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1. Impact of early valve surgery on outcome of staphylococcus aureus prosthetic valve infective endocarditis: Analysis in the international collaboration of endocarditis-prospective cohort study.

Author

Vincelj J., Sexton D.J., Corey G.R., Chu V.H., Wang A., Erpelding M.-L., Durante-Mangoni E., Fernandez-Hidalgo N., Giannitsioti E., Hannan M.M., Lejko-Zupanc T., Pare C., Pericas J., Ramirez J., Rovira I., Sitges M., Anguera I., Font B., Guma J.R., Bermejo J., Bouza E., Fernandez M.A.G., Gonzalez-Ramallo V., Marin M., Pedromingo M., Roda J., Rodriguez-Creixems M., Solis J., Almirante B., Tornos P., De Alarcon A., Parra R., Alestig E., Johansson M., Olaison L., Snygg-Martin U., Pachirat O., Pachirat P., Pussadhamma B., Senthong V., Casey A., Elliott T., Lambert P., Watkin R., Eyton C., Klein J.L., Bradley S., Kauffman C., Bedimo R., Crowley A.L., Douglas P., Drew L., Holland T., Lalani T., Mudrick D., Samad Z., Stryjewski M., Woods C.W., Lerakis S., Cantey R., Steed L., Wray D., Dickerman S.A., Bonilla H., Di Persio J., Salstrom S.-J., Baddley J., Patel M., Peterson G., Stancoven A., Afonso L., Kulman T., Levine D., Rybak M., Cabell C.H., Baloch K., Dixon C.C., Harding T., Jones-Richmond M., Pappas P., Park L.P., Redick T., Stafford J., Anstrom K., Bayer A.S., Karchmer A.W., Durack D.T., Eykyn S., Moreillon P., Chirouze C., Alla F., Fowler V.G., Miro J.M., Munoz P., Murdoch D.R., Tattevin P., Tribouilloy C., Hoen B., Clara L., Sanchez M., Nacinovich F., Oses P.F., Ronderos R., Sucari A., Thierer J., Casabe J., Cortes C., Altclas J., Kogan S., Spelman D., Athan E., Harris O., Kennedy K., Tan R., Gordon D., Papanicolas L., Eisen D., Grigg L., Street A., Korman T., Kotsanas D., Dever R., Konecny P., Lawrence R., Rees D., Ryan S., Feneley M.P., Harkness J., Jones P., Post J., Reinbott P., Gattringer R., Wiesbauer F., Andrade A.R., De Brito A.C.P., Guimaraes A.C., Grinberg M., Mansur A.J., Siciliano R.F., Strabelli T.M.V., Vieira M.L.C., De Medeiros Tranchesi R.A., Paiva M.G., Fortes C.Q., De Oliveira Ramos A., Ferraiuoli G., Golebiovski W., Lamas C., Santos M., Weksler C., Karlowsky J.A., Keynan Y., Morris A.M., Rubinstein E., Jones S.B., Garcia P., Cereceda M., Fica A., Mella R.M., Barsic B., Bukovski S., Krajinovic V., Pangercic A., Rudez I., Freiberger T., Pol J., Zaloudikova B., Zainab A., El Kholy A., Mishaal M., Rizk H., Aissa N., Alauzet C., Campagnac C., Doco-Lecompte T., Selton-Suty C., Casalta J.-P., Fournier P.-E., Habib G., Raoult D., Thuny F., Delahaye F., Delahaye A., Vandenesch F., Donal E., Donnio P.Y., Michelet C., Revest M., Violette J., Chevalier F., Jeu A., Rusinaru D.M.D., Sorel C., Bernard Y., Leroy J., Plesiat P., Naber C., Neuerburg C., Mazaheri B., Athanasia S., Deliolanis I., Giamarellou H., Tsaganos T., Mylona E., Paniara O., Papanicolaou K., Pyros J., Skoutelis A., Sharma G., Francis J., Nair L., Thomas V., Venugopal K., Hurley J., Gilon D., Israel S., Korem M., Strahilevitz J., Casillo R., Cuccurullo S., Dialetto G., Irene M., Ragone E., Tripodi M.F., Utili R., Cecchi E., De Rosa F., Forno D., Imazio M., Trinchero R., Tebini A., Grossi P., Lattanzio M., Toniolo A., Goglio A., Raglio A., Ravasio V., Rizzi M., Suter F., Carosi G., Magri S., Signorini L., Baban T., Kanafani Z., Kanj S.S., Yasmine M., Abidin I., Tamin S.S., Martinez E.R., Nieto G.I.S., Van Der Meer J.T.M., Chambers S., Holland D., Morris A., Raymond N., Read K., Dragulescu S., Ionac A., Mornos C., Butkevich O.M., Chipigina N., Kirill O., Vadim K., Vinogradova T., Edathodu J., Halim M., Lum L.-N., Tan R.-S., Logar M., Mueller-Premru M., Commerford P., Commerford A., Deetlefs E., Hansa C., Ntsekhe M., Almela M., Armero Y., Azqueta M., Castaneda X., Cervera C., Del Rio A., Falces C., Garcia-De-La-Maria C., Fita G., Gatell J.M., Marco F., Mestres C.A., Moreno A., Ninot S., Vincelj J., Sexton D.J., Corey G.R., Chu V.H., Wang A., Erpelding M.-L., Durante-Mangoni E., Fernandez-Hidalgo N., Giannitsioti E., Hannan M.M., Lejko-Zupanc T., Pare C., Pericas J., Ramirez J., Rovira I., Sitges M., Anguera I., Font B., Guma J.R., Bermejo J., Bouza E., Fernandez M.A.G., Gonzalez-Ramallo V., Marin M., Pedromingo M., Roda J., Rodriguez-Creixems M., Solis J., Almirante B., Tornos P., De Alarcon A., Parra R., Alestig E., Johansson M., Olaison L., Snygg-Martin U., Pachirat O., Pachirat P., Pussadhamma B., Senthong V., Casey A., Elliott T., Lambert P., Watkin R., Eyton C., Klein J.L., Bradley S., Kauffman C., Bedimo R., Crowley A.L., Douglas P., Drew L., Holland T., Lalani T., Mudrick D., Samad Z., Stryjewski M., Woods C.W., Lerakis S., Cantey R., Steed L., Wray D., Dickerman S.A., Bonilla H., Di Persio J., Salstrom S.-J., Baddley J., Patel M., Peterson G., Stancoven A., Afonso L., Kulman T., Levine D., Rybak M., Cabell C.H., Baloch K., Dixon C.C., Harding T., Jones-Richmond M., Pappas P., Park L.P., Redick T., Stafford J., Anstrom K., Bayer A.S., Karchmer A.W., Durack D.T., Eykyn S., Moreillon P., Chirouze C., Alla F., Fowler V.G., Miro J.M., Munoz P., Murdoch D.R., Tattevin P., Tribouilloy C., Hoen B., Clara L., Sanchez M., Nacinovich F., Oses P.F., Ronderos R., Sucari A., Thierer J., Casabe J., Cortes C., Altclas J., Kogan S., Spelman D., Athan E., Harris O., Kennedy K., Tan R., Gordon D., Papanicolas L., Eisen D., Grigg L., Street A., Korman T., Kotsanas D., Dever R., Konecny P., Lawrence R., Rees D., Ryan S., Feneley M.P., Harkness J., Jones P., Post J., Reinbott P., Gattringer R., Wiesbauer F., Andrade A.R., De Brito A.C.P., Guimaraes A.C., Grinberg M., Mansur A.J., Siciliano R.F., Strabelli T.M.V., Vieira M.L.C., De Medeiros Tranchesi R.A., Paiva M.G., Fortes C.Q., De Oliveira Ramos A., Ferraiuoli G., Golebiovski W., Lamas C., Santos M., Weksler C., Karlowsky J.A., Keynan Y., Morris A.M., Rubinstein E., Jones S.B., Garcia P., Cereceda M., Fica A., Mella R.M., Barsic B., Bukovski S., Krajinovic V., Pangercic A., Rudez I., Freiberger T., Pol J., Zaloudikova B., Zainab A., El Kholy A., Mishaal M., Rizk H., Aissa N., Alauzet C., Campagnac C., Doco-Lecompte T., Selton-Suty C., Casalta J.-P., Fournier P.-E., Habib G., Raoult D., Thuny F., Delahaye F., Delahaye A., Vandenesch F., Donal E., Donnio P.Y., Michelet C., Revest M., Violette J., Chevalier F., Jeu A., Rusinaru D.M.D., Sorel C., Bernard Y., Leroy J., Plesiat P., Naber C., Neuerburg C., Mazaheri B., Athanasia S., Deliolanis I., Giamarellou H., Tsaganos T., Mylona E., Paniara O., Papanicolaou K., Pyros J., Skoutelis A., Sharma G., Francis J., Nair L., Thomas V., Venugopal K., Hurley J., Gilon D., Israel S., Korem M., Strahilevitz J., Casillo R., Cuccurullo S., Dialetto G., Irene M., Ragone E., Tripodi M.F., Utili R., Cecchi E., De Rosa F., Forno D., Imazio M., Trinchero R., Tebini A., Grossi P., Lattanzio M., Toniolo A., Goglio A., Raglio A., Ravasio V., Rizzi M., Suter F., Carosi G., Magri S., Signorini L., Baban T., Kanafani Z., Kanj S.S., Yasmine M., Abidin I., Tamin S.S., Martinez E.R., Nieto G.I.S., Van Der Meer J.T.M., Chambers S., Holland D., Morris A., Raymond N., Read K., Dragulescu S., Ionac A., Mornos C., Butkevich O.M., Chipigina N., Kirill O., Vadim K., Vinogradova T., Edathodu J., Halim M., Lum L.-N., Tan R.-S., Logar M., Mueller-Premru M., Commerford P., Commerford A., Deetlefs E., Hansa C., Ntsekhe M., Almela M., Armero Y., Azqueta M., Castaneda X., Cervera C., Del Rio A., Falces C., Garcia-De-La-Maria C., Fita G., Gatell J.M., Marco F., Mestres C.A., Moreno A., and Ninot S.

Abstract

Background. The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration on Endocarditis-Prospective Cohort Study. Methods. Participants were enrolled between June 2000 and December 2006. Cox proportional hazards modeling that included surgery as a time-dependent covariate and propensity adjustment for likelihood to receive cardiac surgery was used to evaluate the impact of EVS and 1-year all-cause mortality on patients with definite left-sided S. aureus PVIE and no history of injection drug use. Results. EVS was performed in 74 of the 168 (44.3%) patients. One-year mortality was significantly higher among patients with S. aureus PVIE than in patients with non-S. aureus PVIE (48.2% vs 32.9%; P = .003). Staphylococcus aureus PVIE patients who underwent EVS had a significantly lower 1-year mortality rate (33.8% vs 59.1%; P = .001). In multivariate, propensity-adjusted models, EVS was not associated with 1-year mortality (risk ratio, 0.67 [95% confidence interval, .39-1.15]; P = .15). Conclusions. In this prospective, multinational cohort of patients with S. aureus PVIE, EVS was not associated with reduced 1-year mortality. The decision to pursue EVS should be individualized for each patient, based upon infection-specific characteristics rather than solely upon the microbiology of the infection causing PVIE.Copyright © The Author 2014.

Published
2015

2. Impact of early valve surgery on outcome of staphylococcus aureus prosthetic valve infective endocarditis: Analysis in the international collaboration of endocarditis-prospective cohort study.

Author

Vincelj J., Sexton D.J., Corey G.R., Chu V.H., Wang A., Erpelding M.-L., Durante-Mangoni E., Fernandez-Hidalgo N., Giannitsioti E., Hannan M.M., Lejko-Zupanc T., Pare C., Pericas J., Ramirez J., Rovira I., Sitges M., Anguera I., Font B., Guma J.R., Bermejo J., Bouza E., Fernandez M.A.G., Gonzalez-Ramallo V., Marin M., Pedromingo M., Roda J., Rodriguez-Creixems M., Solis J., Almirante B., Tornos P., De Alarcon A., Parra R., Alestig E., Johansson M., Olaison L., Snygg-Martin U., Pachirat O., Pachirat P., Pussadhamma B., Senthong V., Casey A., Elliott T., Lambert P., Watkin R., Eyton C., Klein J.L., Bradley S., Kauffman C., Bedimo R., Crowley A.L., Douglas P., Drew L., Holland T., Lalani T., Mudrick D., Samad Z., Stryjewski M., Woods C.W., Lerakis S., Cantey R., Steed L., Wray D., Dickerman S.A., Bonilla H., Di Persio J., Salstrom S.-J., Baddley J., Patel M., Peterson G., Stancoven A., Afonso L., Kulman T., Levine D., Rybak M., Cabell C.H., Baloch K., Dixon C.C., Harding T., Jones-Richmond M., Pappas P., Park L.P., Redick T., Stafford J., Anstrom K., Bayer A.S., Karchmer A.W., Durack D.T., Eykyn S., Moreillon P., Chirouze C., Alla F., Fowler V.G., Miro J.M., Munoz P., Murdoch D.R., Tattevin P., Tribouilloy C., Hoen B., Clara L., Sanchez M., Nacinovich F., Oses P.F., Ronderos R., Sucari A., Thierer J., Casabe J., Cortes C., Altclas J., Kogan S., Spelman D., Athan E., Harris O., Kennedy K., Tan R., Gordon D., Papanicolas L., Eisen D., Grigg L., Street A., Korman T., Kotsanas D., Dever R., Konecny P., Lawrence R., Rees D., Ryan S., Feneley M.P., Harkness J., Jones P., Post J., Reinbott P., Gattringer R., Wiesbauer F., Andrade A.R., De Brito A.C.P., Guimaraes A.C., Grinberg M., Mansur A.J., Siciliano R.F., Strabelli T.M.V., Vieira M.L.C., De Medeiros Tranchesi R.A., Paiva M.G., Fortes C.Q., De Oliveira Ramos A., Ferraiuoli G., Golebiovski W., Lamas C., Santos M., Weksler C., Karlowsky J.A., Keynan Y., Morris A.M., Rubinstein E., Jones S.B., Garcia P., Cereceda M., Fica A., Mella R.M., Barsic B., Bukovski S., Krajinovic V., Pangercic A., Rudez I., Freiberger T., Pol J., Zaloudikova B., Zainab A., El Kholy A., Mishaal M., Rizk H., Aissa N., Alauzet C., Campagnac C., Doco-Lecompte T., Selton-Suty C., Casalta J.-P., Fournier P.-E., Habib G., Raoult D., Thuny F., Delahaye F., Delahaye A., Vandenesch F., Donal E., Donnio P.Y., Michelet C., Revest M., Violette J., Chevalier F., Jeu A., Rusinaru D.M.D., Sorel C., Bernard Y., Leroy J., Plesiat P., Naber C., Neuerburg C., Mazaheri B., Athanasia S., Deliolanis I., Giamarellou H., Tsaganos T., Mylona E., Paniara O., Papanicolaou K., Pyros J., Skoutelis A., Sharma G., Francis J., Nair L., Thomas V., Venugopal K., Hurley J., Gilon D., Israel S., Korem M., Strahilevitz J., Casillo R., Cuccurullo S., Dialetto G., Irene M., Ragone E., Tripodi M.F., Utili R., Cecchi E., De Rosa F., Forno D., Imazio M., Trinchero R., Tebini A., Grossi P., Lattanzio M., Toniolo A., Goglio A., Raglio A., Ravasio V., Rizzi M., Suter F., Carosi G., Magri S., Signorini L., Baban T., Kanafani Z., Kanj S.S., Yasmine M., Abidin I., Tamin S.S., Martinez E.R., Nieto G.I.S., Van Der Meer J.T.M., Chambers S., Holland D., Morris A., Raymond N., Read K., Dragulescu S., Ionac A., Mornos C., Butkevich O.M., Chipigina N., Kirill O., Vadim K., Vinogradova T., Edathodu J., Halim M., Lum L.-N., Tan R.-S., Logar M., Mueller-Premru M., Commerford P., Commerford A., Deetlefs E., Hansa C., Ntsekhe M., Almela M., Armero Y., Azqueta M., Castaneda X., Cervera C., Del Rio A., Falces C., Garcia-De-La-Maria C., Fita G., Gatell J.M., Marco F., Mestres C.A., Moreno A., Ninot S., Vincelj J., Sexton D.J., Corey G.R., Chu V.H., Wang A., Erpelding M.-L., Durante-Mangoni E., Fernandez-Hidalgo N., Giannitsioti E., Hannan M.M., Lejko-Zupanc T., Pare C., Pericas J., Ramirez J., Rovira I., Sitges M., Anguera I., Font B., Guma J.R., Bermejo J., Bouza E., Fernandez M.A.G., Gonzalez-Ramallo V., Marin M., Pedromingo M., Roda J., Rodriguez-Creixems M., Solis J., Almirante B., Tornos P., De Alarcon A., Parra R., Alestig E., Johansson M., Olaison L., Snygg-Martin U., Pachirat O., Pachirat P., Pussadhamma B., Senthong V., Casey A., Elliott T., Lambert P., Watkin R., Eyton C., Klein J.L., Bradley S., Kauffman C., Bedimo R., Crowley A.L., Douglas P., Drew L., Holland T., Lalani T., Mudrick D., Samad Z., Stryjewski M., Woods C.W., Lerakis S., Cantey R., Steed L., Wray D., Dickerman S.A., Bonilla H., Di Persio J., Salstrom S.-J., Baddley J., Patel M., Peterson G., Stancoven A., Afonso L., Kulman T., Levine D., Rybak M., Cabell C.H., Baloch K., Dixon C.C., Harding T., Jones-Richmond M., Pappas P., Park L.P., Redick T., Stafford J., Anstrom K., Bayer A.S., Karchmer A.W., Durack D.T., Eykyn S., Moreillon P., Chirouze C., Alla F., Fowler V.G., Miro J.M., Munoz P., Murdoch D.R., Tattevin P., Tribouilloy C., Hoen B., Clara L., Sanchez M., Nacinovich F., Oses P.F., Ronderos R., Sucari A., Thierer J., Casabe J., Cortes C., Altclas J., Kogan S., Spelman D., Athan E., Harris O., Kennedy K., Tan R., Gordon D., Papanicolas L., Eisen D., Grigg L., Street A., Korman T., Kotsanas D., Dever R., Konecny P., Lawrence R., Rees D., Ryan S., Feneley M.P., Harkness J., Jones P., Post J., Reinbott P., Gattringer R., Wiesbauer F., Andrade A.R., De Brito A.C.P., Guimaraes A.C., Grinberg M., Mansur A.J., Siciliano R.F., Strabelli T.M.V., Vieira M.L.C., De Medeiros Tranchesi R.A., Paiva M.G., Fortes C.Q., De Oliveira Ramos A., Ferraiuoli G., Golebiovski W., Lamas C., Santos M., Weksler C., Karlowsky J.A., Keynan Y., Morris A.M., Rubinstein E., Jones S.B., Garcia P., Cereceda M., Fica A., Mella R.M., Barsic B., Bukovski S., Krajinovic V., Pangercic A., Rudez I., Freiberger T., Pol J., Zaloudikova B., Zainab A., El Kholy A., Mishaal M., Rizk H., Aissa N., Alauzet C., Campagnac C., Doco-Lecompte T., Selton-Suty C., Casalta J.-P., Fournier P.-E., Habib G., Raoult D., Thuny F., Delahaye F., Delahaye A., Vandenesch F., Donal E., Donnio P.Y., Michelet C., Revest M., Violette J., Chevalier F., Jeu A., Rusinaru D.M.D., Sorel C., Bernard Y., Leroy J., Plesiat P., Naber C., Neuerburg C., Mazaheri B., Athanasia S., Deliolanis I., Giamarellou H., Tsaganos T., Mylona E., Paniara O., Papanicolaou K., Pyros J., Skoutelis A., Sharma G., Francis J., Nair L., Thomas V., Venugopal K., Hurley J., Gilon D., Israel S., Korem M., Strahilevitz J., Casillo R., Cuccurullo S., Dialetto G., Irene M., Ragone E., Tripodi M.F., Utili R., Cecchi E., De Rosa F., Forno D., Imazio M., Trinchero R., Tebini A., Grossi P., Lattanzio M., Toniolo A., Goglio A., Raglio A., Ravasio V., Rizzi M., Suter F., Carosi G., Magri S., Signorini L., Baban T., Kanafani Z., Kanj S.S., Yasmine M., Abidin I., Tamin S.S., Martinez E.R., Nieto G.I.S., Van Der Meer J.T.M., Chambers S., Holland D., Morris A., Raymond N., Read K., Dragulescu S., Ionac A., Mornos C., Butkevich O.M., Chipigina N., Kirill O., Vadim K., Vinogradova T., Edathodu J., Halim M., Lum L.-N., Tan R.-S., Logar M., Mueller-Premru M., Commerford P., Commerford A., Deetlefs E., Hansa C., Ntsekhe M., Almela M., Armero Y., Azqueta M., Castaneda X., Cervera C., Del Rio A., Falces C., Garcia-De-La-Maria C., Fita G., Gatell J.M., Marco F., Mestres C.A., Moreno A., and Ninot S.

Abstract

Background. The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration on Endocarditis-Prospective Cohort Study. Methods. Participants were enrolled between June 2000 and December 2006. Cox proportional hazards modeling that included surgery as a time-dependent covariate and propensity adjustment for likelihood to receive cardiac surgery was used to evaluate the impact of EVS and 1-year all-cause mortality on patients with definite left-sided S. aureus PVIE and no history of injection drug use. Results. EVS was performed in 74 of the 168 (44.3%) patients. One-year mortality was significantly higher among patients with S. aureus PVIE than in patients with non-S. aureus PVIE (48.2% vs 32.9%; P = .003). Staphylococcus aureus PVIE patients who underwent EVS had a significantly lower 1-year mortality rate (33.8% vs 59.1%; P = .001). In multivariate, propensity-adjusted models, EVS was not associated with 1-year mortality (risk ratio, 0.67 [95% confidence interval, .39-1.15]; P = .15). Conclusions. In this prospective, multinational cohort of patients with S. aureus PVIE, EVS was not associated with reduced 1-year mortality. The decision to pursue EVS should be individualized for each patient, based upon infection-specific characteristics rather than solely upon the microbiology of the infection causing PVIE.Copyright © The Author 2014.

Published
2015

3. Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke.

Author

Zaloudikova B., Garcia-De-La-Maria C., Fita G., Gatell J.M., Marco F., Mestres C.A., Miro J.M., Moreno A., Ninot S., Pare C., Pericas J., Ramirez J., Rovira I., Sitges M., Anguera I., Font B., Guma J.R., Bermejo J., Bouza E., Fernandez M.A.G., Gonzalez-Ramallo V., Marin M., Munoz P., Pedromingo M., Roda J., Rodriguez-Creixems M., Solis J., Almirante B., Fernandez-Hidalgo N., Tornos P., De Alarcon A., Parra R., Alestig E., Johansson M., Snygg-Martin U., Pachirat O., Pachirat P., Pussadhamma B., Senthong V., Casey A., Elliott T., Lambert P., Watkin R., Eyton C., Klein J.L., Bradley S., Kauffman C., Bedimo R., Corey G.R., Crowley A.L., Douglas P., Drew L., Fowler V.G., Holland T., Lalani T., Mudrick D., Samad Z., Sexton D., Stryjewski M., Woods C.W., Lerakis S., Cantey R., Steed L., Wray D., Dickerman S.A., Bonilla H., Di Persio J., Salstrom S.-J., Baddley J., Peterson G., Stancoven A., Afonso L., Kulman T., Levine D., Rybak M., Cabell C.H., Morris A.M., Rubinstein E., Jones S.B., Garcia P., Barsic B., Dickerman S., Krajinovic V., Pappas P., Altclas J., Carosi G., Casabe J.H., Chu V.H., Delahaye F., Edathodu J., Fortes C.Q., Olaison L., Pangercic A., Patel M., Rudez I., Tamin S.S., Vincelj J., Bayer A.S., Wang A., Clara L., Sanchez M., Nacinovich F., Oses P.F., Ronderos R., Sucari A., Thierer J., Casabe J., Cortes C., Kogan S., Spelman D., Athan E., Harris O., Kennedy K., Tan R., Gordon D., Papanicolas L., Eisen D., Grigg L., Street A., Korman T., Kotsanas D., Dever R., Jones P., Konecny P., Lawrence R., Rees D., Ryan S., Feneley M.P., Harkness J., Post J., Reinbott P., Gattringer R., Wiesbauer F., Andrade A.R., De Brito A.C.P., Guimaraes A.C., Grinberg M., Mansur A.J., Siciliano R.F., Strabelli T.M.V., Vieira M.L.C., De Medeiros Tranchesi R.A., Paiva M.G., De Oliveira Ramos A., Ferraiuoli G., Golebiovski W., Lamas C., Santos M., Weksler C., Karlowsky J.A., Keynan Y., Cereceda M., Fica A., Mella R.M., Bukovski S., Freiberger T., Pol J., Sharma G., Ashour Z., Kholy A.E., Mishaal M., Rizk H., Aissa N., Alauzet C., Alla F., Campagnac C., Doco-Lecompte T., Selton-Suty C., Casalta J.-P., Fournier P.-E., Habib G., Raoult D., Thuny F., Delahaye A., Vandenesch F., Donal E., Donnio P.Y., Michelet C., Revest M., Tattevin P., Violette J., Chevalier F., Jeu A., Rusinaru D., Sorel C., Tribouilloy C., Bernard Y., Chirouze C., Hoen B., Leroy J., Plesiat P., Naber G.C., Neuerburg C., Mazaheri B., Naber C., Athanasia S., Giannitsioti E., Mylona E., Paniara O., Papanicolaou K., Pyros J., Skoutelis A., Francis J., Nair L., Thomas D.M.V., Venugopal K., Hannan M., Hurley J., Cahan A., Gilon D., Israel S., Korem M., Strahilevitz J., Tripodi M.F., Casillo R., Cuccurullo S., Dialetto G., Durante-Mangoni E., Irene M., Ragone E., Utili R., Cecchi E., Rosa F.D., Forno D., Imazio M., Trinchero R., Tebini A., Grossi P., Lattanzio M., Toniolo A., Goglio A., Raglio A., Ravasio V., Rizzi M., Suter F., Magri S., Signorini L., Baban T., Kanafani Z., Kanj S.S., Sfeir J., Yasmine M., Abidin I., Martinez E.R., Nieto G.I.S., Van Der Meer J.T.M., Chambers S., Murdoch D.R., Holland D., Morris A., Raymond N., Read K., Dragulescu S., Ionac A., Mornos C., Butkevich O.M., Chipigina N., Kirill O., Vadim K., Vinogradova T., Halim M., Lum L.-N., Tan R.-S., Lejko-Zupanc T., Logar M., Mueller-Premru M., Commerford P., Commerford A., Deetlefs E., Hansa C., Ntsekhe M., Almela M., Armero Y., Azqueta M., Castaneda X., Cervera C., Del Rio A., Falces C., Zaloudikova B., Garcia-De-La-Maria C., Fita G., Gatell J.M., Marco F., Mestres C.A., Miro J.M., Moreno A., Ninot S., Pare C., Pericas J., Ramirez J., Rovira I., Sitges M., Anguera I., Font B., Guma J.R., Bermejo J., Bouza E., Fernandez M.A.G., Gonzalez-Ramallo V., Marin M., Munoz P., Pedromingo M., Roda J., Rodriguez-Creixems M., Solis J., Almirante B., Fernandez-Hidalgo N., Tornos P., De Alarcon A., Parra R., Alestig E., Johansson M., Snygg-Martin U., Pachirat O., Pachirat P., Pussadhamma B., Senthong V., Casey A., Elliott T., Lambert P., Watkin R., Eyton C., Klein J.L., Bradley S., Kauffman C., Bedimo R., Corey G.R., Crowley A.L., Douglas P., Drew L., Fowler V.G., Holland T., Lalani T., Mudrick D., Samad Z., Sexton D., Stryjewski M., Woods C.W., Lerakis S., Cantey R., Steed L., Wray D., Dickerman S.A., Bonilla H., Di Persio J., Salstrom S.-J., Baddley J., Peterson G., Stancoven A., Afonso L., Kulman T., Levine D., Rybak M., Cabell C.H., Morris A.M., Rubinstein E., Jones S.B., Garcia P., Barsic B., Dickerman S., Krajinovic V., Pappas P., Altclas J., Carosi G., Casabe J.H., Chu V.H., Delahaye F., Edathodu J., Fortes C.Q., Olaison L., Pangercic A., Patel M., Rudez I., Tamin S.S., Vincelj J., Bayer A.S., Wang A., Clara L., Sanchez M., Nacinovich F., Oses P.F., Ronderos R., Sucari A., Thierer J., Casabe J., Cortes C., Kogan S., Spelman D., Athan E., Harris O., Kennedy K., Tan R., Gordon D., Papanicolas L., Eisen D., Grigg L., Street A., Korman T., Kotsanas D., Dever R., Jones P., Konecny P., Lawrence R., Rees D., Ryan S., Feneley M.P., Harkness J., Post J., Reinbott P., Gattringer R., Wiesbauer F., Andrade A.R., De Brito A.C.P., Guimaraes A.C., Grinberg M., Mansur A.J., Siciliano R.F., Strabelli T.M.V., Vieira M.L.C., De Medeiros Tranchesi R.A., Paiva M.G., De Oliveira Ramos A., Ferraiuoli G., Golebiovski W., Lamas C., Santos M., Weksler C., Karlowsky J.A., Keynan Y., Cereceda M., Fica A., Mella R.M., Bukovski S., Freiberger T., Pol J., Sharma G., Ashour Z., Kholy A.E., Mishaal M., Rizk H., Aissa N., Alauzet C., Alla F., Campagnac C., Doco-Lecompte T., Selton-Suty C., Casalta J.-P., Fournier P.-E., Habib G., Raoult D., Thuny F., Delahaye A., Vandenesch F., Donal E., Donnio P.Y., Michelet C., Revest M., Tattevin P., Violette J., Chevalier F., Jeu A., Rusinaru D., Sorel C., Tribouilloy C., Bernard Y., Chirouze C., Hoen B., Leroy J., Plesiat P., Naber G.C., Neuerburg C., Mazaheri B., Naber C., Athanasia S., Giannitsioti E., Mylona E., Paniara O., Papanicolaou K., Pyros J., Skoutelis A., Francis J., Nair L., Thomas D.M.V., Venugopal K., Hannan M., Hurley J., Cahan A., Gilon D., Israel S., Korem M., Strahilevitz J., Tripodi M.F., Casillo R., Cuccurullo S., Dialetto G., Durante-Mangoni E., Irene M., Ragone E., Utili R., Cecchi E., Rosa F.D., Forno D., Imazio M., Trinchero R., Tebini A., Grossi P., Lattanzio M., Toniolo A., Goglio A., Raglio A., Ravasio V., Rizzi M., Suter F., Magri S., Signorini L., Baban T., Kanafani Z., Kanj S.S., Sfeir J., Yasmine M., Abidin I., Martinez E.R., Nieto G.I.S., Van Der Meer J.T.M., Chambers S., Murdoch D.R., Holland D., Morris A., Raymond N., Read K., Dragulescu S., Ionac A., Mornos C., Butkevich O.M., Chipigina N., Kirill O., Vadim K., Vinogradova T., Halim M., Lum L.-N., Tan R.-S., Lejko-Zupanc T., Logar M., Mueller-Premru M., Commerford P., Commerford A., Deetlefs E., Hansa C., Ntsekhe M., Almela M., Armero Y., Azqueta M., Castaneda X., Cervera C., Del Rio A., and Falces C.

Abstract

Background. The timing of cardiac surgery after stroke in infective endocarditis (IE) remains controversial. We examined the relationship between the timing of surgery after stroke and the incidence of in-hospital and 1-year mortalities. Methods. Data were obtained from the International Collaboration on Endocarditis-Prospective Cohort Study of 4794 patients with definite IE who were admitted to 64 centers from June 2000 through December 2006. Multivariate logistic regression and Cox regression analyses were performed to estimate the impact of early surgery on hospital and 1-year mortality after adjustments for other significant covariates. Results. Of the 857 patients with IE complicated by ischemic stroke syndromes, 198 who underwent valve replacement surgery poststroke were available for analysis. Overall, 58 (29.3%) patients underwent early surgical treatment vs 140 (70.7%) patients who underwent late surgical treatment. After adjustment for other risk factors, early surgery was not significantly associated with increased in-hospital mortality rates (odds ratio, 2.308; 95% confidence interval[CI], .942-5.652). Overall, probability of death after 1-year follow-up did not differ between 2 treatment groups (27.1% in early surgery and 19.2% in late surgery group, P = .328; adjusted hazard ratio, 1.138; 95% CI, .802-1.650). Conclusions. There is no apparent survival benefit in delaying surgery when indicated in IE patients after ischemic stroke. Further observational analyses that include detailed pre- and postoperative clinical neurologic findings and advanced imaging data (eg, ischemic stroke size), may allow for more refined recommendations on the optimal timing of valvular surgery in patients with IE and recent stroke syndromes.Copyright © The Author 2012.

Published
2013

4. Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke.

Author

Zaloudikova B., Garcia-De-La-Maria C., Fita G., Gatell J.M., Marco F., Mestres C.A., Miro J.M., Moreno A., Ninot S., Pare C., Pericas J., Ramirez J., Rovira I., Sitges M., Anguera I., Font B., Guma J.R., Bermejo J., Bouza E., Fernandez M.A.G., Gonzalez-Ramallo V., Marin M., Munoz P., Pedromingo M., Roda J., Rodriguez-Creixems M., Solis J., Almirante B., Fernandez-Hidalgo N., Tornos P., De Alarcon A., Parra R., Alestig E., Johansson M., Snygg-Martin U., Pachirat O., Pachirat P., Pussadhamma B., Senthong V., Casey A., Elliott T., Lambert P., Watkin R., Eyton C., Klein J.L., Bradley S., Kauffman C., Bedimo R., Corey G.R., Crowley A.L., Douglas P., Drew L., Fowler V.G., Holland T., Lalani T., Mudrick D., Samad Z., Sexton D., Stryjewski M., Woods C.W., Lerakis S., Cantey R., Steed L., Wray D., Dickerman S.A., Bonilla H., Di Persio J., Salstrom S.-J., Baddley J., Peterson G., Stancoven A., Afonso L., Kulman T., Levine D., Rybak M., Cabell C.H., Morris A.M., Rubinstein E., Jones S.B., Garcia P., Barsic B., Dickerman S., Krajinovic V., Pappas P., Altclas J., Carosi G., Casabe J.H., Chu V.H., Delahaye F., Edathodu J., Fortes C.Q., Olaison L., Pangercic A., Patel M., Rudez I., Tamin S.S., Vincelj J., Bayer A.S., Wang A., Clara L., Sanchez M., Nacinovich F., Oses P.F., Ronderos R., Sucari A., Thierer J., Casabe J., Cortes C., Kogan S., Spelman D., Athan E., Harris O., Kennedy K., Tan R., Gordon D., Papanicolas L., Eisen D., Grigg L., Street A., Korman T., Kotsanas D., Dever R., Jones P., Konecny P., Lawrence R., Rees D., Ryan S., Feneley M.P., Harkness J., Post J., Reinbott P., Gattringer R., Wiesbauer F., Andrade A.R., De Brito A.C.P., Guimaraes A.C., Grinberg M., Mansur A.J., Siciliano R.F., Strabelli T.M.V., Vieira M.L.C., De Medeiros Tranchesi R.A., Paiva M.G., De Oliveira Ramos A., Ferraiuoli G., Golebiovski W., Lamas C., Santos M., Weksler C., Karlowsky J.A., Keynan Y., Cereceda M., Fica A., Mella R.M., Bukovski S., Freiberger T., Pol J., Sharma G., Ashour Z., Kholy A.E., Mishaal M., Rizk H., Aissa N., Alauzet C., Alla F., Campagnac C., Doco-Lecompte T., Selton-Suty C., Casalta J.-P., Fournier P.-E., Habib G., Raoult D., Thuny F., Delahaye A., Vandenesch F., Donal E., Donnio P.Y., Michelet C., Revest M., Tattevin P., Violette J., Chevalier F., Jeu A., Rusinaru D., Sorel C., Tribouilloy C., Bernard Y., Chirouze C., Hoen B., Leroy J., Plesiat P., Naber G.C., Neuerburg C., Mazaheri B., Naber C., Athanasia S., Giannitsioti E., Mylona E., Paniara O., Papanicolaou K., Pyros J., Skoutelis A., Francis J., Nair L., Thomas D.M.V., Venugopal K., Hannan M., Hurley J., Cahan A., Gilon D., Israel S., Korem M., Strahilevitz J., Tripodi M.F., Casillo R., Cuccurullo S., Dialetto G., Durante-Mangoni E., Irene M., Ragone E., Utili R., Cecchi E., Rosa F.D., Forno D., Imazio M., Trinchero R., Tebini A., Grossi P., Lattanzio M., Toniolo A., Goglio A., Raglio A., Ravasio V., Rizzi M., Suter F., Magri S., Signorini L., Baban T., Kanafani Z., Kanj S.S., Sfeir J., Yasmine M., Abidin I., Martinez E.R., Nieto G.I.S., Van Der Meer J.T.M., Chambers S., Murdoch D.R., Holland D., Morris A., Raymond N., Read K., Dragulescu S., Ionac A., Mornos C., Butkevich O.M., Chipigina N., Kirill O., Vadim K., Vinogradova T., Halim M., Lum L.-N., Tan R.-S., Lejko-Zupanc T., Logar M., Mueller-Premru M., Commerford P., Commerford A., Deetlefs E., Hansa C., Ntsekhe M., Almela M., Armero Y., Azqueta M., Castaneda X., Cervera C., Del Rio A., Falces C., Zaloudikova B., Garcia-De-La-Maria C., Fita G., Gatell J.M., Marco F., Mestres C.A., Miro J.M., Moreno A., Ninot S., Pare C., Pericas J., Ramirez J., Rovira I., Sitges M., Anguera I., Font B., Guma J.R., Bermejo J., Bouza E., Fernandez M.A.G., Gonzalez-Ramallo V., Marin M., Munoz P., Pedromingo M., Roda J., Rodriguez-Creixems M., Solis J., Almirante B., Fernandez-Hidalgo N., Tornos P., De Alarcon A., Parra R., Alestig E., Johansson M., Snygg-Martin U., Pachirat O., Pachirat P., Pussadhamma B., Senthong V., Casey A., Elliott T., Lambert P., Watkin R., Eyton C., Klein J.L., Bradley S., Kauffman C., Bedimo R., Corey G.R., Crowley A.L., Douglas P., Drew L., Fowler V.G., Holland T., Lalani T., Mudrick D., Samad Z., Sexton D., Stryjewski M., Woods C.W., Lerakis S., Cantey R., Steed L., Wray D., Dickerman S.A., Bonilla H., Di Persio J., Salstrom S.-J., Baddley J., Peterson G., Stancoven A., Afonso L., Kulman T., Levine D., Rybak M., Cabell C.H., Morris A.M., Rubinstein E., Jones S.B., Garcia P., Barsic B., Dickerman S., Krajinovic V., Pappas P., Altclas J., Carosi G., Casabe J.H., Chu V.H., Delahaye F., Edathodu J., Fortes C.Q., Olaison L., Pangercic A., Patel M., Rudez I., Tamin S.S., Vincelj J., Bayer A.S., Wang A., Clara L., Sanchez M., Nacinovich F., Oses P.F., Ronderos R., Sucari A., Thierer J., Casabe J., Cortes C., Kogan S., Spelman D., Athan E., Harris O., Kennedy K., Tan R., Gordon D., Papanicolas L., Eisen D., Grigg L., Street A., Korman T., Kotsanas D., Dever R., Jones P., Konecny P., Lawrence R., Rees D., Ryan S., Feneley M.P., Harkness J., Post J., Reinbott P., Gattringer R., Wiesbauer F., Andrade A.R., De Brito A.C.P., Guimaraes A.C., Grinberg M., Mansur A.J., Siciliano R.F., Strabelli T.M.V., Vieira M.L.C., De Medeiros Tranchesi R.A., Paiva M.G., De Oliveira Ramos A., Ferraiuoli G., Golebiovski W., Lamas C., Santos M., Weksler C., Karlowsky J.A., Keynan Y., Cereceda M., Fica A., Mella R.M., Bukovski S., Freiberger T., Pol J., Sharma G., Ashour Z., Kholy A.E., Mishaal M., Rizk H., Aissa N., Alauzet C., Alla F., Campagnac C., Doco-Lecompte T., Selton-Suty C., Casalta J.-P., Fournier P.-E., Habib G., Raoult D., Thuny F., Delahaye A., Vandenesch F., Donal E., Donnio P.Y., Michelet C., Revest M., Tattevin P., Violette J., Chevalier F., Jeu A., Rusinaru D., Sorel C., Tribouilloy C., Bernard Y., Chirouze C., Hoen B., Leroy J., Plesiat P., Naber G.C., Neuerburg C., Mazaheri B., Naber C., Athanasia S., Giannitsioti E., Mylona E., Paniara O., Papanicolaou K., Pyros J., Skoutelis A., Francis J., Nair L., Thomas D.M.V., Venugopal K., Hannan M., Hurley J., Cahan A., Gilon D., Israel S., Korem M., Strahilevitz J., Tripodi M.F., Casillo R., Cuccurullo S., Dialetto G., Durante-Mangoni E., Irene M., Ragone E., Utili R., Cecchi E., Rosa F.D., Forno D., Imazio M., Trinchero R., Tebini A., Grossi P., Lattanzio M., Toniolo A., Goglio A., Raglio A., Ravasio V., Rizzi M., Suter F., Magri S., Signorini L., Baban T., Kanafani Z., Kanj S.S., Sfeir J., Yasmine M., Abidin I., Martinez E.R., Nieto G.I.S., Van Der Meer J.T.M., Chambers S., Murdoch D.R., Holland D., Morris A., Raymond N., Read K., Dragulescu S., Ionac A., Mornos C., Butkevich O.M., Chipigina N., Kirill O., Vadim K., Vinogradova T., Halim M., Lum L.-N., Tan R.-S., Lejko-Zupanc T., Logar M., Mueller-Premru M., Commerford P., Commerford A., Deetlefs E., Hansa C., Ntsekhe M., Almela M., Armero Y., Azqueta M., Castaneda X., Cervera C., Del Rio A., and Falces C.

Abstract

Background. The timing of cardiac surgery after stroke in infective endocarditis (IE) remains controversial. We examined the relationship between the timing of surgery after stroke and the incidence of in-hospital and 1-year mortalities. Methods. Data were obtained from the International Collaboration on Endocarditis-Prospective Cohort Study of 4794 patients with definite IE who were admitted to 64 centers from June 2000 through December 2006. Multivariate logistic regression and Cox regression analyses were performed to estimate the impact of early surgery on hospital and 1-year mortality after adjustments for other significant covariates. Results. Of the 857 patients with IE complicated by ischemic stroke syndromes, 198 who underwent valve replacement surgery poststroke were available for analysis. Overall, 58 (29.3%) patients underwent early surgical treatment vs 140 (70.7%) patients who underwent late surgical treatment. After adjustment for other risk factors, early surgery was not significantly associated with increased in-hospital mortality rates (odds ratio, 2.308; 95% confidence interval[CI], .942-5.652). Overall, probability of death after 1-year follow-up did not differ between 2 treatment groups (27.1% in early surgery and 19.2% in late surgery group, P = .328; adjusted hazard ratio, 1.138; 95% CI, .802-1.650). Conclusions. There is no apparent survival benefit in delaying surgery when indicated in IE patients after ischemic stroke. Further observational analyses that include detailed pre- and postoperative clinical neurologic findings and advanced imaging data (eg, ischemic stroke size), may allow for more refined recommendations on the optimal timing of valvular surgery in patients with IE and recent stroke syndromes.Copyright © The Author 2012.

Published
2013

5. Candidaemia with uncommon Candida species: Predisposing factors, outcome, antifungal susceptibility, and implications for management.

Author

McBride J., Chen S.C.A., Marriott D., Playford E.G., Nguyen Q., Ellis D., Meyer W., Sorrell T.C., Slavin M., McCormack J., Walmsley K., Looke D., Johnson B., Nimmo G., Playford G., Drummond D., Forgan Smith R., Preston E., Allworth A., Faoagali J., Gerns N., Botes J., Cherian S., Robson J., Vohra R., Norton R., Coulter C., O'Kane G., Robb D., Gottlieb T., Chambers I., DeWit D., Carroll M., Dobson P., Ferguson J., Tierney L., Jozwiak F., Munro R., Tomasotos V., Pickles R., Holland J., Groenwad F., Hale K., Watson M., Vaz R., Hardiman R., Baleriola C., Ryan S., Pritchard R., Weeks K., Benn R., Lawrence R., Taylor P., Lindstrom S., Harkness J., Palasanthrian P., Grant R., McPetrie R., Johnson R., Halliday C., Maszewska K., Dennis N., Newton P., Franklin C., Morrisey O., Spelman D., Wesselingh S., Speed B., Hellsten J., Mayall B., Russell J., Broughton S., Woolley I., Coloe S., Sherman A., Korman T., Graves S., Huysmans M., Gordon D., Rowlands K., Shaw D., Ritchie B., Handkle R., Beaman M., Chiam A., McCarthy J., Heath C., Altmann S., Arthur I., Speers D., Cox E., Cooley L., McGregor A., Currie B., Lum G., Fisher D., Collignon P., Roberts J., Watson A., McBride J., Chen S.C.A., Marriott D., Playford E.G., Nguyen Q., Ellis D., Meyer W., Sorrell T.C., Slavin M., McCormack J., Walmsley K., Looke D., Johnson B., Nimmo G., Playford G., Drummond D., Forgan Smith R., Preston E., Allworth A., Faoagali J., Gerns N., Botes J., Cherian S., Robson J., Vohra R., Norton R., Coulter C., O'Kane G., Robb D., Gottlieb T., Chambers I., DeWit D., Carroll M., Dobson P., Ferguson J., Tierney L., Jozwiak F., Munro R., Tomasotos V., Pickles R., Holland J., Groenwad F., Hale K., Watson M., Vaz R., Hardiman R., Baleriola C., Ryan S., Pritchard R., Weeks K., Benn R., Lawrence R., Taylor P., Lindstrom S., Harkness J., Palasanthrian P., Grant R., McPetrie R., Johnson R., Halliday C., Maszewska K., Dennis N., Newton P., Franklin C., Morrisey O., Spelman D., Wesselingh S., Speed B., Hellsten J., Mayall B., Russell J., Broughton S., Woolley I., Coloe S., Sherman A., Korman T., Graves S., Huysmans M., Gordon D., Rowlands K., Shaw D., Ritchie B., Handkle R., Beaman M., Chiam A., McCarthy J., Heath C., Altmann S., Arthur I., Speers D., Cox E., Cooley L., McGregor A., Currie B., Lum G., Fisher D., Collignon P., Roberts J., and Watson A.

Abstract

The risk factors for and clinical features of bloodstream infection with uncommon Candida spp. (species other than C. albicans, C. glabrata, C. parapsilosis, C. tropicals and C. krusei) are incompletely defined. To identify clinical variables associated with these species that might guide management, 57 cases of candidaemia resulting from uncommon Candida spp. were analysed in comparison with 517 episodes of Candida albicans candidaemia (2001-2004). Infection with uncommon Candida spp. (5.3% of candidaemia cases), as compared with C. albicans candidaemia, was significantly more likely to be outpatient-acquired than inpatient-acquired (15 of 57 vs. 65 of 517 episodes, p0.01). Prior exposure to fluconazole was uncommon (n =1). Candida dubliniensis was the commonest species (n =22, 39%), followed by Candida guilliermondii (n = 11, 19%) and Candida lusitaniae (n = 7, 12%). C. dubliniensis candidaemia was independently associated with recent intravenous drug use (p0.01) and chronic liver disease (p0.03), and infection with species other than C. dubliniensis was independently associated with age <65 years (p0.02), male sex (p0.03) and human immunodeficiency virus infection (p0.05). Presence of sepsis at diagnosis and crude 30-day mortality rates were similar for C. dubliniensis-related, non- C. dubliniensis-related and C. albicans-related candidaemia. Haematological malignancy was the commonest predisposing factor in C. guilliermondii (n = 3, 27%) and C. lusitaniae (n = 3, 43%) candidaemia. The 30-day mortality rate of C. lusitaniae candidaemia was higher than the overall death rate for all uncommon Candida spp. (42.9% vs. 25%, not significant). All isolates were susceptible to amphotericin.B, voriconazole, posaconazole, and caspofungin; five strains (9%) had fluconazole MIC values of 16-32 mg/L. Candidaemia due to uncommon Candida spp. is emerging among hospital outpatients; certain clinical variables may assist in recognition of this entity. © 2009 The Authors Journal c

Published
2012

6. A longitudinal study of Acinetobacter in three Australian hospitals.

Author

Richards M., Black J., Sinickas V., Korman T., Dendle C., Spelman D., Marshall C., Richards M., Black J., Sinickas V., Korman T., Dendle C., Spelman D., and Marshall C.

Abstract

Acinetobacter has recently risen in prominence as a nosocomial pathogen, particularly due to increasing antibiotic resistance. The aim of this study was to describe changes in rates and antibiotic susceptibility patterns of Acinetobacter in three Melbourne hospitals. This was a retrospective review of microbiology records over five years. The rates of new clinical isolates of Acinetobacter per 10 000 discharges per quarter were calculated. Other information collected included antibiotic susceptibility patterns, age, gender, length of stay and ward [intensive care unit (ICU) or non-ICU]. Rates increased substantially at two hospitals, but not at the third. Increasing numbers at one hospital were associated with antibiotic resistance. Most first isolates were identified while the patient was in the ICU. Many isolates were from respiratory specimens, although a significant proportion was from blood. This study documents the establishment of Acinetobacter as a nosocomial pathogen in two Melbourne hospitals and serves as a warning for the future. © 2007 The Hospital Infection Society.

Published
2012

7. Population-based surveillance for scedosporiosis in Australia: Epidemiology, disease manifestations and emergence of Scedosporium aurantiacum infection.

Author

McGregor A., Cooley L., Cox E., Franklin C., Korman T., Morrissey O., Spelman D., Speed B., Boan P., Dyer J., Gardam D., McLennan D., Murray R., Pryce T., Heath C.H., Slavin M.A., Sorrell T.C., Handke R., Harun A., Phillips M., Nguyen Q., Delhaes L., Ellis D., Meyer W., Chen S.C.A., Collignon P., Benn R., Chambers I., Dennis N., DeWit D., Ferguson J., Gosbell I., Gottlieb T., Halliday C., Holland J., Kesson A., Lawrence R., Marriott D., Newton P., Palasanthrian P., Pickles R., Pritchard B., Tierney L., Tomasotos V., Vaz R., Weeks K., Currie B., Allworth A., Coulter C., Faoagali J., Johnson B., Looke D., McCormack J., Nimmo G., O'Kane G., Playford E.G., Robson J., Rowlands K., Shaw D., McGregor A., Cooley L., Cox E., Franklin C., Korman T., Morrissey O., Spelman D., Speed B., Boan P., Dyer J., Gardam D., McLennan D., Murray R., Pryce T., Heath C.H., Slavin M.A., Sorrell T.C., Handke R., Harun A., Phillips M., Nguyen Q., Delhaes L., Ellis D., Meyer W., Chen S.C.A., Collignon P., Benn R., Chambers I., Dennis N., DeWit D., Ferguson J., Gosbell I., Gottlieb T., Halliday C., Holland J., Kesson A., Lawrence R., Marriott D., Newton P., Palasanthrian P., Pickles R., Pritchard B., Tierney L., Tomasotos V., Vaz R., Weeks K., Currie B., Allworth A., Coulter C., Faoagali J., Johnson B., Looke D., McCormack J., Nimmo G., O'Kane G., Playford E.G., Robson J., Rowlands K., and Shaw D.

Abstract

Australia-wide population-based surveillance for scedosporiosis identified 180 cases, with 118 (65.6%) cases of colonization and 62 (34.4%) cases of infection. Predisposing factors for isolation of Scedosporium spp. included chronic lung disease in 37.8% and malignancy in 21.7% of cases. Predictors of invasive disease (n = 62) included haematological stem cell transplantation (n = 7), leukaemia (n = 16) and diabetes mellitus (n = 8). Of 183 phenotypically-speciated isolates, 75 (41%) were Scedosporium prolificans (risk factors: haematologic cancer (n = 17), neutropaenia (n = 14)) and 108 (59%) had Scedosporium apiospermum/Pseudallescheria boydii phenotype [risk factor: diabetes (n = 15)]. Scedosporium prolificans (p 0.01) and leukaemia (p 0.03) independently predicted death. Epidemiological and antifungal susceptibility profiles of Scedosporium aurantiacum (prevalence >=15.8%) and S. apiospermum were similar. No patient with S aurantiacum infection (n = 6) died. This is the first description of clinical features associated with S. aurantiacum. © 2009 The Authors Journal compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases.

Published
2012

8. Candidaemia with uncommon Candida species: Predisposing factors, outcome, antifungal susceptibility, and implications for management.

Author

McBride J., Chen S.C.A., Marriott D., Playford E.G., Nguyen Q., Ellis D., Meyer W., Sorrell T.C., Slavin M., McCormack J., Walmsley K., Looke D., Johnson B., Nimmo G., Playford G., Drummond D., Forgan Smith R., Preston E., Allworth A., Faoagali J., Gerns N., Botes J., Cherian S., Robson J., Vohra R., Norton R., Coulter C., O'Kane G., Robb D., Gottlieb T., Chambers I., DeWit D., Carroll M., Dobson P., Ferguson J., Tierney L., Jozwiak F., Munro R., Tomasotos V., Pickles R., Holland J., Groenwad F., Hale K., Watson M., Vaz R., Hardiman R., Baleriola C., Ryan S., Pritchard R., Weeks K., Benn R., Lawrence R., Taylor P., Lindstrom S., Harkness J., Palasanthrian P., Grant R., McPetrie R., Johnson R., Halliday C., Maszewska K., Dennis N., Newton P., Franklin C., Morrisey O., Spelman D., Wesselingh S., Speed B., Hellsten J., Mayall B., Russell J., Broughton S., Woolley I., Coloe S., Sherman A., Korman T., Graves S., Huysmans M., Gordon D., Rowlands K., Shaw D., Ritchie B., Handkle R., Beaman M., Chiam A., McCarthy J., Heath C., Altmann S., Arthur I., Speers D., Cox E., Cooley L., McGregor A., Currie B., Lum G., Fisher D., Collignon P., Roberts J., Watson A., McBride J., Chen S.C.A., Marriott D., Playford E.G., Nguyen Q., Ellis D., Meyer W., Sorrell T.C., Slavin M., McCormack J., Walmsley K., Looke D., Johnson B., Nimmo G., Playford G., Drummond D., Forgan Smith R., Preston E., Allworth A., Faoagali J., Gerns N., Botes J., Cherian S., Robson J., Vohra R., Norton R., Coulter C., O'Kane G., Robb D., Gottlieb T., Chambers I., DeWit D., Carroll M., Dobson P., Ferguson J., Tierney L., Jozwiak F., Munro R., Tomasotos V., Pickles R., Holland J., Groenwad F., Hale K., Watson M., Vaz R., Hardiman R., Baleriola C., Ryan S., Pritchard R., Weeks K., Benn R., Lawrence R., Taylor P., Lindstrom S., Harkness J., Palasanthrian P., Grant R., McPetrie R., Johnson R., Halliday C., Maszewska K., Dennis N., Newton P., Franklin C., Morrisey O., Spelman D., Wesselingh S., Speed B., Hellsten J., Mayall B., Russell J., Broughton S., Woolley I., Coloe S., Sherman A., Korman T., Graves S., Huysmans M., Gordon D., Rowlands K., Shaw D., Ritchie B., Handkle R., Beaman M., Chiam A., McCarthy J., Heath C., Altmann S., Arthur I., Speers D., Cox E., Cooley L., McGregor A., Currie B., Lum G., Fisher D., Collignon P., Roberts J., and Watson A.

Abstract

The risk factors for and clinical features of bloodstream infection with uncommon Candida spp. (species other than C. albicans, C. glabrata, C. parapsilosis, C. tropicals and C. krusei) are incompletely defined. To identify clinical variables associated with these species that might guide management, 57 cases of candidaemia resulting from uncommon Candida spp. were analysed in comparison with 517 episodes of Candida albicans candidaemia (2001-2004). Infection with uncommon Candida spp. (5.3% of candidaemia cases), as compared with C. albicans candidaemia, was significantly more likely to be outpatient-acquired than inpatient-acquired (15 of 57 vs. 65 of 517 episodes, p0.01). Prior exposure to fluconazole was uncommon (n =1). Candida dubliniensis was the commonest species (n =22, 39%), followed by Candida guilliermondii (n = 11, 19%) and Candida lusitaniae (n = 7, 12%). C. dubliniensis candidaemia was independently associated with recent intravenous drug use (p0.01) and chronic liver disease (p0.03), and infection with species other than C. dubliniensis was independently associated with age <65 years (p0.02), male sex (p0.03) and human immunodeficiency virus infection (p0.05). Presence of sepsis at diagnosis and crude 30-day mortality rates were similar for C. dubliniensis-related, non- C. dubliniensis-related and C. albicans-related candidaemia. Haematological malignancy was the commonest predisposing factor in C. guilliermondii (n = 3, 27%) and C. lusitaniae (n = 3, 43%) candidaemia. The 30-day mortality rate of C. lusitaniae candidaemia was higher than the overall death rate for all uncommon Candida spp. (42.9% vs. 25%, not significant). All isolates were susceptible to amphotericin.B, voriconazole, posaconazole, and caspofungin; five strains (9%) had fluconazole MIC values of 16-32 mg/L. Candidaemia due to uncommon Candida spp. is emerging among hospital outpatients; certain clinical variables may assist in recognition of this entity. © 2009 The Authors Journal c

Published
2012

9. A longitudinal study of Acinetobacter in three Australian hospitals.

Author

Richards M., Black J., Sinickas V., Korman T., Dendle C., Spelman D., Marshall C., Richards M., Black J., Sinickas V., Korman T., Dendle C., Spelman D., and Marshall C.

Abstract

Acinetobacter has recently risen in prominence as a nosocomial pathogen, particularly due to increasing antibiotic resistance. The aim of this study was to describe changes in rates and antibiotic susceptibility patterns of Acinetobacter in three Melbourne hospitals. This was a retrospective review of microbiology records over five years. The rates of new clinical isolates of Acinetobacter per 10 000 discharges per quarter were calculated. Other information collected included antibiotic susceptibility patterns, age, gender, length of stay and ward [intensive care unit (ICU) or non-ICU]. Rates increased substantially at two hospitals, but not at the third. Increasing numbers at one hospital were associated with antibiotic resistance. Most first isolates were identified while the patient was in the ICU. Many isolates were from respiratory specimens, although a significant proportion was from blood. This study documents the establishment of Acinetobacter as a nosocomial pathogen in two Melbourne hospitals and serves as a warning for the future. © 2007 The Hospital Infection Society.

Published
2012

10. Population-based surveillance for scedosporiosis in Australia: Epidemiology, disease manifestations and emergence of Scedosporium aurantiacum infection.

Author

McGregor A., Cooley L., Cox E., Franklin C., Korman T., Morrissey O., Spelman D., Speed B., Boan P., Dyer J., Gardam D., McLennan D., Murray R., Pryce T., Heath C.H., Slavin M.A., Sorrell T.C., Handke R., Harun A., Phillips M., Nguyen Q., Delhaes L., Ellis D., Meyer W., Chen S.C.A., Collignon P., Benn R., Chambers I., Dennis N., DeWit D., Ferguson J., Gosbell I., Gottlieb T., Halliday C., Holland J., Kesson A., Lawrence R., Marriott D., Newton P., Palasanthrian P., Pickles R., Pritchard B., Tierney L., Tomasotos V., Vaz R., Weeks K., Currie B., Allworth A., Coulter C., Faoagali J., Johnson B., Looke D., McCormack J., Nimmo G., O'Kane G., Playford E.G., Robson J., Rowlands K., Shaw D., McGregor A., Cooley L., Cox E., Franklin C., Korman T., Morrissey O., Spelman D., Speed B., Boan P., Dyer J., Gardam D., McLennan D., Murray R., Pryce T., Heath C.H., Slavin M.A., Sorrell T.C., Handke R., Harun A., Phillips M., Nguyen Q., Delhaes L., Ellis D., Meyer W., Chen S.C.A., Collignon P., Benn R., Chambers I., Dennis N., DeWit D., Ferguson J., Gosbell I., Gottlieb T., Halliday C., Holland J., Kesson A., Lawrence R., Marriott D., Newton P., Palasanthrian P., Pickles R., Pritchard B., Tierney L., Tomasotos V., Vaz R., Weeks K., Currie B., Allworth A., Coulter C., Faoagali J., Johnson B., Looke D., McCormack J., Nimmo G., O'Kane G., Playford E.G., Robson J., Rowlands K., and Shaw D.

Abstract

Australia-wide population-based surveillance for scedosporiosis identified 180 cases, with 118 (65.6%) cases of colonization and 62 (34.4%) cases of infection. Predisposing factors for isolation of Scedosporium spp. included chronic lung disease in 37.8% and malignancy in 21.7% of cases. Predictors of invasive disease (n = 62) included haematological stem cell transplantation (n = 7), leukaemia (n = 16) and diabetes mellitus (n = 8). Of 183 phenotypically-speciated isolates, 75 (41%) were Scedosporium prolificans (risk factors: haematologic cancer (n = 17), neutropaenia (n = 14)) and 108 (59%) had Scedosporium apiospermum/Pseudallescheria boydii phenotype [risk factor: diabetes (n = 15)]. Scedosporium prolificans (p 0.01) and leukaemia (p 0.03) independently predicted death. Epidemiological and antifungal susceptibility profiles of Scedosporium aurantiacum (prevalence >=15.8%) and S. apiospermum were similar. No patient with S aurantiacum infection (n = 6) died. This is the first description of clinical features associated with S. aurantiacum. © 2009 The Authors Journal compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases.

Published
2012

11. Determinants of mortality in non-neutropenic ICU patients with candidaemia.

Author

Pritchard R., Marriott D.J.E., Geoffrey E.G., Chen S., Slavin M., Nguyen Q., Ellis D., Sorrell T.C., Coulter C., McCormack J., Walmsley K., Looke D., Johnson B., Nimmo G., Playford G., Drummond D., Preston E., Allworth A., Faoagali J., Botes J., Robson J., Norton R., Robb D., Gottlieb T., Chambers I., DeWit D., Ferguson J., Tierney L., Jozwiak F., Munro R., Pickles R., Holland J., Groenwald F., Hale K., Vaz R., Hardiman R., Baleriola C., Weeks K., Benn R., Adams N., Lawrence R., Taylor P., Harkness J., Marriott J., Palasanthrian P., Grant R., Halliday C., Lee O.C., Sorrell T., Newton P., Dennis N., Franklin C., Morrisey O., Spelman D., Speed B., Russell H.J., Coloe S., Sherman A., Korman T., Graves S., Huysmans M., Gordon D., Rowlands K., Shaw D., Ferguson W., Handke R., Davis S., Beaman M., McCarthy J., Heath C., Altmann S., Arthur I., Speers D., Cox E., Cooley L., McGregor A., Currie B., Lum G., Fisher D., Collignon P., Watson A., McBride J., Pritchard R., Marriott D.J.E., Geoffrey E.G., Chen S., Slavin M., Nguyen Q., Ellis D., Sorrell T.C., Coulter C., McCormack J., Walmsley K., Looke D., Johnson B., Nimmo G., Playford G., Drummond D., Preston E., Allworth A., Faoagali J., Botes J., Robson J., Norton R., Robb D., Gottlieb T., Chambers I., DeWit D., Ferguson J., Tierney L., Jozwiak F., Munro R., Pickles R., Holland J., Groenwald F., Hale K., Vaz R., Hardiman R., Baleriola C., Weeks K., Benn R., Adams N., Lawrence R., Taylor P., Harkness J., Marriott J., Palasanthrian P., Grant R., Halliday C., Lee O.C., Sorrell T., Newton P., Dennis N., Franklin C., Morrisey O., Spelman D., Speed B., Russell H.J., Coloe S., Sherman A., Korman T., Graves S., Huysmans M., Gordon D., Rowlands K., Shaw D., Ferguson W., Handke R., Davis S., Beaman M., McCarthy J., Heath C., Altmann S., Arthur I., Speers D., Cox E., Cooley L., McGregor A., Currie B., Lum G., Fisher D., Collignon P., Watson A., and McBride J.

Abstract

Introduction: Candidaemia in critically-ill intensive care unit (ICU) patients is associated with high crude mortality. Determinants of mortality - particularly those amenable to potential modification - are incompletely defined. Method(s): A nationwide prospective clinical and microbiological cohort study of all episodes of ICU-acquired candidaemia occurring in non-neutropenic adults was undertaken in Australian ICUs between 2001 and 2004. Multivariate Cox regression analyses were performed to determine independently significant variables associated with mortality. Result(s): 183 episodes of ICU-acquired candidaemia occurred in 183 patients during the study period. Of the 179 with microbiological data, Candida albicans accounted for 111 (62%) episodes and Candida glabrata, 32 (18%). Outcome data were available for 173: crude hospital mortality at 30 days was 56%. Host factors (older age, ICU admission diagnosis, mechanical ventilation and ICU admission diagnosis) and failure to receive systemic antifungal therapy were significantly associated with mortality on multivariate analysis. Among the subset who received initial fluconazole therapy (n = 93), the crude mortality was 52%. Host factors (increasing age and haemodialysis receipt), but not organism- (Candida species, fluconazole MIC), pharmacokinetic- (fluconazole dose, time to initiation), or pharmacodynamic-related parameters (fluconazole dose:MIC ratio) were associated with mortality. Process of care measures advocated in recent guidelines were implemented inconsistently: follow-up blood cultures were obtained in 68% of patients, central venous catheters removed within five days in 80% and ophthalmological examination performed in 36%. Conclusion(s): Crude mortality remains highin Australian ICU patients with candidaemia and is overwhelmingly related to host factors but not treatment variables (the time to initiation of antifungals or fluconazole pharmacokinetic and pharmacodynamic factors). The role and timin

Published
2009

12. Determinants of mortality in non-neutropenic ICU patients with candidaemia.

Author

Pritchard R., Marriott D.J.E., Geoffrey E.G., Chen S., Slavin M., Nguyen Q., Ellis D., Sorrell T.C., Coulter C., McCormack J., Walmsley K., Looke D., Johnson B., Nimmo G., Playford G., Drummond D., Preston E., Allworth A., Faoagali J., Botes J., Robson J., Norton R., Robb D., Gottlieb T., Chambers I., DeWit D., Ferguson J., Tierney L., Jozwiak F., Munro R., Pickles R., Holland J., Groenwald F., Hale K., Vaz R., Hardiman R., Baleriola C., Weeks K., Benn R., Adams N., Lawrence R., Taylor P., Harkness J., Marriott J., Palasanthrian P., Grant R., Halliday C., Lee O.C., Sorrell T., Newton P., Dennis N., Franklin C., Morrisey O., Spelman D., Speed B., Russell H.J., Coloe S., Sherman A., Korman T., Graves S., Huysmans M., Gordon D., Rowlands K., Shaw D., Ferguson W., Handke R., Davis S., Beaman M., McCarthy J., Heath C., Altmann S., Arthur I., Speers D., Cox E., Cooley L., McGregor A., Currie B., Lum G., Fisher D., Collignon P., Watson A., McBride J., Pritchard R., Marriott D.J.E., Geoffrey E.G., Chen S., Slavin M., Nguyen Q., Ellis D., Sorrell T.C., Coulter C., McCormack J., Walmsley K., Looke D., Johnson B., Nimmo G., Playford G., Drummond D., Preston E., Allworth A., Faoagali J., Botes J., Robson J., Norton R., Robb D., Gottlieb T., Chambers I., DeWit D., Ferguson J., Tierney L., Jozwiak F., Munro R., Pickles R., Holland J., Groenwald F., Hale K., Vaz R., Hardiman R., Baleriola C., Weeks K., Benn R., Adams N., Lawrence R., Taylor P., Harkness J., Marriott J., Palasanthrian P., Grant R., Halliday C., Lee O.C., Sorrell T., Newton P., Dennis N., Franklin C., Morrisey O., Spelman D., Speed B., Russell H.J., Coloe S., Sherman A., Korman T., Graves S., Huysmans M., Gordon D., Rowlands K., Shaw D., Ferguson W., Handke R., Davis S., Beaman M., McCarthy J., Heath C., Altmann S., Arthur I., Speers D., Cox E., Cooley L., McGregor A., Currie B., Lum G., Fisher D., Collignon P., Watson A., and McBride J.

Abstract

Introduction: Candidaemia in critically-ill intensive care unit (ICU) patients is associated with high crude mortality. Determinants of mortality - particularly those amenable to potential modification - are incompletely defined. Method(s): A nationwide prospective clinical and microbiological cohort study of all episodes of ICU-acquired candidaemia occurring in non-neutropenic adults was undertaken in Australian ICUs between 2001 and 2004. Multivariate Cox regression analyses were performed to determine independently significant variables associated with mortality. Result(s): 183 episodes of ICU-acquired candidaemia occurred in 183 patients during the study period. Of the 179 with microbiological data, Candida albicans accounted for 111 (62%) episodes and Candida glabrata, 32 (18%). Outcome data were available for 173: crude hospital mortality at 30 days was 56%. Host factors (older age, ICU admission diagnosis, mechanical ventilation and ICU admission diagnosis) and failure to receive systemic antifungal therapy were significantly associated with mortality on multivariate analysis. Among the subset who received initial fluconazole therapy (n = 93), the crude mortality was 52%. Host factors (increasing age and haemodialysis receipt), but not organism- (Candida species, fluconazole MIC), pharmacokinetic- (fluconazole dose, time to initiation), or pharmacodynamic-related parameters (fluconazole dose:MIC ratio) were associated with mortality. Process of care measures advocated in recent guidelines were implemented inconsistently: follow-up blood cultures were obtained in 68% of patients, central venous catheters removed within five days in 80% and ophthalmological examination performed in 36%. Conclusion(s): Crude mortality remains highin Australian ICU patients with candidaemia and is overwhelmingly related to host factors but not treatment variables (the time to initiation of antifungals or fluconazole pharmacokinetic and pharmacodynamic factors). The role and timin

Published
2009

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