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Ibrahim T, Abdallah TA, Abdallah A, Qazi R, Alimam A, Mohammad H, Eltayeb F, Daghfal J, Ali M, Hadi HA. Epidemiology, microbiological, clinical characteristics, and outcome of Burkholderia cepacia complex infections in non-cystic fibrosis adult patients from Qatar. IJID Reg 2024; 11:100355. [PMID: 38617502 PMCID: PMC11015122 DOI: 10.1016/j.ijregi.2024.03.010] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/16/2024]
Abstract
Objectives Burkholderia species infections are associated with diverse and challenging clinical presentations because of distinct virulence and antimicrobial resistance factors. The study aims to evaluate the epidemiology, microbiological, and clinical outcomes of Burkholderia cepacia complex (Bcc) infections in non-cystic fibrosis (CF) patients from Qatar. Methods A retrospective study was conducted on adult patients across all hospitals at Hamad Medical Corporation between January 2012 and December 2018 to evaluate clinically relevant Bcc in non-CF adult patients. Results Over 7 years, 72 episodes of Burkholderia species infections were recorded, 64 were secondary to Bcc primarily affecting males (78.12%) with a mean age of 53 years, from the Middle and Southeastern region (92.2%) affected predominantly by diabetes mellitus (34.4%), chronic kidney (23.4%), coronary heart (20.3%), and hypertensive diseases (17.2%) while recent hospitalization and admission to critical care were evident in 45.3% and 93.8% of cases, respectively. Main infection sites were urinary (43.8%) and respiratory (29.7%) with associated bacteremia recorded in 26.6% of cases. Microbiological characteristics demonstrated high-level resistance profiles leading to delayed microbiological clearance in case of bacteremia (61%) and management with multiple therapeutic agents (range 4-6) resulting in disease resolution in 90.6% of cases with observed 30-day mortality of 7.8%. Conclusions B. cepacia infections are infrequent, recorded mainly in middle-aged males with chronic comorbidities presenting as urinary, respiratory, and bacteremia associated with hospitalization, admission to critical care, and invasive procedures. High-level antimicrobial resistance is observed necessitating multiple therapeutic agents and suboptimal bacteriological clearance.
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Affiliation(s)
- Tawheeda Ibrahim
- Department of Bariatric Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Ahmed Abdallah
- Departmnet of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Rabia Qazi
- Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
| | - Abeir Alimam
- Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
| | - Hashim Mohammad
- Departmnet of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Faiha Eltayeb
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Joanne Daghfal
- Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
| | - Maisa Ali
- Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
| | - Hamad Abdel Hadi
- Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
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Alattar RA, Abdalla S, Abdallah T, Kazman R, Qadmour A, Ibrahim T, Alhariri B, Shaar SH, Bajwa A, Alimam A, Qazi R, Ben Abid F, Daghfal J, Eldeeb A, Shukri K, Elsayed A, Rustom F, Alsamawi M, Abdelmajid A, Basulto MAP, Cobian AAR, Abukhattab M, Alkhal A, Almaslamani MA, Omrani AS. Favipiravir for the treatment of coronavirus disease 2019 pneumonia; a propensity score-matched cohort study. J Infect Public Health 2022; 15:1061-1064. [PMID: 36087547 PMCID: PMC9420008 DOI: 10.1016/j.jiph.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/21/2022] [Accepted: 08/21/2022] [Indexed: 11/18/2022] Open
Abstract
We retrospectively investigated the clinical outcomes of favipiravir in patients with COVID-19 pneumonia. Patients who between 23 May 2020 and 18 July 2020 received ≥ 24 h of favipiravir were assigned to the favipiravir group, while those who did not formed the non-favipiravir group. The primary outcome was 28-day clinical improvement, defined as two-category improvement from baseline on an 8-point ordinal scale. Propensity scores (PS) for favipiravir therapy were used for 1:1 matching. The unmatched cohort included 1493 patients, of which 51.7% were in the favipiravir group, and 48.3% were not receiving supplemental oxygen at baseline. Significant baseline differences between the two unmatched groups existed, but not between the PS-matched groups (N = 774). After PS-matching, there were no significant differences between the two groups in the proportion with 28-day clinical improvement (93.3% versus 92.8%, P 0.780), or 28-day all-cause mortality (2.1% versus 3.1%, P 0.360). Favipiravir was associated with more viral clearance by day 28 (79.8% versus 64.1%, P < 0.001). Adverse events were common in both groups, but the 93.9% were Grades 1-3. Favipiravir therapy for COVID-19 pneumonia is well tolerated but is not associated with an increased likelihood of clinical improvement or reduced all-cause mortality by 28 days.
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Affiliation(s)
| | | | - Tasneem Abdallah
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Rashid Kazman
- Division of Internal Medicine, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Aseelah Qadmour
- Division of Internal Medicine, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Tawheeda Ibrahim
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Bassem Alhariri
- Division of Internal Medicine, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Shahd H Shaar
- Communicable Disease Center, Hamad Medical Corporation
| | - Abeer Bajwa
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Abeir Alimam
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Rabia Qazi
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Fatma Ben Abid
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Ali Eldeeb
- Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar
| | - Kinda Shukri
- Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Elsayed
- Communicable Disease Center, Hamad Medical Corporation
| | - Fatima Rustom
- Communicable Disease Center, Hamad Medical Corporation
| | - Musaed Alsamawi
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Alaaeldin Abdelmajid
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Mohamed Abukhattab
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Abdullatif Alkhal
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Muna A Almaslamani
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Ali S Omrani
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar; Faculty of Medicine, Qatar University.
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Zaqout A, Almaslamani MA, Chemaitelly H, Hashim SA, Ittaman A, Alimam A, Rustom F, Daghfal J, Abukhattab M, AlMukdad S, Kaleeckal AH, Latif AN, Butt AA, Bertollini R, Al-Khal A, Omrani AS, Abu-Raddad LJ. Effectiveness of the neutralizing antibody sotrovimab among high-risk patients with mild to moderate SARS-CoV-2 in Qatar. Int J Infect Dis 2022; 124:96-103. [PMID: 36218031 PMCID: PMC9484101 DOI: 10.1016/j.ijid.2022.09.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/30/2022] [Accepted: 09/14/2022] [Indexed: 10/31/2022] Open
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Alattar RA, Ahmed SA, Abdallah T, Kazman R, Qadmour AN, Ibrahim T, Alhariri B, Shaar SH, Bajwa A, Alimam A, Qazi R, Abid FB, Daghfal J, Eldeeb AM, Shukri K, Elsayed A, Rustom F, AlSamawi MS, Abdelmajid AA, Basulto M, Cobian A, Khattab MA, Almaslamani M, Khal AA, Omrani AS. 508. Title Favipiravir for the Treatment of Coronavirus Disease 2019; A Propensity Score Matched Cohort Study. Open Forum Infect Dis 2021. [PMCID: PMC8644787 DOI: 10.1093/ofid/ofab466.707] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background We investigated clinical outcomes of favipiravir in patients with COVID-19 pneumonia. Methods Patients who between 23 May 2020 and 18 July 2020 received ≥24 hours of favipiravir were assigned to the favipiravir group, while those who did not formed the non-favipiravir group. The primary outcome was 28-day clinical improvement, defined as two-category improvement from baseline on an 8-point ordinal scale. Propensity scores (PS) for favipiravir therapy were used for 1:1 matching. Cox regression was used to examine associations with the primary endpoint. Results The unmatched cohort included 1,493 patients, of which 51.7% were in the favipiravir group, and 48.3% were not receiving supplemental oxygen at baseline (table 1). Favipiravir was started within a median of 5 days from symptoms onset. Significant baseline differences between the two unmatched groups existed, but not between the PSmatched groups (N = 774) (table 1). After PS-matching, there were no significant differences between the two groups in the proportion with 28-day clinical improvement (93.3% versus 92.8%, P 0.780), or 28-day all-cause mortality (2.1% versus 3.1%, P 0.360) (Table 2). Favipiravir was associated with more viral clearance by day 28 (79.8% versus 64.1%, P < 0.001) (table 2). In the adjusted Cox proportional hazards model, favipiravir therapy was not associated 28-day clinical improvement (adjusted hazard ratio 0.978, 95% confidence interval 0.862 –1.109, P 0.726) (Table 3). ![]()
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Conclusion Favipiravir therapy for COVID-19 pneumonia is well tolerated but is not associated with an increased likelihood of clinical improvement or reduced all-cause mortality by 28 days. Disclosures All Authors: No reported disclosures
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Affiliation(s)
| | | | | | | | | | | | | | | | - Abeer Bajwa
- Hamad Medical corporation, Doha, Ad Dawhah, Qatar
| | - Abeir Alimam
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | - Rabia Qazi
- Hamad Medical corporation, Doha, Ad Dawhah, Qatar
| | | | | | - Ali M Eldeeb
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | - Kinda Shukri
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | | | | | | | | | | | | | | | | | | | - Ali S Omrani
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
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Abdallah T, Elajez R, Ibrahim T, Alimam A, Omrani AS. 1242. Efficacy and Safety of Intravenous Fosfomycin for the Treatment of Multi-resistant Gram Negative Infections. Open Forum Infect Dis 2021. [PMCID: PMC8644471 DOI: 10.1093/ofid/ofab466.1434] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background To describe the clinical use, efficacy and safety of intravenous (IV) fosfomycin in the treatment of infections caused by Gram-negative bacteria (GNB). Methods Hospitalized patients who received ≥48 hours of IV fosfomycin therapy during September 27, 2017 thru January 31, 2020 were included. The primary outcome was the proportion of subjects with clinical improvement at the end of IV fosfomycin therapy; defined as resolution of baseline signs and symptoms of infection. Results Thirty patients were included, of which 19 (63.3%) were males, and the median age was 63.5 years (interquartile range 46─73). Frequent risk factors for GNB infection included hospitalization (23, 76%), receipt of broad-spectrum antibiotics (15, 50%), and surgery (10, 33.3%), all within the preceding 90 days. Urinary tract infection (17, 56.7%) was the most common indication for use of IV fosfomycin, followed by bacteremia (4, 13.3), and skin and soft tissue infections (4, 13.3%). Kelbsiella pneumoniae (17, 56.7%), Escherichia coli (7, 23.3%) and Pseudomonas species (4, 13.3%) were the most common target pathogens. Almost all target pathogens (29, 96.7%) were resistant in vitro to ≥1 agent from ≥3 different antimicrobial classes. The primary outcome was achieved in 22 (73.3%) patients. The most frequently observed adverse events were hypokalemia (13, 43.3%) and hypernatremia (7, 23.3%). However, the majority of adverse events were classified as Grade 1 or Grade 2 severity. Microbiological characteristics ![]()
The table describes microbiological characteristics of the isolated organism species, resistance pattern, development of fosfomycin resistance Management outcomes and safety profile ![]()
The table describes percentage of primary outcome (clinical success ) along with safety profile and mortality rate Conclusion IV fosfomycin is a potentially effective and safe option for the treatment of patient with GNB infections. Disclosures All Authors: No reported disclosures
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Affiliation(s)
| | - Reem Elajez
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | | | - Abeir Alimam
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | - Ali S Omrani
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
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