonzalez-Domenec CM, Viciana P, Espinosa N, López-Cortés LF, Podzamczer D, Imaz A, Tiraboschi J, Silva A, Saumoy M, Prieto P, Ribera E, Curran A, Sierra JO, Stachowski JP, del Arco A, de la torre J, Prada JL, de Lomas Guerrero JMG, Martínez OJ, Vera FJ, Martínez L, García J, Alcaraz B, Jimeno A, Iglesias AC, Souto BP, de Cea AM, Muñoz J, Zubero MZ, Baraia-Etxaburu JM, Ugarte SI, Beneitez OLF, de Munain JL, López MMC, de la Peña M, Lopez M, Azkarreta IL, Galera C, Albendin H, Pérez A, Iborra A, Moreno A, Merlos MA, Vidal A, Meca M, Amador C, Pasquau F, Ena J, Benito C, Fenoll V, Anguita CG, Rabasa JTA, Suárez-García I, Malmierca E, González-Ruano P, Rodrigo DM, Seco MPR, Mohamed-Balghata MO, Vidal MAG, de Zarraga MA, Pérez VE, Molina MJT, García JV, Moreno JPS, Górgolas M, Cabello A, Álvarez B, Prieto L, Moreno JS, Caso AA, Gutiérrez CH, Mena MN, Puerto MJG, Vilalta RF, Ribera AF, Román AR, Juárez AR, López PL, Sánchez IM, Casas MF, Espejo AC, Jiménez MC, Perea RT, Pineda JA, Mayo PR, Sanchez JM, Gutierrez NM, Real LM, Gomez AC, Fuertes MF, Gonzalez-Serna A, Poveda E, Pérez A, Crespo M, Morano L, Miralles C, Ocampo A, Pousada G. Effectiveness of the combination elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COB/TFV/FTC) plus darunavir among treatment-experienced patients in clinical practice: a multicentre cohort study. AIDS Res Ther 2020; 17:45. [PMID: 32690099 PMCID: PMC7372769 DOI: 10.1186/s12981-020-00302-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 07/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the effectiveness and tolerability of the combination elvitegravir/cobicistat/tenofovir/emtricitabine plus darunavir (EVG/COB/TFV/FTC + DRV) in treatment-experienced patients from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). METHODS Treatment-experienced patients starting treatment with EVG/COB/TFV/FTC + DRV during the years 2014-2018 and with more than 24 weeks of follow-up were included. TFV could be administered either as tenofovir disoproxil fumarate or tenofovir alafenamide. We evaluated virological response, defined as viral load (VL) < 50 copies/ml and < 200 copies/ml at 24 and 48 weeks after starting this regimen, stratified by baseline VL (< 50 or ≥ 50 copies/ml at the start of the regimen). RESULTS We included 39 patients (12.8% women). At baseline, 10 (25.6%) patients had VL < 50 copies/ml and 29 (74.4%) had ≥ 50 copies/ml. Among patients with baseline VL < 50 copies/ml, 85.7% and 80.0% had VL < 50 copies/ml at 24 and 48 weeks, respectively, and 100% had VL < 200 copies/ml at 24 and 48 weeks. Among patients with baseline VL ≥ 50 copies/ml, 42.3% and 40.9% had VL < 50 copies/ml and 69.2% and 68.2% had VL < 200 copies/ml at 24 and 48 weeks. During the first 48 weeks, no patients changed their treatment due to toxicity, and 4 patients (all with baseline VL ≥ 50 copies/ml) changed due to virological failure. CONCLUSIONS EVG/COB/TFV/FTC + DRV was well tolerated and effective in treatment-experienced patients with undetectable viral load as a simplification strategy, allowing once-daily, two-pill regimen with three antiretroviral drug classes. Effectiveness was low in patients with detectable viral loads.
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Moreno-Pérez O, Andres M, Leon-Ramirez JM, Sánchez-Payá J, Rodríguez JC, Sánchez R, García-Sevila R, Boix V, Gil J, Merino E. Experience with tocilizumab in severe COVID-19 pneumonia after 80 days of follow-up: A retrospective cohort study. J Autoimmun 2020; 114:102523. [PMID: 32690352 PMCID: PMC7365106 DOI: 10.1016/j.jaut.2020.102523] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To describe the clinical characteristics and predictors of major outcomes in patients treated with tocilizumab (TCZ) for severe COVID-19 pneumonia. PATIENTS AND METHODS Case series of all sequential patients with severe COVID-19 pneumonia treated with TCZ at an Academic Spanish hospital (March 12 - May 2, 2020). Clinical outcomes: death, length of hospital stay. An early clinical response to TCZ (48-72 h after the administration) was assessed by variations in respiratory function markers, Brescia COVID Respiratory Severity Scale (BCRSS), inflammatory parameters, and patients' and physicians' opinion. Associations were tested by multiple logistic regression. RESULTS From a cohort of 236 patients, 77 patients treated with TCZ were included (median age 62 years (IQR 53.0-72.0), 64.9% were males), 42.9% had Charlson index ≥3; hypertension (41.6%), obesity (34.7%), and diabetes (20.8%). Median follow-up was 83.0 days (78.0-86.5), no patient was readmitted. ICU admission was required for 42 (54.5%), invasive mechanical ventilation in 38 (49.4%) and 10 patients died (12.9% global, 23.8% at ICU admitted). After multivariate adjustment, TCZ response by BCRSS (OR 0.03 (0.01-0.68), p = 0.028), and Charlson index (OR 3.54 (1.20-10.44), p = 0.022) has been identified as independent factors associated with mortality. Median of hospital stay was 16.0 days (11.0-23.0); BCRSS, physician subjective and D-dimer response were associated with shorter hospitalization stay. CONCLUSIONS In a Mediterranean cohort, use of tocilizumab for severe COVID-19 show 12.9% of mortality. Early TCZ-response by BCRSS and low comorbidity were associated with increased survival. Early TCZ-response was related to shorter median hospital stay.
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MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antiviral Agents/administration & dosage
- Betacoronavirus/immunology
- Betacoronavirus/pathogenicity
- COVID-19
- Coronavirus Infections/diagnosis
- Coronavirus Infections/immunology
- Coronavirus Infections/mortality
- Coronavirus Infections/therapy
- Drug Therapy, Combination
- Female
- Fibrin Fibrinogen Degradation Products/analysis
- Follow-Up Studies
- Hospital Mortality
- Humans
- Infusions, Intravenous
- Interleukin-6/immunology
- Interleukin-6/metabolism
- Length of Stay/statistics & numerical data
- Male
- Middle Aged
- Pandemics
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/immunology
- Pneumonia, Viral/mortality
- Pneumonia, Viral/therapy
- Prognosis
- Receptors, Interleukin-6/antagonists & inhibitors
- Receptors, Interleukin-6/metabolism
- Respiration, Artificial/statistics & numerical data
- Respiratory Function Tests/statistics & numerical data
- Retrospective Studies
- SARS-CoV-2
- Severity of Illness Index
- Spain/epidemiology
- Survival Analysis
- Time Factors
- Time-to-Treatment
- Treatment Outcome
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Affiliation(s)
- Oscar Moreno-Pérez
- Endocrinology and Nutrition Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain; Clinical Medicine Department, Miguel Hernández University, Elche, Spain.
| | - Mariano Andres
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain; Rheumatology Department, Alicante General University Hospital Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Jose-Manuel Leon-Ramirez
- Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - José Sánchez-Payá
- Preventive Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Juan Carlos Rodríguez
- Microbiology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain; Miguel Hernández University, Elche, Spain.
| | - Rosario Sánchez
- Internal Medicine Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Raquel García-Sevila
- Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Vicente Boix
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain; Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Joan Gil
- Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Esperanza Merino
- Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
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Ventero MP, Espinosa N, Jover R, Guillen Y, Merino E, Rodríguez JC. Evolution of intestinal microbiome in a process of faecal microbiota transfer (FMT) in a patient with Clostridioides difficile infection: NGS analysis with different software programs. Enferm Infecc Microbiol Clin 2020; 39:184-187. [PMID: 32680797 DOI: 10.1016/j.eimc.2020.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/26/2020] [Revised: 04/30/2020] [Accepted: 05/16/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Clostridioides difficile infection (CDI) has become a global healthcare challenge due to increases in its incidence and mortality rates. Faecal microbiota transfer (FMT) is postulated as a protocol to prevent CDI recurrence. MATERIAL AND METHODS A donor faecal sample and patient faecal samples (pre-FMT and post-FMT) were analysed. The r16S gene was amplified and sequenced by NGS, and its diversity and taxonomy composition were examined. RESULTS Microbial richness increased in post-FMT samples, and the β diversity studies grouped the samples into two clusters. One included the non-pathological samples (donor and pre-FMT samples), and the other included the pathological sample. The results obtained by Qiime2 and Bioconductor were similar. CONCLUSION The analysis showed an increase in taxonomic diversity after the FMT, which suggests its usefulness. Moreover, these results showed that standardisation of bioinformatics analysis is key.
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Affiliation(s)
- María Paz Ventero
- Servicio de Microbiología. Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria y Biomédica de Alicante-ISABIAL, Alicante, España.
| | - Noelia Espinosa
- Servicio de Microbiología. Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria y Biomédica de Alicante-ISABIAL, Alicante, España
| | - Rodrigo Jover
- Servicio Digestivo. Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria y Biomédica de Alicante-ISABIAL, Alicante, España
| | | | - Esperanza Merino
- Unidad de Enfermedades infecciosas. Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria y Biomédica de Alicante-ISABIAL, Alicante, España
| | - Juan Carlos Rodríguez
- Servicio de Microbiología. Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria y Biomédica de Alicante-ISABIAL, Alicante, España; Departamento de Producción Vegetal y Microbiología. Universidad Miguel Hernández de Elche (Alicante), Elche, España
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Ruiz-Azcona L, Santibañez M, Gimeno A, Roig FJ, Vanaclocha H, Ventero MP, Boix V, Sánchez-Payá J, Portilla-Sogorb J, Merino E, Rodríguez JC. Etiology of bloodstream infections at a population level during 2013-2017 in the Autonomous Community of Valencia, Spain. Rev Esp Quimioter 2020; 33:200-206. [PMID: 32345004 PMCID: PMC7262391 DOI: 10.37201/req/024.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 02/03/2023]
Abstract
Introduction Bloodstream Infections has become in one of the priorities for the antimicrobial stewardship teams due to their high mortality and morbidity rates. Usually, the first antibiotic treatment for this pathology must be empirical, without microbiology data about the microorganism involved. For this reason, the population studies about the etiology of bacteremia are a key factor to improve the selection of the empirical treatment, because they describe the main microorganisms associated to this pathology in each area, and this data could facilitate the selection of correct antibiotic therapy. Material and methods This study describes the etiology of bloodstream infections in the Southeast of Spain. The etiology of bacteremia was analysed by a retrospective review of all age-ranged patients from every public hospital in the Autonomous Community of Valencia (approximately 5,000,000 inhabitants) for five years. Results A total of 92,097 isolates were obtained, 44.5% of them were coagulase-negative staphylococci. Enterobacteriales was the most prevalent group and an increase in frequency was observed along the time. Streptococcus spp. were the second microorganisms more frequently isolated. Next, the most prevalent were Staphylococcus aureus and Enterococcus spp., both with a stable incidence along the study. Finally, Pseudomonas aeruginosa was the fifth microorganism more frequently isolated. Conclusions These data constitute a useful tool that can help in the choice of empirical treatment for bloodstream infections, since the knowledge of local epidemiology is key to prescribe a fast and appropriate antibiotic therapy, aspect capital to improve survival.
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Affiliation(s)
| | | | | | | | | | - M P Ventero
- Maria Paz Ventero, Servicio Microbiología. Hospital General Universitario de Alicante. Instituto de Investigación, Biomédica y Sanitaria de Alicante (ISABIAL). C/ Pintor Baeza 10. 03010, Alicante, Spain.
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Xu Y, Cancino-Muñoz I, Torres-Puente M, Villamayor LM, Borrás R, Borrás-Máñez M, Bosque M, Camarena JJ, Colomer-Roig E, Colomina J, Escribano I, Esparcia-Rodríguez O, Gil-Brusola A, Gimeno C, Gimeno-Gascón A, Gomila-Sard B, González-Granda D, Gonzalo-Jiménez N, Guna-Serrano MR, López-Hontangas JL, Martín-González C, Moreno-Muñoz R, Navarro D, Navarro M, Orta N, Pérez E, Prat J, Rodríguez JC, Ruiz-García MM, Vanaclocha H, Colijn C, Comas I. High-resolution mapping of tuberculosis transmission: Whole genome sequencing and phylogenetic modelling of a cohort from Valencia Region, Spain. PLoS Med 2019; 16:e1002961. [PMID: 31671150 PMCID: PMC6822721 DOI: 10.1371/journal.pmed.1002961] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 10/07/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Whole genome sequencing provides better delineation of transmission clusters in Mycobacterium tuberculosis than traditional methods. However, its ability to reveal individual transmission links within clusters is limited. Here, we used a 2-step approach based on Bayesian transmission reconstruction to (1) identify likely index and missing cases, (2) determine risk factors associated with transmitters, and (3) estimate when transmission happened. METHODS AND FINDINGS We developed our transmission reconstruction method using genomic and epidemiological data from a population-based study from Valencia Region, Spain. Tuberculosis (TB) incidence during the study period was 8.4 cases per 100,000 people. While the study is ongoing, the sampling frame for this work includes notified TB cases between 1 January 2014 and 31 December 2016. We identified a total of 21 transmission clusters that fulfilled the criteria for analysis. These contained a total of 117 individuals diagnosed with active TB (109 with epidemiological data). Demographic characteristics of the study population were as follows: 80/109 (73%) individuals were Spanish-born, 76/109 (70%) individuals were men, and the mean age was 42.51 years (SD 18.46). We found that 66/109 (61%) TB patients were sputum positive at diagnosis, and 10/109 (9%) were HIV positive. We used the data to reveal individual transmission links, and to identify index cases, missing cases, likely transmitters, and associated transmission risk factors. Our Bayesian inference approach suggests that at least 60% of index cases are likely misidentified by local public health. Our data also suggest that factors associated with likely transmitters are different to those of simply being in a transmission cluster, highlighting the importance of differentiating between these 2 phenomena. Our data suggest that type 2 diabetes mellitus is a risk factor associated with being a transmitter (odds ratio 0.19 [95% CI 0.02-1.10], p < 0.003). Finally, we used the most likely timing for transmission events to study when TB transmission occurred; we identified that 5/14 (35.7%) cases likely transmitted TB well before symptom onset, and these were largely sputum negative at diagnosis. Limited within-cluster diversity does not allow us to extrapolate our findings to the whole TB population in Valencia Region. CONCLUSIONS In this study, we found that index cases are often misidentified, with downstream consequences for epidemiological investigations because likely transmitters can be missed. Our findings regarding inferred transmission timing suggest that TB transmission can occur before patient symptom onset, suggesting also that TB transmits during sub-clinical disease. This result has direct implications for diagnosing TB and reducing transmission. Overall, we show that a transition to individual-based genomic epidemiology will likely close some of the knowledge gaps in TB transmission and may redirect efforts towards cost-effective contact investigations for improved TB control.
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Affiliation(s)
- Yuanwei Xu
- Centre for Mathematics of Precision Healthcare, Department of Mathematics, Imperial College London, London, United Kingdom
| | - Irving Cancino-Muñoz
- Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain
| | - Manuela Torres-Puente
- Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain
| | | | - Rafael Borrás
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
| | - María Borrás-Máñez
- Microbiology and Parasitology Service, Hospital Universitario de La Ribera, Alzira, Spain
| | | | - Juan J. Camarena
- Microbiology Service, Hospital Universitario Dr. Peset, Valencia, Spain
| | - Ester Colomer-Roig
- Genomics and Health Unit, FISABIO Public Health, Valencia, Spain
- Microbiology Service, Hospital Universitario Dr. Peset, Valencia, Spain
| | - Javier Colomina
- Microbiology and Parasitology Service, Hospital Universitario de La Ribera, Alzira, Spain
| | - Isabel Escribano
- Microbiology Laboratory, Hospital Virgen de los Lírios, Alcoy, Spain
| | | | - Ana Gil-Brusola
- Microbiology Service, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Concepción Gimeno
- Microbiology Service, Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Bárbara Gomila-Sard
- Microbiology Service, Hospital General Universitario de Castellón, Castellon, Spain
| | | | | | | | | | - Coral Martín-González
- Microbiology Service, Hospital Universitario de San Juan de Alicante, Alicante, Spain
| | - Rosario Moreno-Muñoz
- Microbiology Service, Hospital General Universitario de Castellón, Castellon, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
| | - María Navarro
- Microbiology Service, Hospital de la Vega Baixa, Orihuela, Spain
| | - Nieves Orta
- Microbiology Service, Hospital San Francesc de Borja, Gandía, Spain
| | - Elvira Pérez
- Subdirección General de Epidemiología y Vigilancia de la Salud, Dirección General de Salud Pública, Valencia, Spain
| | - Josep Prat
- Microbiology Service, Hospital de Sagunto, Sagunto, Spain
| | | | | | - Herme Vanaclocha
- Subdirección General de Epidemiología y Vigilancia de la Salud, Dirección General de Salud Pública, Valencia, Spain
| | - Caroline Colijn
- Centre for Mathematics of Precision Healthcare, Department of Mathematics, Imperial College London, London, United Kingdom
- Department of Mathematics, Simon Fraser University, Burnaby, British Columbia, Canada
- * E-mail: (CC); (IC)
| | - Iñaki Comas
- Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain
- * E-mail: (CC); (IC)
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Hessheimer AJ, Coll E, Ruíz P, Gastaca M, Rivas JI, Gómez M, Sánchez B, Santoyo J, Ramírez P, Parrilla P, Marín LM, Gómez-Bravo MÁ, García-Valdecasas JC, López-Monclús J, Boscá A, López-Andújar R, Fundora-Suárez Y, Villar J, García-Sesma Á, Jiménez C, Rodríguez-Laíz G, Lladó L, Rodríguez JC, Barrera M, Charco R, López-Baena JÁ, Briceño J, Pardo F, Blanco G, Pacheco D, Domínguez-Gil B, Sánchez Turrión V, Fondevila C. Reply to: "Normothermic regional perfusion - What is the benefit?". J Hepatol 2019; 71:443-445. [PMID: 31130439 DOI: 10.1016/j.jhep.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 12/04/2022]
Affiliation(s)
- Amelia J Hessheimer
- Department of General & Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Spain
| | | | | | | | | | - Manuel Gómez
- Complejo Hospitalario Universitario La Coruña, Spain
| | | | | | - Pablo Ramírez
- Hospital Clínico Universitario Virgen de la Arrixaca (IMIB), Murcia, Spain
| | - Pascual Parrilla
- Hospital Clínico Universitario Virgen de la Arrixaca (IMIB), Murcia, Spain
| | | | | | - Juan Carlos García-Valdecasas
- Department of General & Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Spain
| | | | - Andrea Boscá
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | - Jesús Villar
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | | | - Gonzalo Rodríguez-Laíz
- Department of General & Digestive Surgery, ISABIAL, Hospital General Universitario de Alicante, Spain
| | - Laura Lladó
- Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Spain
| | | | - Manuel Barrera
- Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Ramón Charco
- Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | | | | | | | | | - David Pacheco
- Hospital Universitario Río Hortega, Valladolid, Spain
| | | | | | - Constantino Fondevila
- Department of General & Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Spain.
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Rodríguez JC, Borrajo E, Bosque M, Camarena JJ, Colomina J, Márquez MVD, Fuentes E, García-Aguayo JM, Gimeno A, Gonzalo N, Guna R, Martínez O, Moreno R, Nogueira JM, Orta N, Prat J, Yagüe A, Gimeno C, Navarro D. Adoption of new technologies in laboratory workflow practices for positive blood culture bottles: a cross-sectional survey among hospitals in the Autonomous Community of Valencia, Spain. Eur J Clin Microbiol Infect Dis 2019; 38:1199-1202. [DOI: 10.1007/s10096-019-03522-1] [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] [Received: 02/19/2019] [Accepted: 02/25/2019] [Indexed: 11/29/2022]
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Hessheimer AJ, Coll E, Ruíz P, Gastaca M, Rivas JI, Gómez M, Sánchez B, Santoyo J, Ramírez P, Parrilla P, Marín LM, Gómez-Bravo MÁ, García-Valdecasas JC, López-Monclús J, Boscá A, López-Andújar R, Fundora-Suárez J, Villar J, García-Sesma Á, Jiménez C, Rodríguez-Laíz G, Lladó L, Rodríguez JC, Barrera M, Charco R, López-Baena JÁ, Briceño J, Pardo F, Blanco G, Pacheco D, Domínguez-Gil B, Sánchez Turrión V, Fondevila C. The UK DCD Risk Score: Still no consensus on futility in DCD liver transplantation. J Hepatol 2019; 70:1034-1035. [PMID: 30782424 DOI: 10.1016/j.jhep.2019.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 12/04/2022]
Affiliation(s)
- Amelia J Hessheimer
- Department of General & Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Spain
| | | | | | | | | | - Manuel Gómez
- Complejo Hospitalario Universitario La Coruña, Spain
| | | | | | - Pablo Ramírez
- Hospital Clínico Universitario Virgen de la Arrixaca (IMIB), Murcia, Spain
| | - Pascual Parrilla
- Hospital Clínico Universitario Virgen de la Arrixaca (IMIB), Murcia, Spain
| | | | | | - Juan Carlos García-Valdecasas
- Department of General & Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Spain
| | | | - Andrea Boscá
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | - Jesús Villar
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | | | - Gonzalo Rodríguez-Laíz
- Department of General & Digestive Surgery, ISABIAL, Hospital General Universitario de Alicante, Spain
| | - Laura Lladó
- Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Spain
| | | | - Manuel Barrera
- Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Ramón Charco
- Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | | | | | | | | | - David Pacheco
- Hospital Universitario Río Hortega, Valladolid, Spain
| | | | | | - Constantino Fondevila
- Department of General & Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Spain.
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Hessheimer AJ, Coll E, Torres F, Ruíz P, Gastaca M, Rivas JI, Gómez M, Sánchez B, Santoyo J, Ramírez P, Parrilla P, Marín LM, Gómez-Bravo MÁ, García-Valdecasas JC, López-Monclús J, Boscá A, López-Andújar R, Fundora-Suárez J, Villar J, García-Sesma Á, Jiménez C, Rodríguez-Laíz G, Lladó L, Rodríguez JC, Barrera M, Charco R, López-Baena JÁ, Briceño J, Pardo F, Blanco G, Pacheco D, Domínguez-Gil B, Sánchez Turrión V, Fondevila C. Normothermic regional perfusion vs. super-rapid recovery in controlled donation after circulatory death liver transplantation. J Hepatol 2019; 70:658-665. [PMID: 30582980 DOI: 10.1016/j.jhep.2018.12.013] [Citation(s) in RCA: 171] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/14/2018] [Accepted: 12/08/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Although there is increasing interest in its use, definitive evidence demonstrating a benefit for postmortem normothermic regional perfusion (NRP) in controlled donation after circulatory death (cDCD) liver transplantation is lacking. The aim of this study was to compare results of cDCD liver transplants performed with postmortem NRP vs. super-rapid recovery (SRR), the current standard for cDCD. METHODS This was an observational cohort study including all cDCD liver transplants performed in Spain between June 2012 and December 2016, with follow-up ending in December 2017. Each donor hospital determined whether organ recovery was performed using NRP or SRR. The propensity scores technique based on the inverse probability of treatment weighting (IPTW) was used to balance covariates across study groups; logistic and Cox regression models were used for binary and time-to-event outcomes. RESULTS During the study period, there were 95 cDCD liver transplants performed with postmortem NRP and 117 with SRR. The median donor age was 56 years (interquartile range 45-65 years). After IPTW analysis, baseline covariates were balanced, with all absolute standardised differences <0.15. IPTW-adjusted risks were significantly improved among NRP livers for overall biliary complications (odds ratio 0.14; 95% CI 0.06-0.35, p <0.001), ischaemic type biliary lesions (odds ratio 0.11; 95% CI 0.02-0.57; p = 0.008), and graft loss (hazard ratio 0.39; 95% CI 0.20-0.78; p = 0.008). CONCLUSIONS The use of postmortem NRP in cDCD liver transplantation appears to reduce postoperative biliary complications, ischaemic type biliary lesions and graft loss, and allows for the transplantation of livers even from cDCD donors of advanced age. LAY SUMMARY This is a propensity-matched nationwide observational cohort study performed using livers recovered from donors undergoing cardiac arrest provoked by the intentional withdrawal of life support (controlled donation after circulatory death, cDCD). Approximately half of the livers were recovered after a period of postmortem in situ normothermic regional perfusion, which restored warm oxygenated blood to the abdominal organs, whereas the remainder were recovered after rapid preservation with a cold solution. The study results suggest that the use of postmortem normothermic regional perfusion helps reduce rates of post-transplant biliary complications and graft loss and allows for the successful transplantation of livers from older cDCD donors.
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Affiliation(s)
- Amelia J Hessheimer
- Department of General & Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | | | - Ferrán Torres
- Medical Statistics Core Facility, IDIBAPS, Hospital Clínic Barcelona & Biostatistics Unit, Faculty of Medicine, Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | | | | | - Manuel Gómez
- Complejo Hospitalario Universitario La Coruña, La Coruña, Spain
| | | | - Julio Santoyo
- Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Pablo Ramírez
- Hospital Clínico Universitario Virgen de la Arrixaca (IMIB), Murcia, Spain
| | - Pascual Parrilla
- Hospital Clínico Universitario Virgen de la Arrixaca (IMIB), Murcia, Spain
| | | | | | - Juan Carlos García-Valdecasas
- Department of General & Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | | | - Andrea Boscá
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | - Jesús Villar
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | | | - Gonzalo Rodríguez-Laíz
- Department of General & Digestive Surgery, ISABIAL, Hospital General Universitario de Alicante, Alicante, Spain
| | - Laura Lladó
- Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Spain
| | | | - Manuel Barrera
- Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Ramón Charco
- Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | | | | | | | | | - David Pacheco
- Hospital Universitario Río Hortega, Valladolid, Spain
| | | | | | - Constantino Fondevila
- Department of General & Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain.
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Camelo-Castillo A, Henares D, Brotons P, Galiana A, Rodríguez JC, Mira A, Muñoz-Almagro C. Nasopharyngeal Microbiota in Children With Invasive Pneumococcal Disease: Identification of Bacteria With Potential Disease-Promoting and Protective Effects. Front Microbiol 2019; 10:11. [PMID: 30745895 PMCID: PMC6360994 DOI: 10.3389/fmicb.2019.00011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 04/03/2018] [Accepted: 01/07/2019] [Indexed: 01/26/2023] Open
Abstract
Background and Aims: The risk of suffering from some infectious diseases can be related to specific microbiota profiles. Specifically, the nasopharyngeal microbiota could play a role as a risk or protective factor in the development of invasive disease caused by S. pneumoniae. Methodology: We analyzed the nasopharyngeal microbiota of children with invasive pneumococcal disease (IPD) and that of healthy controls matched by age, sex, and seasonality from Catalonia, Spain. Epidemiological, microbiological and clinical variables were considered to compare microbiota profiles, analyzed by sequencing the V1-V4 region of the 16S rRNA gene. Results: Twenty-eight children with IPD (median age 43 months) and 28 controls (42.6 months) were included in the study. IPD children presented a significantly higher bacterial diversity and richness (p < 0.001). Principal coordinate analysis revealed three different microbiota profiles: microbiota A, dominated by the genus Dolosigranulum (44.3%); Microbiota B, mostly represented by Streptococcus (36.9%) and Staphylococcus (21.3%) and a high diversity of anaerobic genera including Veillonella, Prevotella and Porphyromonas; and Microbiota C, mainly containing Haemophilus (52.1%) and Moraxella (31.4%). The only explanatory factor for the three microbiotas was the classification of children into disease or healthy controls (p = 0.006). A significant negative correlation was found between Dolosigranulum vs. Streptococcus (p = 0.029), suggesting a potential antagonistic effect against pneumococcal pathogens. Conclusions: The higher bacterial diversity and richness in children with IPD could suggest an impaired immune response. This lack of immune competence could be aggravated by breastfeeding <6 months and by the presence of keystone pathogens such as Porphyromonas, a bacterium which has been shown to be able to manipulate the immune response, and that could favor the overgrowth of many proteolytic anaerobic organisms giving rise to a dramatic dysbiosis. From an applied viewpoint, we found suggestive microbiota profiles associated to IPD or asymptomatic colonization that could be used as disease biomarkers or to pave the way for characterizing health-associated inhabitants of the respiratory tract. The identification of beneficial bacteria could be useful to prevent pneumococcal infections by integrating those microorganisms in a probiotic formula. The present study suggests not only respiratory tract samples, but also breast milk, as a potential source of those beneficial bacteria.
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Affiliation(s)
- Anny Camelo-Castillo
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Desirée Henares
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.,Network of Epidemiology and Public Health, CIBERESP, Barcelona, Spain
| | - Pedro Brotons
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.,Network of Epidemiology and Public Health, CIBERESP, Barcelona, Spain
| | - Antonio Galiana
- Department of Microbiology, Hospital de Alicante, Alicante, Spain
| | | | - Alex Mira
- Network of Epidemiology and Public Health, CIBERESP, Barcelona, Spain.,Center for Advanced Research in Public Health, FISABIO Foundation, Valencia, Spain
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.,Network of Epidemiology and Public Health, CIBERESP, Barcelona, Spain.,School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
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Tormo N, Albert E, Borrajo E, Bosque M, Camarena JJ, Domínguez V, Fuentes E, Gascón I, Gomila B, Gonzalo N, Jiménez M, Martínez O, Nogueira JM, Orta N, Prat J, Rodríguez JC, Gimeno C, Navarro D. A survey on practices for active surveillance of carriage of multidrug-resistant bacteria in hospitals in the Autonomous Community of Valencia, Spain. Eur J Clin Microbiol Infect Dis 2018; 37:2069-2074. [PMID: 30105621 DOI: 10.1007/s10096-018-3340-5] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 07/23/2018] [Indexed: 11/25/2022]
Abstract
A questionnaire-based cross-sectional study was conducted to gather information on current microbiological practices for active surveillance of carriage of multidrug-resistant (MDR) bacteria in hospitals from 14 health departments of the Autonomous Community of Valencia (ACV), Spain, which together provided medical attention to 3,271,077 inhabitants in 2017, approximately 70% of the population of the ACV. The survey consisted of 35 questions on MDR bacteria screening policies, surveillance approach chosen (universal vs. targeted), and microbiological methods and processes in use for routine detection and reporting of colonization by MDR bacteria, including the anatomical sites scheduled to be sampled for each MDR bacterial species, and the methodology employed (culture-based, molecular-based, or both). Our study revealed striking differences across centers, likely attributable to the lack of consensus on optimal protocols for sampling, body sites for screening, and microbiological testing, thus underscoring the need for consensus guidelines on these issues.
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Affiliation(s)
- Nuria Tormo
- Microbiology Service, Consorcio Hospital General Universitario, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, and Department of Microbiology, School of Medicine, Hospital Clínico Universitario, Av. Blasco Ibáñez 17, 46010, Valencia, Spain
| | | | - Monserrat Bosque
- Microbiology Service, Hospital Arnau de Vilanova, Valencia, Spain
| | | | | | | | | | - Bárbara Gomila
- Microbiology Service, Hospital General Universitario, Castellon, Spain
| | - Nieves Gonzalo
- Microbiology Service, Hospital General Universitario, Elche, Spain
| | | | | | | | - Nieves Orta
- Microbiology Unit, Hospital Francesc de Borja, Gandia, Spain
| | - Josep Prat
- Microbiology Unit, Hospital de Sagunto, Valencia, Spain
| | | | - Concepción Gimeno
- Microbiology Service, Consorcio Hospital General Universitario, Valencia, Spain
| | - David Navarro
- Microbiology Service, and Department of Microbiology, School of Medicine, Hospital Clínico Universitario, Av. Blasco Ibáñez 17, 46010, Valencia, Spain.
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Aliaga F, Chernilo S, Fernández C, Valenzuela H, Rodríguez JC. [Exogenous lipoid pneumonia. Report of three cases]. Rev Med Chil 2018; 145:1495-1499. [PMID: 29664534 DOI: 10.4067/s0034-98872017001101495] [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] [Received: 10/08/2017] [Accepted: 12/18/2017] [Indexed: 11/17/2022]
Abstract
Lipoid pneumonia is an unusual cause of aspiration pneumonia with diverse radiologic manifestations. One of these are pulmonary nodules in which the main differential diagnosis is pulmonary carcinoma. We report an 85 years old male, an 85 years old female and a 34 years old male in whom percutaneous biopsies of suspicious nodules were compatible with lipoid pneumonia.
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Affiliation(s)
| | - Sara Chernilo
- Servicio Medicina, Instituto Nacional del Tórax, Santiago, Chile
| | - Cristina Fernández
- Servicio Anatomía patológica, Instituto Nacional del Tórax, Santiago, Chile
| | - Hugo Valenzuela
- Servicio Medicina, Instituto Nacional del Tórax, Santiago, Chile
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Sánchez-Bautista A, Coy J, García-Shimizu P, Rodríguez JC. Cambio de CLSI a EUCAST en la interpretación de la sensibilidad a antimicrobianos: ¿cómo influye en nuestro medio? Enferm Infecc Microbiol Clin 2018; 36:229-232. [DOI: 10.1016/j.eimc.2017.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 02/28/2017] [Accepted: 03/24/2017] [Indexed: 10/19/2022]
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Merino AM, Vázquez J, Rodríguez JC, Fernández R, Quintela I, González LO, Sánchez LM, Vizoso F. Pepsinogen C Expression in Tumors of Extragastric Origin. Int J Biol Markers 2018; 15:165-70. [PMID: 10883891 DOI: 10.1177/172460080001500207] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We have examined by immunohistochemistry the ability of human carcinomas of various origin to produce pepsinogen C, an aspartyl proteinase mainly involved in the digestion of proteins in the stomach and recently found to be associated with breast carcinomas. Of the 268 tumors analyzed 80 (29.8%) showed positive staining for pepsinogen C. These positive tumors included 12 gastric (38.7% of the 31 examined cases), nine pancreatic (42.8%), two renal (20%), 12 prostatic (40%), three bladder (27.3%), 14 endometrial (29.7%) and 18 ovarian (40%) carcinomas. We also detected 10 melanomas (50%) that were positive for pepsinogen C. By contrast, immunohistochemical staining for the proteinase was not detected in colorectal, cervical, lung and basal cell skin carcinomas. These results demonstrate that pepsinogen C, a proteolytic enzyme of highly restricted expression in human tissues, can also be expressed by a wide variety of human carcinomas. In addition, and similar to pepsinogen C expression in breast carcinomas, the production of this enzyme by different human tumors might be related to putative hormonal alterations associated with the development and progression of these tumors.
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Affiliation(s)
- A M Merino
- Department of Pathology, Hospital de Cabueñes, Gijón, Spain
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Suárez C, Vizoso F, Rodríguez JC, García I, Raigoso P, Allende MT, García-Muñíz JL, García-Morán M. Prognostic Significance of Cytosolic pS2 Protein Content in Gastric Cancer. Int J Biol Markers 2018; 16:37-44. [PMID: 11288953 DOI: 10.1177/172460080101600105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
pS2, a 60-amino-acid chain peptide which is the most widespread estrogen-induced RNA messenger in MCF-7 breast cancer cells, is normally detected in the epithelium of gastric mucosa. The aims of this work were to evaluate the cytosolic pS2 content and its clinical significance in gastric carcinomas. Cytosolic pS2 levels were examined by immunoradiometric methods in 108 patients with primary gastric adenocarcinomas. The mean follow-up period was 23.3 months. The cytosolic pS2 levels of the tumors ranged widely, i.e., from 0.1 to 3217 ng/mg protein. There were no significant differences in pS2 content between tumors (mean ± standard error: 137.2±31.4 ng/mg protein) and paired adjacent mucosa samples (n=84; mean ± standard error: 249.6±32.6 ng/mg protein), nor were there any significant differences in tumoral pS2 levels with respect to clinicopathologic parameters such as patient age and sex or tumor location, stage, histologic type or grade. However, the results indicated that high intratumoral pS2 levels were significantly and independently associated with an unfavorable outcome in the overall group of patients (p=0.0266) and in patients with resectable gastric cancer (p=0.003). In conclusion, pS2 may represent a useful biological marker in gastric cancer.
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Affiliation(s)
- C Suárez
- Department of General Surgery, Hospital de Jove, Gijón, Spain
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Junco A, Rodríguez JC, Allende MT, García-Muñiz JL, González JJ, Vizoso F. The pS2 Protein in Primary Colorectal Carcinomas and in Surrounding Mucosa. Int J Biol Markers 2018; 14:189-91. [PMID: 10569143 DOI: 10.1177/172460089901400312] [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: 11/15/2022]
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Díaz M, Rodríguez JC, Sánchez J, Sánchez MT, Martín A, Merino AM, Vizoso F. Clinical Significance of Pepsinogen C Tumor Expression in Patients with Stage D2 Prostate Carcinoma. Int J Biol Markers 2018; 17:125-9. [PMID: 12113579 DOI: 10.1177/172460080201700208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pepsinogen C is an aspartyl protease mainly involved in the digestion of proteins in the stomach, and an androgen-inducible protein in breast cancer cells. The aims of this study were to evaluate the expression and clinical significance of this enzyme in the primary tumors of prostate cancer patients with bone metastasis who were scheduled to receive antiandrogenic therapy. This study was prospectively performed in 28 stage D2 prostate cancer patients who, after diagnosis, received maximum androgen blockade. Pepsinogen C tumor expression was analyzed in samples (24 from needle biopsy cylinders and four from transurethral resection specimens) from primary tumors using an immunohistochemical assay. Twelve prostate carcinomas (42.8%) were positive for pepsinogen C. Pepsinogen C was a significant prognostic factor to predict a longer overall survival in the patients of our study (p<0.01). Pepsinogen C can be a new prognostic factor and a useful biological marker of androgen dependency in prostate cancer.
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Affiliation(s)
- M Díaz
- Department of Urology, Hospital de Jove, Gijón, Spain
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Valero E, Consuegra-Sánchez L, Miñana G, García-Blas S, Rodríguez JC, Moyano P, Sanchis J, Núñez J. Initial experience with the novel BioMime 60 mm-long sirolimus-eluting tapered stent system in long coronary lesions. EUROINTERVENTION 2018; 13:1591-1594. [PMID: 28870879 DOI: 10.4244/eij-d-17-00616] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ernesto Valero
- Cardiology Department, Hospital Clínico Universitario, Valencia, Spain
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Merino E, Caro E, Ramos JR, Boix V, Gimeno A, Rodríguez JC, Riera G, Más P, Sanchéz-Paya J, Reus S, Torrús D, Portilla J. Impact of a stewardship program on bacteraemia in adult inpatients. Rev Esp Quimioter 2017; 30:257-263. [PMID: 28597623] [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: 06/07/2023]
Abstract
OBJECTIVE Bloodstream infections (BSIs) are associated with considerable morbidity and mortality among inpatients. The aim of this study was to evaluate the impact of a stewardship program on clinical and antimicrobial therapy-related outcomes in patients with bacteraemia. METHODS Single-centre, before-and-after quasi-experimental study in adult inpatients. Over 1 January 2013 to 31 June 2013 all patients aged 18 years or older with a bacteraemia (interven-tion group, N=200) were compared to a historical cohort (1 Janu-ary 2012 to 31 December 2012) (control group, N=200). RESULTS Following blood culture results and adjusting for potential confounders, the stewardship program was associated with more changes to antibiotic regimens (adjusted odds ratio [ORa]: 4.6, 95% CI 2.9, 7.4), more adjustments to antimicrobial therapy (ORa: 2.4, 95% CI 1.5, 3.8), and better source control in the first five days (ORa 1.6, 95% CI: 1.0, 2.7). In the subgroup that initially received inappropriate empiric treatment (n=138), the intervention was associated with more antibiotic changes (OR: 3.9, 95% CI: 1.8, 8.5) and a better choice of definitive antimicrobial therapy (OR 2.3 95% CI: 1.2, 4.6). There were also more antibiotic changes in the subgroups with both Gram-negative (OR: 2.8, 95% CI: 1.6, 4.9; n=217) and Gram-positive (OR: 4.6, 95% CI: 1.8, 9.9; n=135) bacteraemia among those receiving the intervention, while the Gram-positive subgroup also received more appropriate definitive antimicrobial therapy (OR: 3.9, 95% CI: 1.8, 8.8). CONCLUSIONS The stewardship program improved treatment of patients with bacteraemia and appropriateness of therapy.
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Affiliation(s)
| | | | - J R Ramos
- José Manuel Ramos, Department of Internal Medicine, Hospital General Universitario de Alicante e Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-Fundación FISABIO), Calle Pintor Baeza, 12; 03010 Alicante. Spain.
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Galiana A, Coy J, Gimeno A, Guzman NM, Rosales F, Merino E, Royo G, Rodríguez JC. Evaluation of the Sepsis Flow Chip assay for the diagnosis of blood infections. PLoS One 2017; 12:e0177627. [PMID: 28542614 PMCID: PMC5436663 DOI: 10.1371/journal.pone.0177627] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 05/01/2017] [Indexed: 01/30/2023] Open
Abstract
Background Blood infections are serious complex conditions that generally require rapid diagnosis and treatment. The big challenge is to reduce the time necessary to make a diagnosis with current clinical microbiological methods so as to improve the treatment given to patients. Methods In this study, we assess for the first time the Sepsis Flow Chip assay, which is a novel diagnostic assay for simultaneous rapid-detection of the vast majority of bloodstream pathogens, including Gram-positive and Gram-negative bacteria and fungi, in the same assay, and for the detection of most common antibiotic resistance genes. The SFC assay is based on multiplex PCR and low density DNA arrays. Results Positive blood cultures from 202 consecutive bacteremia patients were analyzed by SFC assay and the results were compared with the results obtained by the gold standard methodology used in clinical microbiology diagnostic laboratories (EUCAST guidelines). SFC assay overall sensitivity and specificity for bacterial identification were 93.3% and 100% respectively and sensitivity and specificity for the identification of antibiotic genetic resistance determinants were 93.6% and 100% respectively. Conclusions This is the first evaluation of SFC assay in clinical samples. This new method appears to be very promising by combining the high number of distinct pathogens and genetic resistance determinants identified in a single assay. Further investigations should be done to evaluate the usefulness of this assay in combination with clinical multidisciplinary groups (stewardship), in order for the results to be applied appropriately to the management of patients`infectious processes.
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Affiliation(s)
- Antonio Galiana
- Department of Microbiology, Hospital General Universitario de Elche, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO) Elche, Spain
| | - Javier Coy
- Department of Microbiology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
| | - Adelina Gimeno
- Department of Microbiology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
| | - Noemi Marco Guzman
- Department of Microbiology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
| | - Francisco Rosales
- Department of Microbiology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
| | - Esperanza Merino
- Department of Infectious Diseases, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
| | - Gloria Royo
- Department of Microbiology, Hospital General Universitario de Elche, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO) Elche, Spain
| | - Juan Carlos Rodríguez
- Department of Microbiology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- * E-mail:
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Carlos Rodríguez J, Ángel Bratos M, Merino E, Ezpeleta C. Utilización de MALDI-TOF en el diagnóstico rápido de la sepsis. Enferm Infecc Microbiol Clin 2016; 34 Suppl 2:19-25. [DOI: 10.1016/s0213-005x(16)30186-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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