7 results on '"Jose M. Munita"'
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. Laboratory exposure to Coccidioides: lessons learnt in a non-endemic country
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María Cristina Díaz, Jose M. Munita, Luis Thompson, D. Wilmes, Lorena Porte, R. Alliende, Francisca Valdivieso, Pablo Gaete, Carmen Varela, Volker Rickerts, and Thomas Weitzel
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Microbiological Techniques ,Microbiology (medical) ,medicine.medical_specialty ,Systemic mycosis ,030501 epidemiology ,03 medical and health sciences ,medicine ,Humans ,Coccidioides ,Non endemic ,Chile ,Intensive care medicine ,Infection Control ,0303 health sciences ,Coccidioidomycosis ,biology ,030306 microbiology ,business.industry ,Infectious dose ,General Medicine ,Laboratory Infection ,biology.organism_classification ,MALDI-TOF Mass Spectrometry ,Coccidioides posadasii ,Clinical microbiology ,Infectious Diseases ,Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ,Arthroconidium ,0305 other medical science ,business - Abstract
Coccidioides is a primary pathogenic fungus, which infects humans through highly infectious arthroconidia, causing substantial morbidity including life-threatening disseminated infections. Due to the low infectious dose, laboratory personnel might become infected during diagnostic procedures. Accordingly, coccidioidomycosis is reported as the most frequent laboratory-acquired systemic mycosis worldwide. This risk is aggravated in non-endemic countries, where the diagnosis may not be suspected. We report on an inadvertent exposure of 44 persons to Coccidioides posadasii in a clinical microbiology laboratory in Chile, the measures of containment after rapid diagnosis with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and the lessons learnt in a non-endemic setting.
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- 2019
4. Evaluation of Novel Antigen-Based Rapid Detection Test for the Diagnosis of SARS-CoV-2 in Respiratory Samples
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Gabriel Pizarro, Rafael Araos, Jose M. Munita, Sabine Dittrich, Paulette Legarraga, Valeska Vollrath, Lorena Porte, Ximena Aguilera, Pablo Vial, and Thomas Weitzel
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medicine.medical_specialty ,Rapid diagnostic test ,Antigen ,business.industry ,Informed consent ,Internal medicine ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,medicine ,Context (language use) ,Institutional review board ,business ,Viral load ,Test (assessment) - Abstract
Background: In the context of the COVID-19 pandemic, the development and validation of rapid and easy-to-perform diagnostic methods are of high priority to enable the required testing scale up in most countries. We evaluated a novel rapid antigen detection test (RDT) for SARS-CoV-2 in respiratory samples. Method: sA new fluorescence immunochromatographic SARS-CoV-2 antigen detection test (Bioeasy Biotechnology Co., Shenzhen, China) was evaluated in nasophayngeal (NP) and oropharyngeal (OP) swabs from patients with suspected COVID-19 in Santiago, Chile. Diagnostic accuracy was determined in comparison to SARS-CoV-2 real time (RT)-PCR, using the same material (universal transport medium with NP and OP swab). Findings: A total of 127 samples were included. The median patients’ age was 38 years (IQR 29·5–44), 53·5% were male, and 93·7% were in the first week after symptom onset. Among 82 RT-PCR positive specimens, 77 were correctly detected by RDT. All 45 RT-PCR negative samples were correctly identified. The overall sensitivity and specificity of the RDT were 93·9% (CI95% 86·5–97·4) and 100% (CI95% 92·1–100), respectively, with a diagnostic accuracy of 96·1% and Kappa coefficient of 0·9. Sensitivity was significantly higher in samples with increased viral loads. Interpretation: The antigen-based immunofluorescence RDT showed a high sensitivity and specificity in respiratory samples obtained from patients who mainly presented during the first week of COVID-19, despite the use of a non-validated sample. The assay was easy to use and provided results in a timely manner. It has the potential to become an important tool for early diagnosis of SARS-CoV-2, particularly in situations with limited access to molecular methods. Funding Statement: This work did not receive funding. Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: The study was approved by the local Institutional Review Board (Comite Etico Cientifico, Facultad de Medicina Clinica Alemana, Universidad del Desarrollo, Santiago, Chile) and need for informed consent was waived.
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- 2020
5. Socioeconomic factors associated with antimicrobial resistance in Latin America: A systematic review and empirical analysis of 41 Chilean hospitals
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M. Rendic, Eduardo A. Undurraga, Jaime Labarca, Kasim Allel, Jose M. Munita, and Patricia García
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Microbiology (medical) ,Infectious Diseases ,Geography ,Latin Americans ,Antibiotic resistance ,Environmental health ,lcsh:RC109-216 ,General Medicine ,Socioeconomic status ,lcsh:Infectious and parasitic diseases - Published
- 2020
6. Fungal empyema thoracis in cancer patients
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Ying Jiang, Jose M. Munita, Masayuki Nigo, Macarena R. Vial, Dimitrios P. Kontoyiannis, Jeffrey J. Tarrand, and Carlos A. Jimenez
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Adolescent ,030106 microbiology ,Gastroenterology ,Empyema thoracis ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Neoplasms ,Internal medicine ,Chart review ,Prevalence ,medicine ,Humans ,Risk factor ,Young adult ,Empyema, Pleural ,Aged ,Retrospective Studies ,Aged, 80 and over ,Academic Medical Centers ,Aspergillus ,biology ,Fungi ,Cancer ,Retrospective cohort study ,Middle Aged ,medicine.disease ,biology.organism_classification ,Empyema ,Surgery ,Infectious Diseases ,Mycoses ,030228 respiratory system ,Female - Abstract
Summary Objectives Fungal empyema thoracis (FET) is a rare life-threatening infection. We sought to describe the clinical characteristics of FET in a large academic cancer center. Methods We conducted a retrospective chart review of all cancer patients who had a fungal isolate from the pleural fluid culture between 1/2005 and 8/2013. Results A total of 106 fungal isolates were identified in 97 patients. Yeasts accounted for 62% of the isolates whereas 38% were identified as molds. The most frequent pathogens were Candida spp. (58%) and Aspergillus spp. (12%). All patients with Aspergillus and 83% with Candida met criteria for proven fungal disease. Compared to the Aspergillus group, Candida FET was associated with recent abdominal or thoracic surgical procedures (44% vs. 0%, p = 0.01). Overall, 6-week mortality was high, with no significant differences between Candida and Aspergillus (31% vs. 45%, respectively [p = 0.48]). Only 1 out of 11 patients with uncommon molds died at 6 weeks, despite only 2 of them received appropriate antifungal therapy. Conclusions Development of FET carries a high mortality in cancer patients. A history of a recent surgical procedure is a risk factor for FET due to Candida . Isolation of uncommon molds is likely to represent a contamination of the pleural fluid.
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- 2016
7. Daptomycin for the treatment of bacteraemia due to vancomycin-resistant enterococci
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Cesar A. Arias, Jose M. Munita, and Barbara E. Murray
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Microbiology (medical) ,medicine.medical_specialty ,VRE ,Enterococci ,medicine.drug_class ,Antibiotics ,Treatment outcome ,Bacteremia ,Context (language use) ,Microbial Sensitivity Tests ,Article ,Vancomycin-Resistant Enterococci ,chemistry.chemical_compound ,Daptomycin ,medicine ,Animals ,Humans ,Pharmacology (medical) ,Intensive care medicine ,Gram-Positive Bacterial Infections ,business.industry ,Lipopeptide ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,medicine.disease ,Anti-Bacterial Agents ,Disease Models, Animal ,Treatment Outcome ,Infectious Diseases ,chemistry ,Daptomicina ,Bacteriemia ,Therapeutic failure ,Enterococos resistentes a la vancomicina ,Enterococcal bacteraemia ,business ,medicine.drug - Abstract
Treatment of severe infections caused by vancomycin-resistant enterococci (VRE) is challenging due to the scarcity of reliable therapeutic alternatives. In this context, daptomycin (DAP), a lipopeptide antibiotic, has emerged as an interesting alternative as it is one of the few compounds that retain in vitro bactericidal activity against VRE isolates, although it has not been approved for this purpose by regulatory agencies. In this review, we will summarise the clinical, animal and in vitro evidence evaluating the efficacy of DAP for the management of deep-seated VRE infections. In addition, we will address important clinical concerns such as the emergence of DAP resistance during therapy and reports of therapeutic failure with DAP monotherapy. Finally, we will discuss possible future strategies (such as the use of higher doses and/or combination therapies) to optimise the use of this antibiotic against VRE.
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- 2014
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