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2 results on '"Gozalo M"'

1. Predictors of outcome in patients with severe sepsis or septic shock due to extended-spectrum beta-lactamase-producing Enterobacteriaceae

Author

Russo, A., Falcone, M., Gutierrez-Gutierrez, B., Calbo, E., Almirante, B., Viale, P. L., Oliver, A., Ruiz-Garbajosa, R., Gasch, O., Gozalo, M., Pitout, J., Akova, M., Pena, C., Cisneros, J. M., Hernandez-Torres, A., Farcomeni, A., Prim, N., Origun, J., Bou, G., Tacconelli, E., Tumbarello, M., Hamprecht, A., Karaiskos, I, de la Calle, C., Perez, F., Schwaber, M. J., Bermejo, J., Lowman, W., Hsueh, R-R, Mora-Rillo, M., Rodriguez-Gomez, J., Souli, M., Bonomo, R. A., Paterson, D. L., Carmeli, Y., Pascual, A., Rodriguez-Bano, J., Venditti, M., Russo, A., Falcone, M., Gutierrez-Gutierrez, B., Calbo, E., Almirante, B., Viale, P. L., Oliver, A., Ruiz-Garbajosa, R., Gasch, O., Gozalo, M., Pitout, J., Akova, M., Pena, C., Cisneros, J. M., Hernandez-Torres, A., Farcomeni, A., Prim, N., Origun, J., Bou, G., Tacconelli, E., Tumbarello, M., Hamprecht, A., Karaiskos, I, de la Calle, C., Perez, F., Schwaber, M. J., Bermejo, J., Lowman, W., Hsueh, R-R, Mora-Rillo, M., Rodriguez-Gomez, J., Souli, M., Bonomo, R. A., Paterson, D. L., Carmeli, Y., Pascual, A., Rodriguez-Bano, J., and Venditti, M.

Abstract

Purpose: There are few data in the literature regarding sepsis or septic shock due to extended-spectrum fi-lactamases (ESBL)-producing Enterobacteriaceae (E). The aim of this study was to assess predictors of outcome in septic patients with bloodstream infection (BSI) caused by ESBL-E. Methods: Patients with severe sepsis or septic shock and BSI due to ESBL-E were selected from the INCREMENT database. The primary endpoint of the study was the evaluation of predictors of outcome after 30 days from development of severe sepsis or septic shock due to ESBL-E infection. Three cohorts were created for analysis: global, empirical-therapy and targeted-therapy cohorts. Results: 367 septic patients were analysed. Overall mortality was 43.9% at 30 days. Escherichia coli (62.4%) and Klebsiella pneumoniae (27.2%) were the most frequent isolates. fi-lactam/fi-lactamase inhibitor (BLBLI) combinations were the most empirically used drug (43.6%), followed by carbapenems (29.4%). Empirical therapy was active in vitro in 249 (67.8%) patients, and escalation of antibiotic therapy was reported in 287 (78.2%) patients. Cox regression analysis showed that age, Charlson Comorbidity Index, McCabe classification, Pitt bacteremia score, abdominal source of infection and escalation of antibiotic therapy were independently associated with 30-day mortality. No differences in survival were reported in patients treated with BLBLI combinations or carbapenems in empirical or definitive therapy. Conclusions: BSI due to ESBL-E in patients who developed severe sepsis or septic shock was associated with high 30-day mortality. Comorbidities, severity scores, source of infection and antibiotic therapy escalation were important determinants of unfavorable outcome. (C) 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Published
2018

2. Predictors of outcome in patients with severe sepsis or septic shock due to extended-spectrum β-lactamase-producing Enterobacteriaceae

Author

Robert A. Bonomo, Mónica Gozalo, Evelina Tacconelli, Axel Hamprecht, Julia Origüen, Benito Almirante, Increment investigators, Warren Lowman, Marco Falcone, Po-Ren Hsueh, Germán Bou, C. de la Calle, Belén Gutiérrez-Gutiérrez, Pierluigi Viale, Alessandro Russo, Yehuda Carmeli, Marta Mora-Rillo, Maria Souli, Mario Tumbarello, Reipi, Alessio Farcomeni, Mitchell J. Schwaber, José Miguel Cisneros, Esgbis, Alicia Hernandez-Torres, Murat Akova, Jesús Rodríguez-Baño, David L. Paterson, Federico Perez, Jorge Rodriguez-Gómez, Mario Venditti, Patricia Ruiz-Garbajosa, Esther Calbo, Antonio Oliver, Oriol Gasch, Johann D. D. Pitout, N. Prim, Ilias Karaiskos, Álvaro Pascual, Carmen Peña, Joaquín Bermejo, Russo, A., Falcone, M., Gutiérrez-Gutiérrez, B., Calbo, E., Almirante, B., Viale, P.L., Oliver, A., Ruiz-Garbajosa, P., Gasch, O., Gozalo, M., Pitout, J., Akova, M., Peña, C., Cisneros, J.M., Hernández-Torres, A., Farcomeni, A., Prim, N., Origüen, J., Bou, G., Tacconelli, E., Tumbarello, M., Hamprecht, A., Karaiskos, I., de la Calle, C., Pérez, F., Schwaber, M.J., Bermejo, J., Lowman, W., Hsueh, P.-R., Mora-Rillo, M., Rodriguez-Gomez, J., Souli, M., Bonomo, R.A., Paterson, D.L., Carmeli, Y., Pascual, A., Rodríguez-Baño, J., and Venditti, M.

Subjects
0301 basic medicine, Male, Klebsiella pneumoniae, ß-lactam/ß-lactamase inhibitor, extended-spectrum ß-lactamases, sepsis, carbapenems, septic shock, ß-lactam/ß-lactamase inhibitors, Aged, Aged, 80 and over, Anti-Bacterial Agents, Drug Therapy, Combination, Enterobacteriaceae, Enterobacteriaceae Infections, Female, Humans, Middle Aged, Prognosis, Retrospective Studies, Sepsis, Survival Analysis, Treatment Outcome, beta-Lactamase Inhibitors, beta-Lactamases, beta-Lactams, Decision Support Techniques, 0302 clinical medicine, Clinical endpoint, 80 and over, Medicine, Pharmacology (medical), 030212 general & internal medicine, biology, extended-spectrum ß-lactamase, General Medicine, Infectious Diseases, Combination, sepsi, Settore SECS-S/01 - Statistica, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, Infectious Disease, carbapenem, 03 medical and health sciences, Drug Therapy, Internal medicine, In patient, business.industry, Proportional hazards model, Septic shock, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Bacteremia, business
Abstract

Purpose There are few data in the literature regarding sepsis or septic shock due to extended-spectrum β-lactamases (ESBL)-producing Enterobacteriaceae (E). The aim of this study was to assess predictors of outcome in septic patients with bloodstream infection (BSI) caused by ESBL-E. Methods Patients with severe sepsis or septic shock and BSI due to ESBL-E were selected from the INCREMENT database. The primary endpoint of the study was the evaluation of predictors of outcome after 30 days from development of severe sepsis or septic shock due to ESBL-E infection. Three cohorts were created for analysis: global, empirical-therapy and targeted-therapy cohorts. Results 367 septic patients were analysed. Overall mortality was 43.9% at 30 days. Escherichia coli (62.4%) and Klebsiella pneumoniae (27.2%) were the most frequent isolates. β-lactam/β-lactamase inhibitor (BLBLI) combinations were the most empirically used drug (43.6%), followed by carbapenems (29.4%). Empirical therapy was active in vitro in 249 (67.8%) patients, and escalation of antibiotic therapy was reported in 287 (78.2%) patients. Cox regression analysis showed that age, Charlson Comorbidity Index, McCabe classification, Pitt bacteremia score, abdominal source of infection and escalation of antibiotic therapy were independently associated with 30-day mortality. No differences in survival were reported in patients treated with BLBLI combinations or carbapenems in empirical or definitive therapy. Conclusions BSI due to ESBL-E in patients who developed severe sepsis or septic shock was associated with high 30-day mortality. Comorbidities, severity scores, source of infection and antibiotic therapy escalation were important determinants of unfavorable outcome.

Published
2018

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