Showing papers by "Maddalena Peghin published in 2017"
TL;DR: A high incidence of RV infections in LTRs was documented and Associations were observed between AR and RVs, between P. aeruginosa colonization or infection and LRTID, and between CMV replication or disease and URTID.
51 citations
University of Udine1, University of Genoa2, Misericordia University3, Katholieke Universiteit Leuven4, University of Turin5, National and Kapodistrian University of Athens6, Federal University of São Paulo7, Federal University of Rio de Janeiro8, Hospital General Universitario Gregorio Marañón9, Catholic University of the Sacred Heart10
TL;DR: Thirty-day mortality was associated with candidemia and severe clinical presentation, whereas adequate antifungal treatment improved the prognosis, andCandidemia and IAC were associated with significant mortality in cirrhotic patients.
Abstract: The aim of the study was to describe the characteristics of cirrhotic patients with candidemia and intra-abdominal candidiasis (IAC) and to evaluate the risk factors associated with 30-day mortality. A multicenter multinational retrospective study including all consecutive episodes of candidemia and IAC in adult patients with liver cirrhosis in 14 European hospitals during the period 2011–2013 was performed. A total of 241 episodes (169 candidemia, 72 IAC) were included. Most Candida infections were acquired in hospital (208, 86.3%), mainly in the intensive care unit (ICU) (121, 50.2%). At clinical presentation, fever was seen in 60.6% of episodes (146/241) and septic shock in 34.9% (84/241). C. albicans was the most common species (found in 131 episodes, 54.4%), followed by C. glabrata (35, 14.5%) and C. parapsilosis (34, 14.1%). Overall, the 30-day mortality was 35.3%. Multivariable analysis identified candidemia (OR 2.2, 95% CI 1.2–4.5) and septic shock (OR 3.2, 95% CI 1.7–6) as independent factors associated with 30-day mortality. Adequate antifungal treatment (OR 0.4, 95% CI 0.3–0.9) was associated with survival benefit. A shift towards increasing prevalence of C. glabrata and C. parapsilosis species in patients with liver disease was documented. Candidemia and IAC were associated with significant mortality in cirrhotic patients. Thirty-day mortality was associated with candidemia and severe clinical presentation, whereas adequate antifungal treatment improved the prognosis.
47 citations
TL;DR: This study confirms the occurrence of high mortality rates in LTRs developing ICIs, with candidemia representing a risk factor for mortality, and the high rates of antifungal resistance should be considered in the choice of the empiric antIFungal regimen.
Abstract: BackgroundInvasive fungal infections remain a leading cause of morbidity and mortality among liver transplant recipients (LTRs). In this patient population, invasive Candida infections (ICIs) account for the large majority of cases. To date, only small studies and case-series analysing clinical pres
31 citations
TL;DR: A case of MDR P. aeruginosa skin and soft-tissue infection successfully treated with Ceftolozane/tazobactam.
Abstract: Ceftolozane/tazobactam (C/T) is a novel β-lactam/β-lactamase inhibitor combination antibiotic approved by the US Food and Drug Administration for the treatment of complicated intra-abdominal and urinary tract infections due to Gram-negative bacteria, particularly extended-spectrum β-lactamase-producing Enterobacteriaceae and multidrug-resistant (MDR) Pseudomonas aeruginosa strains. Here we report a case of MDR P. aeruginosa skin and soft-tissue infection successfully treated with C/T.
19 citations
Carlos III Health Institute1, University of Barcelona2, University of São Paulo3, Hacettepe University4, Spanish National Research Council5, Complutense University of Madrid6, Universidade Federal de Minas Gerais7, University of Nebraska Medical Center8, Autonomous University of Barcelona9, Concord Repatriation General Hospital10, University of Udine11, University of Seville12
TL;DR: The aim of the BICAR study is to compare the efficacy of BLBLI combinations with that of carbapenems for the treatment of BSI due to an ESBL-GNB in this population of haematological patients with neutropaenia.
Abstract: Introduction Bloodstream infection (BSI) due to extended-spectrum β-lactamase-producing Gram-negative bacilli (ESBL-GNB) is increasing at an alarming pace worldwide. Although β-lactam/β-lactamase inhibitor (BLBLI) combinations have been suggested as an alternative to carbapenems for the treatment of BSI due to these resistant organisms in the general population, their usefulness for the treatment of BSI due to ESBL-GNB in haematological patients with neutropaenia is yet to be elucidated. The aim of the BICAR study is to compare the efficacy of BLBLI combinations with that of carbapenems for the treatment of BSI due to an ESBL-GNB in this population. Methods and analysis A multinational, multicentre, observational retrospective study. Episodes of BSI due to ESBL-GNB occurring in haematological patients and haematopoietic stem cell transplant recipients with neutropaenia from 1 January 2006 to 31 March 2015 will be analysed. The primary end point will be case-fatality rate within 30 days of onset of BSI. The secondary end points will be 7-day and 14-day case-fatality rates, microbiological failure, colonisation/infection by resistant bacteria, superinfection, intensive care unit admission and development of adverse events. Sample size The number of expected episodes of BSI due to ESBL-GNB in the participant centres will be 260 with a ratio of control to experimental participants of 2. Ethics and dissemination The protocol of the study was approved at the first site by the Research Ethics Committee (REC) of Hospital Universitari de Bellvitge. Approval will be also sought from all relevant RECs. Any formal presentation or publication of data from this study will be considered as a joint publication by the participating investigators and will follow the recommendations of the International Committee of Medical Journal Editors (ICMJE). The study has been endorsed by the European Study Group for Bloodstream Infection and Sepsis (ESGBIS) and the European Study Group for Infections in Compromised Hosts (ESGICH).
9 citations
TL;DR: This review focuses on the current epidemiology of CRE, with a specific focus on HAP/VAP and suggests a possible strategy for the empiric and targeted treatment of HAP and VAP in which the involvement of CRE is suspected or is confirmed.
Abstract: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) represent a common problem in hospital setting worldwide Infections caused by carbapenem-resistant Enterobacteriaceae (CRE) are an emergent problem due to the lack of therapeutic options available, leading to significant increases in morbidity and mortality CRE have frequently been reported both in HAP/VAP, but limited data regarding the optimal treatment strategy in this setting are available This review focuses on the current epidemiology of CRE, with a specific focus on HAP/VAP Moreover, we will suggest a possible strategy for the empiric and targeted treatment of HAP and VAP in which the involvement of CRE is suspected or is confirmed
9 citations