5 results on '"Martin E Stryjewski"'
Search Results
2. Clinical outcomes and bacterial characteristics of carbapenem-resistant Klebsiella pneumoniae complex among patients from different global regions (CRACKLE-2): a prospective, multicentre, cohort study
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Minggui Wang, Michelle Earley, Liang Chen, Blake M Hanson, Yunsong Yu, Zhengyin Liu, Soraya Salcedo, Eric Cober, Lanjuan Li, Souha S Kanj, Hainv Gao, Jose M Munita, Karen Ordoñez, Greg Weston, Michael J Satlin, Sandra L Valderrama-Beltrán, Kalisvar Marimuthu, Martin E Stryjewski, Lauren Komarow, Courtney Luterbach, Steve H Marshall, Susan D Rudin, Claudia Manca, David L Paterson, Jinnethe Reyes, Maria V Villegas, Scott Evans, Carol Hill, Rebekka Arias, Keri Baum, Bettina C Fries, Yohei Doi, Robin Patel, Barry N Kreiswirth, Robert A Bonomo, Henry F Chambers, Vance G Fowler, Cesar A Arias, David van Duin, Lilian M Abbo, Deverick J Anderson, Kean Lee Chew, Heather R Cross, Partha Pratim De, Samit Desai, Sorabh Dhar, Valentina Di Castelnuovo, Lorena Diaz, AN Q Dinh, Brandon Eilertson, Beth Evans, Vance G Fowler Jr, Julia Garcia-Diaz, Omai B Garner, Kerryl Greenwood-Quaintance, Blake Hanson, Erica Herc, Jesse T Jacob, Jianping Jiang, Robert C Kalayjian, Keith S Kaye, Angela Kim, Courtney Lauterbach, Steven H Marshall, Todd McCarty, Jose Munita, Oon Tek Ng, Jose Millan Oñate Gutierrez, Anton Peleg, Robert A Salata, Suzannah Schmidt-Malan, Nares Smitasin, Maria Spencer, Martin Stryjewski, Jiachun Su, Paul Ananth Tambyah, Sandra Valderrama, Maria Virginia Villegas Botero, Mary Waters, Darren Wong, Glenn Wortmann, Yang Yang, and Fujie Zhang
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medicine.medical_specialty ,Carbapenem resistant Klebsiella pneumoniae ,Clinical Sciences ,Bacteremia ,Logistic regression ,Microbiology ,Article ,Cohort Studies ,Clinical Research ,Internal medicine ,medicine ,Humans ,Multi-Drug Resistant Organism Network Investigators ,In patient ,Prospective Studies ,Lung ,Respiratory Sounds ,business.industry ,Confounding ,Pneumonia ,Odds ratio ,medicine.disease ,Anti-Bacterial Agents ,Klebsiella Infections ,Klebsiella pneumoniae ,Good Health and Well Being ,Carbapenem-Resistant Enterobacteriaceae ,Infectious Diseases ,Carbapenems ,Medical Microbiology ,Baseline characteristics ,Pneumonia & Influenza ,Public Health and Health Services ,Infection ,business ,Cohort study - Abstract
Summary Background Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a global threat. We therefore analysed the bacterial characteristics of CRKP infections and the clinical outcomes of patients with CRKP infections across different countries. Methods In this prospective, multicentre, cohort study (CRACKLE-2), hospitalised patients with cultures positive for CRKP were recruited from 71 hospitals in Argentina, Australia, Chile, China, Colombia, Lebanon, Singapore, and the USA. The first culture positive for CRKP was included for each unique patient. Clinical data on post-hospitalisation death and readmission were collected from health records, and whole genome sequencing was done on all isolates. The primary outcome was a desirability of outcome ranking at 30 days after the index culture, and, along with bacterial characteristics and 30-day all-cause mortality (a key secondary outcome), was compared between patients from China, South America, and the USA. The desirability of outcome ranking was adjusted for location before admission, Charlson comorbidity index, age at culture, Pitt bacteremia score, and anatomical culture source through inverse probability weighting; mortality was adjusted for the same confounders, plus region where relevant, through multivariable logistic regression. This study is registered at ClinicalTrials.gov , NCT03646227 , and is complete. Findings Between June 13, 2017, and Nov 30, 2018, 991 patients were enrolled, of whom 502 (51%) met the criteria for CRKP infection and 489 (49%) had positive cultures that were considered colonisation. We observed little intra-country genetic variation in CRKP. Infected patients from the USA were more acutely ill than were patients from China or South America (median Pitt bacteremia score 3 [IQR 2–6] vs 2 [0–4] vs 2 [0–4]) and had more comorbidities (median Charlson comorbidity index 3 [IQR 2–5] vs 1 [0–3] vs 1 [0–2]). Adjusted desirability of outcome ranking outcomes were similar in infected patients from China (n=246), South America (n=109), and the USA (n=130); the estimates were 53% (95% CI 42–65) for China versus South America, 50% (41–61) for the USA versus China, and 53% (41–66) for the USA versus South America. In patients with CRKP infections, unadjusted 30-day mortality was lower in China (12%, 95% CI 8–16; 29 of 246) than in the USA (23%, 16–30; 30 of 130) and South America (28%, 20–37; 31 of 109). Adjusted 30-day all-cause mortality was higher in South America than in China (adjusted odds ratio [aOR] 4·82, 95% CI 2·22–10·50) and the USA (aOR 3·34, 1·50–7·47), with the mortality difference between the USA and China no longer being significant (aOR 1·44, 0·70–2·96). Interpretation Global CRKP epidemics have important regional differences in patients’ baseline characteristics and clinical outcomes, and in bacterial characteristics. Research findings from one region might not be generalisable to other regions. Funding The National Institutes of Health.
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- 2022
3. A 31-Year-Old Man With Seizures, Brain Lesion, and Lung Nodules
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Luis Patricio Maskin, Matias H. Garcia Hernandez, Martin E. Stryjewski, and Pablo Oscar Rodriguez
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Adult ,Male ,Pulmonary and Respiratory Medicine ,Brain Diseases ,Antifungal Agents ,Lung Diseases, Fungal ,Granulomatous Disease, Chronic ,Critical Care and Intensive Care Medicine ,Magnetic Resonance Imaging ,Diagnosis, Differential ,Immunocompromised Host ,Ascomycota ,Seizures ,Humans ,Tomography, X-Ray Computed ,CHEST Pearls ,Cardiology and Cardiovascular Medicine - Abstract
A 31-year-old man was admitted to our hospital with a recent history of generalized seizures. Three months earlier, he started with intermittent hemoptysis. CT scan showed a cavitary lung lesion in the upper segment of the right inferior lobe (RIL). Because of his job as a social worker in a high-risk population, he started treatment for Mycobacterium TB; however, the BAL culture result was negative. At the time of his current admission, he has continued taking rifampicin, isoniazid, pyrazinamide, and levofloxacin. He denied the use of any illicit drugs or alcohol. He had no history of smoking. One year earlier, he visited Southeast Asia, Oceania, and South Africa for several months. He reported a weight loss of 7 kg since then. Except for a recurrent oral candidiasis, he did not have a relevant medical history. His family history was notable for mother with lupus, and brother with sarcoidosis.
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- 2021
4. Response
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Luis Patricio Maskin, Matias H. Garcia Hernandez, Martin E. Stryjewski, and Pablo Oscar Rodriguez
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Pulmonary and Respiratory Medicine ,Cardiology and Cardiovascular Medicine ,Critical Care and Intensive Care Medicine - Published
- 2022
5. Clinical characteristics and outcomes of hospitalized patients with SARS-CoV-2 infection in a Latin American country: Results from the ECCOVID multicenter prospective study
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Ezequiel Cordova, Analia Mykietiuk, Omar Sued, Lautaro De Vedia, Natalia Pacifico, Matias H Garcia Hernandez, Natalia M Baeza, Franco Garibaldi, Maria Fernanda Alzogaray, Rosa Contreras, Lucrecia Soler Puy, Pablo G Scapellato, Laura Barcelona, Mariana L Golikow, Maria Florencia Piñeiro, Hugo J Miño, Maria Fernanda Consalvo, Corina Nemirovsky, Marisa Sanchez, Myrna Cabral, Lucia Lamponi Tappata, Mariano Blasco, Jamile Ballivian, Gustavo Lopardo, Martin E Stryjewski, and ECCOVID study group
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Male ,RNA viruses ,Viral Diseases ,Pulmonology ,Coronaviruses ,Physiology ,Logistic regression ,Geographical locations ,law.invention ,Medical Conditions ,Risk Factors ,law ,Medicine and Health Sciences ,Medicine ,Hospital Mortality ,Prospective Studies ,Prospective cohort study ,Pathology and laboratory medicine ,Oxygen saturation (medicine) ,Multidisciplinary ,Age Factors ,Middle Aged ,Medical microbiology ,Intensive care unit ,Hospitals ,Hospitalization ,Intensive Care Units ,Chemistry ,Infectious Diseases ,Physiological Parameters ,Physical Sciences ,Viruses ,Cohort ,Female ,SARS CoV 2 ,Pathogens ,Research Article ,Chemical Elements ,Adult ,medicine.medical_specialty ,SARS coronavirus ,Science ,Argentina ,Microbiology ,Respiratory Disorders ,Sex Factors ,Signs and Symptoms ,Lymphopenia ,Internal medicine ,Diabetes mellitus ,Humans ,Obesity ,Aged ,Biology and life sciences ,SARS-CoV-2 ,business.industry ,Body Weight ,Organisms ,Viral pathogens ,COVID-19 ,Covid 19 ,South America ,medicine.disease ,Comorbidity ,Microbial pathogens ,Health Care ,Oxygen ,Health Care Facilities ,Respiratory Infections ,People and places ,Clinical Medicine ,business - Abstract
Background Clinical features and outcomes of SARS-CoV-2 infections diverge in different countries. The aim of this study was to describe clinical characteristics and outcomes in a cohort of patients hospitalized with SARS-CoV-2 in Argentina. Methods Multicenter prospective cohort study of ≥18 years-old patients with confirmed SARS-CoV-2 infection consecutively admitted to 19 hospitals in Argentina. Multivariable logistic regression models were used to identify variables associated with 30-day mortality and admission to intensive care unit (ICU). Results A total of 809 patients were analyzed. Median age was 53 years, 56% were males and 71% had at least one comorbidity. The most common comorbidities were hypertension (32%), obesity (23%) and diabetes (17%). Disease severity at admission was classified as mild 25%, moderate 51%, severe 17%, and critical 7%. Almost half of patients (49%) required supplemental oxygen, 18% ICU, and 12% invasive ventilation. Overall, 30-day mortality was 11%. Factors independently associated with ICU admission were male gender (OR 1.81; 95%CI 1.16–2.81), hypertension (OR 3.21; 95%CI 2.08–4.95), obesity (OR 2.38; 95%CI 1.51–3.7), oxygen saturation ≤93% (OR 6.45; 95%CI 4.20–9.92) and lymphopenia (OR 3.21; 95%CI 2.08–4.95). Factors independently associated with 30-day mortality included age ≥60 years-old (OR 2.68; 95% CI 1.63–4.43), oxygen saturation ≤93% (OR 3.19; 95%CI 1.97–5.16) and lymphopenia (OR 2.65; 95%CI 1.64–4.27). Conclusions This cohort validates crucial clinical data on patients hospitalized with SARS-CoV-2 in Argentina.
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- 2021
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