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1. Prospective Study on Incidence, Risk Factors and Outcome of Recurrent Clostridioides difficile Infections

Author

Granata, G, Petrosillo, N, Adamoli, L, Bartoletti, M, Bartoloni, A, Basile, G, Bassetti, M, Bonfanti, P, Borromeo, R, Ceccarelli, G, De Luca, A, Di Bella, S, Fossati, S, Franceschini, E, Gentile, I, Giacobbe, D, Giacometti, E, Ingrassia, F, Lagi, F, Lobreglio, G, Lombardi, A, Lupo, L, Luzzati, R, Maraolo, A, Mikulska, M, Mondelli, M, Mularoni, A, Mussini, C, Oliva, A, Pandolfo, A, Rogati, C, Trapani, F, Venditti, M, Viale, P, Caraffa, E, Cataldo, M, Granata, Guido, Petrosillo, Nicola, Adamoli, Lucia, Bartoletti, Michele, Bartoloni, Alessandro, Basile, Gregorio, Bassetti, Matteo, Bonfanti, Paolo, Borromeo, Raffaella, Ceccarelli, Giancarlo, De Luca, Anna, Di Bella, Stefano, Fossati, Sara, Franceschini, Erica, Gentile, Ivan, Giacobbe, Daniele, Giacometti, Enrica, Ingrassia, Fabrizio, Lagi, Filippo, Lobreglio, Giambattista, Lombardi, Andrea, Lupo, Laura, Luzzati, Roberto, Maraolo, Alberto, Mikulska, Malgorzata, Mondelli, Mario, Mularoni, Alessandra, Mussini, Cristina, Oliva, Alessandra, Pandolfo, Alessandro, Rogati, Carlotta, Trapani, Filippo, Venditti, Mario, Viale, Pierluigi, Caraffa, Emanuela, Cataldo, Maria, Granata, G, Petrosillo, N, Adamoli, L, Bartoletti, M, Bartoloni, A, Basile, G, Bassetti, M, Bonfanti, P, Borromeo, R, Ceccarelli, G, De Luca, A, Di Bella, S, Fossati, S, Franceschini, E, Gentile, I, Giacobbe, D, Giacometti, E, Ingrassia, F, Lagi, F, Lobreglio, G, Lombardi, A, Lupo, L, Luzzati, R, Maraolo, A, Mikulska, M, Mondelli, M, Mularoni, A, Mussini, C, Oliva, A, Pandolfo, A, Rogati, C, Trapani, F, Venditti, M, Viale, P, Caraffa, E, Cataldo, M, Granata, Guido, Petrosillo, Nicola, Adamoli, Lucia, Bartoletti, Michele, Bartoloni, Alessandro, Basile, Gregorio, Bassetti, Matteo, Bonfanti, Paolo, Borromeo, Raffaella, Ceccarelli, Giancarlo, De Luca, Anna, Di Bella, Stefano, Fossati, Sara, Franceschini, Erica, Gentile, Ivan, Giacobbe, Daniele, Giacometti, Enrica, Ingrassia, Fabrizio, Lagi, Filippo, Lobreglio, Giambattista, Lombardi, Andrea, Lupo, Laura, Luzzati, Roberto, Maraolo, Alberto, Mikulska, Malgorzata, Mondelli, Mario, Mularoni, Alessandra, Mussini, Cristina, Oliva, Alessandra, Pandolfo, Alessandro, Rogati, Carlotta, Trapani, Filippo, Venditti, Mario, Viale, Pierluigi, Caraffa, Emanuela, and Cataldo, Maria

Abstract

Background: Limited and wide-ranging data are available on the recurrent Clostridioides difficile infection (rCDI) incidence rate. Methods: We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case-control study was performed to identify risk factors associated with 30-day onset rCDI. Results: Three hundred nine patients with a first CDI were included in the study; 32% of the CDI episodes (99/309) were severe/complicated; complete follow-up was available for 288 patients (19 died during the first CDI episode, and 2 were lost during follow-up). At the end of the study, the crude all-cause mortality rate was 10.7% (33 deaths/309 patients). Two hundred seventy-one patients completed the follow-up; rCDI occurred in 21% of patients (56/271) with an incidence rate of 72/10,000 patient-days. Logistic regression analysis identified exposure to cephalosporin as an independent risk factor associated with rCDI (RR: 1.7; 95% CI: 1.1-2.7, p = 0.03). Conclusion: Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.

Published
2021

2. Recurrence of Clostridioides difficile infection: A multicenter study on incidence and risk factors

Author

Cataldo, M.A., primary, Granata, G., additional, Caraffa, E., additional, Adamoli, L., additional, Borromeo, R., additional, Fossati, S., additional, Franceschini, E., additional, Giacobbe, D.R., additional, Giacometti, E., additional, Lagi, F., additional, Lombardi, A., additional, Oliva, A., additional, Pandolfo, A., additional, Trapani, F., additional, and Petrosillo, N., additional

Published
2020
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3. Antibiotic use and impact on outcome from bacteraemic critical illness: the BActeraemia Study in Intensive Care (BASIC)

Author

Corona, A, Bertolini, G, Lipman, J, Wilson, Ap, Singer, M, Rodriguez, A, Cueto, G, Canales, Hs, Acosta Gnass, S, Marinoni, M, Becherucci, A, Baccaro, F, Peake, S, Reece, G, Blythe, D, Mcfayden, B, French, C, Hawker, F, Dobb, G, Seppelt, I, Finfer, S, Skowronski, G, Banerjee, A, Richards, B, Neumark, G, Hiesmayr, M, Rutraert, P, Franck, S, Spapen, H, Ludovic, L, Bruzzi de Carvalho, F, Souza, P, Gasparovic, V, Barsic, B, Chytra, I, Novak, I, Pestel, G, Kaiser, S, Giokas, G, Matamis, D, Yap Hiu Yi, F, Kapadia, F, Iqbal, M, Batoli, T, Costanzo, E, Pistocchini, A, Acquarolo, A, Greco, S, Di Masi, P, Quattrocchi, P, Navarra, M, Rotella, S, Giugiaro, P, Todesco, L, Borromeo, R, Ostando, M, Benassai, C, Pezzi, G, Marchi, M, Luise, C, Di Filippo, A, Mangani, V, Pelagatti, C, Pasetti, G, Salvi, G, Salcuni, R, Marongiu, A, Tavola, M, Rossi, G, Biffali, F, Brunori, E, Piccioni, G, Guadagnucci, A, David, Antonio, Pulici, M, Ughi, F, Sicignano, A, Leggieri, C, Fiore, G, Banfi, G, Lanza, S, Postiglione, M, Bosso, R, Piga, G, Croce, G, Sapuppo, Mf, Giarratano, A, Barbagallo, M, Favetta, P, Gorietti, A, Breschi, C, Andrei, O, Bertolini, R, Bonfà, A, Rossi, S, Asti, A, Rendina, F, Bilotta, F, Azzeri, F, Piacevoli, Q, Hellmann, F, Vaira, C, Avarello, N, Clementi, S, Della Valle, A, Segala, V, Berardino, M, Vaj, M, Sega, P, Bcchi, A, Pizzaballa, Ml, Cohen, J, Sprung, C, Hashimoto, S, Baskiene, R, Mcdonald, J, Sollid, S, Paiva, Ja, Moreno, R, Gloria, C, Yaghi, A, Voga, G, Joo Lee, Y, Zaragoza, R, Valles, J, Gonzalez Diaz, G, Alvarez Lerma, F, Sirvent, Jm, Herve, Z, Romand, Ja, Niblett, D, Laurenson, J, Peters, T, von der Osten, I, and Tomic, V.

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Pediatrics, Asia, Critical Care, medicine.drug_class, Critical Illness, Antibiotics, Bacteremia, Microbial Sensitivity Tests, Outcome (game theory), Pharmacotherapy, Intensive care, Epidemiology, medicine, Humans, Pharmacology (medical), Prospective Studies, Antibiotic use, Intensive care medicine, bloodstream infections, critically ill patients, prevalence, antibiotic strategy, Aged, Aged, 80 and over, Pharmacology, Australasia, business.industry, Septic shock, Mortality rate, Odds ratio, Middle Aged, South America, medicine.disease, Drug Utilization, Confidence interval, Anti-Bacterial Agents, Europe, Treatment Outcome, Infectious Diseases, Critical illness, Female, business, Fungemia
Abstract

The lack of prospective, randomized, controlled trial data to guide optimal antibiotic use in bacteraemic critically ill patients has led to a wide variety of strategies and major issues with drug resistance. We therefore prospectively investigated the epidemiology of bacteraemia and fungaemia in intensive care units (ICUs); and the impact of timing, type and appropriateness of antibiotic intervention.We conducted a multinational, multicentre, prospective observational study in 132 ICUs from 26 countries with no interventions.1702 patients [European (69.6%), Australasian (12.2%), South American (8.3%) and Asian (9.9%)] developed 1942 bacteraemic episodes over the study period. Mortality rates were similar for those receiving empirical (40.5%), semi-targeted (37.6%) or fully targeted (33.3%) antibiotic therapy (P=0.40), and in those initially receiving broad- (39.3%) or restricted-spectrum (39.1%) therapy (P=0.94). First-line therapy was effective in terms of the antibiogram (where available) in 70.4% of cases. This in vitro susceptibility ranged from 76.3% for broad-spectrum antibiotics to 46.3% for restricted-spectrum antibiotics (P0.0001). However, no antibiotic policy-associated variable, including in vitro susceptibility (odds ratio 0.89, 95% confidence interval 0.61-1.30), was a statistically significant predictor of mortality.We could not show an impact of antibiotics on mortality in critically ill patients, despite in vitro activity and early commencement. Randomized, multicentre trials are urgently needed to establish the appropriate duration, timing and combinations of antibiotics that will both optimally treat infection and minimize development of resistance and other complications.

Published
2010
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4. Prospective Study on Incidence, Risk Factors and Outcome of Recurrent

Author

Erica Franceschini, Malgorzata Mikulska, Andrea Lombardi, Gregorio Basile, Laura Isabella Lupo, Giambattista Lobreglio, Daniele Roberto Giacobbe, Giancarlo Ceccarelli, Maria Adriana Cataldo, Anna Maria De Luca, Mario Venditti, Stefano Di Bella, Emanuela Caraffa, Michele Bartoletti, Enrica Giacometti, Nicola Petrosillo, Matteo Bassetti, Alessandra Oliva, Guido Granata, Ivan Gentile, Pierluigi Viale, Cristina Mussini, Alessandro Pandolfo, Paolo Bonfanti, Raffaella Borromeo, Sara Fossati, Alessandra Mularoni, Lucia Adamoli, Fabrizio Ingrassia, Filippo Lagi, Alberto Enrico Maraolo, Carlotta Rogati, Filippo Trapani, Roberto Luzzati, Alessandro Bartoloni, Mario U. Mondelli, Granata, G, Petrosillo, N, Adamoli, L, Bartoletti, M, Bartoloni, A, Basile, G, Bassetti, M, Bonfanti, P, Borromeo, R, Ceccarelli, G, De Luca, A, Di Bella, S, Fossati, S, Franceschini, E, Gentile, I, Giacobbe, D, Giacometti, E, Ingrassia, F, Lagi, F, Lobreglio, G, Lombardi, A, Lupo, L, Luzzati, R, Maraolo, A, Mikulska, M, Mondelli, M, Mularoni, A, Mussini, C, Oliva, A, Pandolfo, A, Rogati, C, Trapani, F, Venditti, M, Viale, P, Caraffa, E, Cataldo, M, Granata, Guido, Petrosillo, Nicola, Adamoli, Lucia, Bartoletti, Michele, Bartoloni, Alessandro, Basile, Gregorio, Bassetti, Matteo, Bonfanti, Paolo, Borromeo, Raffaella, Ceccarelli, Giancarlo, De Luca, Anna Maria, Di Bella, Stefano, Fossati, Sara, Franceschini, Erica, Gentile, Ivan, Giacobbe, Daniele Roberto, Giacometti, Enrica, Ingrassia, Fabrizio, Lagi, Filippo, Lobreglio, Giambattista, Lombardi, Andrea, Lupo, Laura Isabella, Luzzati, Roberto, Maraolo, Alberto Enrico, Mikulska, Malgorzata, Mondelli, Mario Umberto, Mularoni, Alessandra, Mussini, Cristina, Oliva, Alessandra, Pandolfo, Alessandro, Rogati, Carlotta, Trapani, Filippo Fabio, Venditti, Mario, Viale, Pierluigi, Caraffa, Emanuela, Cataldo, Maria Adriana, Granata G., Petrosillo N., Adamoli L., Bartoletti M., Bartoloni A., Basile G., Bassetti M., Bonfanti P., Borromeo R., Ceccarelli G., De Luca A.M., Di Bella S., Fossati S., Franceschini E., Gentile I., Giacobbe D.R., Giacometti E., Ingrassia F., Lagi F., Lobreglio G., Lombardi A., Lupo L.I., Luzzati R., Maraolo A.E., Mikulska M., Mondelli M.U., Mularoni A., Mussini C., Oliva A., Pandolfo A., Rogati C., Trapani F.F., Venditti M., Viale P., Caraffa E., and Cataldo M.A.

Subjects
medicine.medical_specialty, recurrence, genetic structures, lcsh:Medicine, Logistic regression, Clostridioides difficile, Article, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, risk factors, 030212 general & internal medicine, Risk factor, Prospective cohort study, 0303 health sciences, Adult patients, 030306 microbiology, business.industry, Incidence (epidemiology), Mortality rate, lcsh:R, General Medicine, risk factor, outcome, incidence, business, Clostridioides, Cohort study
Abstract

Background: Limited and wide-ranging data are available on the recurrent Clostridioides difficile infection (rCDI) incidence rate. Methods: We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case–control study was performed to identify risk factors associated with 30-day onset rCDI. Results: Three hundred nine patients with a first CDI were included in the study, 32% of the CDI episodes (99/309) were severe/complicated, complete follow-up was available for 288 patients (19 died during the first CDI episode, and 2 were lost during follow-up). At the end of the study, the crude all-cause mortality rate was 10.7% (33 deaths/309 patients). Two hundred seventy-one patients completed the follow-up, rCDI occurred in 21% of patients (56/271) with an incidence rate of 72/10,000 patient-days. Logistic regression analysis identified exposure to cephalosporin as an independent risk factor associated with rCDI (RR: 1.7, 95% CI: 1.1–2.7, p = 0.03). Conclusion: Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.

Published
2020

5. Prospective Study on Incidence, Risk Factors and Outcome of Recurrent Clostridioides difficile Infections.

Author

Granata G, Petrosillo N, Adamoli L, Bartoletti M, Bartoloni A, Basile G, Bassetti M, Bonfanti P, Borromeo R, Ceccarelli G, De Luca AM, Di Bella S, Fossati S, Franceschini E, Gentile I, Giacobbe DR, Giacometti E, Ingrassia F, Lagi F, Lobreglio G, Lombardi A, Lupo LI, Luzzati R, Maraolo AE, Mikulska M, Mondelli MU, Mularoni A, Mussini C, Oliva A, Pandolfo A, Rogati C, Trapani FF, Venditti M, Viale P, Caraffa E, Cataldo MA, and On Behalf Of The ReCloDi Recurrence Of Clostridioides Difficile Infection Study Group

Abstract

Background: Limited and wide-ranging data are available on the recurrent Clostridioides difficile infection (rCDI) incidence rate., Methods: We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case-control study was performed to identify risk factors associated with 30-day onset rCDI., Results: Three hundred nine patients with a first CDI were included in the study; 32% of the CDI episodes (99/309) were severe/complicated; complete follow-up was available for 288 patients (19 died during the first CDI episode, and 2 were lost during follow-up). At the end of the study, the crude all-cause mortality rate was 10.7% (33 deaths/309 patients). Two hundred seventy-one patients completed the follow-up; rCDI occurred in 21% of patients (56/271) with an incidence rate of 72/10,000 patient-days. Logistic regression analysis identified exposure to cephalosporin as an independent risk factor associated with rCDI (RR: 1.7; 95% CI: 1.1-2.7, p = 0.03)., Conclusion: Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.

Published
2021
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6. The treatment of mild endometriosis with laser laparoscopy: a two-step treatment analysis of patients whose primary therapy was successful.

Author

Paulson JD, Habli M, Alizade A, and Borromeo R

Subjects
Female, Humans, Infertility, Female surgery, Pregnancy, Endometriosis surgery, Laparoscopy methods, Laser Therapy
Abstract

Objectives: The most advantageous treatment for pelvic endometriosis that is not extensive has long been the subject of debate. In recent years, the ability to detect atypical presentations has allowed the gynecological surgeon to treat this entity more readily. The treatment in the past has been concerned with the singular treatment being applied at the time, not on the prior treatment effects on current therapy. The purpose of the current study was to see whether previous successful treatment modalities affected the success of subsequent laparoscopic laser fulguration treatment of endometriosis., Methods: Patients who were previously treated for their endometriosis (minimal and mild) and had success in achieving pregnancy were treated for their disease after failing to become pregnant after delivery. They were treated with laparoscopic laser fulguration of the disease and the results were examined by chi-square (chi2) analysis., Results: There appears to be no difference in current pregnancy rates in patients who were successfully treated in the original treatment for endometriosis, no matter which of the therapies had been used., Conclusion: If endometriosis is diagnosed at the time of laparoscopy and is easily amenable to treatment, it should be treated at the time of surgery regardless of prior treatment and results.

Published
2006

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