Search

Your search keyword '"Barsic, Bruno"' showing total 36 results
Start Over Author "Barsic, Bruno" Search Limiters Full Text
36 results on '"Barsic, Bruno"'

2. Incidence, Risk Factors and Mortality Associated with Major Bleeding Events in Hospitalized COVID-19 Patients

Author

Lucijanic, Marko, primary, Tjesic-Drinkovic, Ida, additional, Piskac Zivkovic, Nevenka, additional, Pastrovic, Frane, additional, Rob, Zrinka, additional, Bacevac, Mersiha, additional, Sedinic Lacko, Martina, additional, Dzambas, Eleonora, additional, Medic, Barbara, additional, Vukoja, Ivan, additional, Busic, Iva, additional, Grgurevic, Ivica, additional, Luksic, Ivica, additional, and Barsic, Bruno, additional

Published
2023
Full Text
View/download PDF

4. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association

Author

Baddour, Larry M., Wilson, Walter R., Bayer, Arnold S., Fowler, Vance G., Jr, Tleyjeh, Imad M., Rybak, Michael J., Barsic, Bruno, Lockhart, Peter B., Gewitz, Michael H., Levison, Matthew E., Bolger, Ann F., Steckelberg, James M., Baltimore, Robert S., Fink, Anne M., O‘Gara, Patrick, and Taubert, Kathryn A.

Published
2015
Full Text
View/download PDF

5. Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients

Author

Paštrovic, Frane, primary, Lucijanic, Marko, additional, Atic, Armin, additional, Stojic, Josip, additional, Barisic Jaman, Mislav, additional, Tjesic Drinkovic, Ida, additional, Zelenika, Marko, additional, Milosevic, Marko, additional, Medic, Barbara, additional, Loncar, Jelena, additional, Mijic, Maja, additional, Filipec Kanizaj, Tajana, additional, Kralj, Dominik, additional, Lerotic, Ivan, additional, Virovic Jukic, Lucija, additional, Ljubicic, Neven, additional, Luetic, Kresimir, additional, Grgic, Dora, additional, Majerovic, Matea, additional, Ostojic, Rajko, additional, Krznaric, Zeljko, additional, Luksic, Ivica, additional, Piskac Zivkovic, Nevenka, additional, Keres, Tatjana, additional, Grabovac, Vlatko, additional, Persec, Jasminka, additional, Barsic, Bruno, additional, and Grgurevic, Ivica, additional

Published
2021
Full Text
View/download PDF

6. Infective Endocarditis in Patients on Chronic Hemodialysis

Author

Pericàs, Juan M., primary, Llopis, Jaume, additional, Jiménez-Exposito, Maria Jesús, additional, Kourany, Wissam M., additional, Almirante, Benito, additional, Carosi, Giampiero, additional, Durante-Mangoni, Emanuele, additional, Fortes, Claudio Querido, additional, Giannitsioti, Efthymia, additional, Lerakis, Stamatios, additional, Montagna-Mella, Rodrigo, additional, Ambrosioni, Juan, additional, Tan, Ru-San, additional, Mestres, Carlos A., additional, Wray, Dannah, additional, Pachirat, Orathai, additional, Moreno, Asuncion, additional, Chu, Vivian H., additional, de Lazzari, Elisa, additional, Fowler, Vance G., additional, Miró, Jose M., additional, Clara, Liliana, additional, Sanchez, Marisa, additional, Casabé, José, additional, Cortes, Claudia, additional, Nacinovich, Francisco, additional, Oses, Pablo Fernandez, additional, Ronderos, Ricardo, additional, Sucari, Adriana, additional, Thierer, Jorge, additional, Altclas, Javier, additional, Kogan, Silvia, additional, Spelman, Denis, additional, Athan, Eugene, additional, Harris, Owen, additional, Kennedy, Karina, additional, Tan, Ren, additional, Gordon, David, additional, Papanicolas, Lito, additional, Korman, Tony, additional, Kotsanas, Despina, additional, Dever, Robyn, additional, Jones, Phillip, additional, Konecny, Pam, additional, Lawrence, Richard, additional, Rees, David, additional, Ryan, Suzanne, additional, Feneley, Michael P., additional, Harkness, John, additional, Post, Jeffrey, additional, Reinbott, Porl, additional, Gattringer, Rainer, additional, Wiesbauer, Franz, additional, Andrade, Adriana Ribas, additional, Passos de Brito, Ana Cláudia, additional, Guimarães, Armenio Costa, additional, Grinberg, Max, additional, Mansur, Alfredo José, additional, Siciliano, Rinaldo Focaccia, additional, Varejao Strabelli, Tania Mara, additional, Campos Vieira, Marcelo Luiz, additional, de Medeiros Tranchesi, Regina Aparecida, additional, Paiva, Marcelo Goulart, additional, de Oliveira Ramos, Auristela, additional, Weksler, Clara, additional, Ferraiuoli, Giovanna, additional, Golebiovski, Wilma, additional, Lamas, Cristiane, additional, Karlowsky, James A., additional, Keynan, Yoav, additional, Morris, Andrew M., additional, Rubinstein, Ethan, additional, Jones, Sandra Braun, additional, Garcia, Patricia, additional, Cereceda, M., additional, Fica, Alberto, additional, Mella, Rodrigo Montagna, additional, Fernandez, Ricardo, additional, Franco, Liliana, additional, Gonzalez, Javier, additional, Jaramillo, Astrid Natalia, additional, Barsic, Bruno, additional, Bukovski, Suzana, additional, Krajinovic, Vladimir, additional, Pangercic, Ana, additional, Rudez, Igor, additional, Vincelj, Josip, additional, Freiberger, Tomas, additional, Pol, Jiri, additional, Zaloudikova, Barbora, additional, Ashour, Zainab, additional, El Kholy, Amani, additional, Mishaal, Marwa, additional, Osama, Dina, additional, Rizk, Hussien, additional, Aissa, Neijla, additional, Alauzet, Corentine, additional, Alla, Francois, additional, Campagnac, CHU Catherine, additional, Doco-Lecompte, Thanh, additional, Selton-Suty, Christine, additional, Casalta, Jean-Paul, additional, Fournier, Pierre-Edouard, additional, Habib, Gilbert, additional, Raoult, Didier, additional, Thuny, Franck, additional, Delahaye, Francois, additional, Delahaye, Armelle, additional, Vandenesch, Francois, additional, Donal, Erwan, additional, Donnio, Pierre Yves, additional, Flecher, Erwan, additional, Michelet, Christian, additional, Revest, Matthieu, additional, Tattevin, Pierre, additional, Chevalier, Florent, additional, Jeu, Antoine, additional, Rémadi, Jean Paul, additional, Rusinaru, Dan, additional, Tribouilloy, Christophe, additional, Bernard, Yvette, additional, Chirouze, Catherine, additional, Hoen, Bruno, additional, Leroy, Joel, additional, Plesiat, Patrick, additional, Naber, Christoph, additional, Neuerburg, Carl, additional, Mazaheri, Bahram, additional, Sophia Athanasia, Carl Neuerburg, additional, Deliolanis, Ioannis, additional, Giamarellou, Helen, additional, Thomas, Tsaganos, additional, Mylona, Elena, additional, Paniara, Olga, additional, Papanicolaou, Konstantinos, additional, Pyros, John, additional, Skoutelis, Athanasios, additional, Papanikolaou, Konstantinos, additional, Sharma, Gautam, additional, Francis, Johnson, additional, Nair, Lathi, additional, Thomas, Vinod, additional, Venugopal, Krishnan, additional, Hannan, Margaret M., additional, Hurley, John P., additional, Wanounou, Maor, additional, Gilon, Dan, additional, Israel, Sarah, additional, Korem, Maya, additional, Strahilevitz, Jacob, additional, Iossa, Domenico, additional, Orlando, Serena, additional, Ursi, Maria Paola, additional, Pafundi, Pia Clara, additional, D’Amico, Fabiana, additional, Bernardo, Mariano, additional, Cuccurullo, Susanna, additional, Dialetto, Giovanni, additional, Covino, Franco Enrico, additional, Manduca, Sabrina, additional, Della Corte, Alessandro, additional, De Feo, Marisa, additional, Tripodi, Marie Françoise, additional, Cecchi, Enrico, additional, De Rosa, Francesco, additional, Forno, Davide, additional, Imazio, Massimo, additional, Trinchero, Rita, additional, Grossi, Paolo, additional, Lattanzio, Mariangela, additional, Toniolo, Antonio, additional, Goglio, Antonio, additional, Raglio, Annibale, additional, Ravasio, Veronica, additional, Rizzi, Marco, additional, Suter, Fredy, additional, Magri, Silvia, additional, Signorini, Liana, additional, Kanafani, Zeina, additional, Kanj, Souha S., additional, Sharif-Yakan, Ahmad, additional, Abidin, Imran, additional, Tamin, Syahidah Syed, additional, Martínez, Eduardo Rivera, additional, Soto Nieto, Gabriel Israel, additional, van der Meer, Jan T.M., additional, Chambers, Stephen, additional, Holland, David, additional, Morris, Arthur, additional, Raymond, Nigel, additional, Read, Kerry, additional, Murdoch, David R., additional, Dragulescu, Stefan, additional, Ionac, Adina, additional, Mornos, Cristian, additional, Butkevich, O.M., additional, Chipigina, Natalia, additional, Kirill, Ozerecky, additional, Vadim, Kulichenko, additional, Vinogradova, Tatiana, additional, Edathodu, Jameela, additional, Halim, Magid, additional, Liew, Yee-Yun, additional, Lejko-Zupanc, Tatjana, additional, Logar, Mateja, additional, Mueller-Premru, Manica, additional, Commerford, Patrick, additional, Commerford, Anita, additional, Deetlefs, Eduan, additional, Hansa, Cass, additional, Ntsekhe, Mpiko, additional, Almela, Manel, additional, Azqueta, Manuel, additional, Brunet, Merce, additional, Castro, Pedro, additional, De Lazzari, Elisa, additional, Falces, Carlos, additional, Fuster, David, additional, Fita, Guillermina, additional, Garcia- de- la- Maria, Cristina, additional, Garcia-Gonzalez, Javier, additional, Gatell, Jose M., additional, Marco, Francesc, additional, Miró, José M., additional, Ortiz, José, additional, Ninot, Salvador, additional, Paré, J. Carlos, additional, Pericas, Juan M., additional, Quintana, Eduard, additional, Ramirez, Jose, additional, Rovira, Irene, additional, Sandoval, Elena, additional, Sitges, Marta, additional, Tellez, Adrian, additional, Tolosana, José M., additional, Vidal, Barbara, additional, Vila, Jordi, additional, Anguera, Ignasi, additional, Font, Bernat, additional, Guma, Joan Raimon, additional, Bermejo, Javier, additional, Bouza, Emilio, additional, Garcia Fernández, Miguel Angel, additional, Gonzalez-Ramallo, Victor, additional, Marín, Mercedes, additional, Muñoz, Patricia, additional, Pedromingo, Miguel, additional, Roda, Jorge, additional, Rodríguez-Créixems, Marta, additional, Solis, Jorge, additional, Fernandez-Hidalgo, Nuria, additional, Tornos, Pilar, additional, de Alarcón, Arístides, additional, Parra, Ricardo, additional, Alestig, Eric, additional, Johansson, Magnus, additional, Olaison, Lars, additional, Snygg-Martin, Ulrika, additional, Pachirat, Pimchitra, additional, Pussadhamma, Burabha, additional, Senthong, Vichai, additional, Casey, Anna, additional, Elliott, Tom, additional, Lambert, Peter, additional, Watkin, Richard, additional, Eyton, Christina, additional, Klein, John L., additional, Bradley, Suzanne, additional, Kauffman, Carol, additional, Bedimo, Roger, additional, Corey, G. Ralph, additional, Crowley, Anna Lisa, additional, Douglas, Pamela, additional, Drew, Laura, additional, Holland, Thomas, additional, Lalani, Tahaniyat, additional, Mudrick, Daniel, additional, Samad, Zaniab, additional, Sexton, Daniel, additional, Stryjewski, Martin, additional, Wang, Andrew, additional, Woods, Christopher W., additional, Cantey, Robert, additional, Steed, Lisa, additional, Dickerman, Stuart A., additional, Bonilla, Hector, additional, DiPersio, Joseph, additional, Salstrom, Sara-Jane, additional, Baddley, John, additional, Patel, Mukesh, additional, Peterson, Gail, additional, Stancoven, Amy, additional, Levine, Donald, additional, Riddle, Jonathan, additional, Rybak, Michael, additional, and Cabell, Christopher H., additional

Published
2021
Full Text
View/download PDF

8. Extended Infusion of beta-Lactams for Bloodstream Infection in Patients With Liver Cirrhosis: An Observational Multicenter Study

Author

Bartoletti, Michele, Giannella, Maddalena, Lewis, Russell E., Caraceni, Paolo, Tedeschi, Sara, Paul, Mical, Schramm, Christoph, Bruns, Tony, Merli, Manuela, Cobos-Trigueros, Nazaret, Seminari, Elena, Retamar, Pilar, Munoz, Patricia, Tumbarello, Mario, Burra, Patrizia, Cerenzia, Maria Torrani, Barsic, Bruno, Calbo, Ester, Maraolo, Alberto Enrico, Petrosillo, Nicola, Galan-Ladero, Maria Angeles, D'Offizi, Gianpiero, Zak-Doron, Yael, Rodriguez-Bano, Jesus, Baldassarre, Maurizio, Verucchi, Gabriella, Domenicali, Marco, Bernardi, Mauro, Viale, Pierluigi, Campoli, Caterina, Pascale, Renato, Stallmach, Andreas, Venditti, Mario, Lucidi, Cristina, Ludovisi, Serena, de Cueto, Marina, Maria Dolores, Navarro, Cortes Eduardo, Lopez, Bouza, Emilo, Valerio, Maricela, Eworo, Alia, Losito, Raffaella, Senzolo, Marco, Nadal, Elena, Ottobrelli, Antonio, Varguvic, Martina, Badia, Cristina, Guglielmo, Borgia, Gentile, Ivan, Buonomo, Antonio Riccardo, Boumis, Evangelo, Beteta-Lopez, Alicia, Rianda, Alessia, Taliani, Gloria, Grieco, Stefania, Bartoletti, Michele, Giannella, Maddalena, Lewis, Russell E., Caraceni, Paolo, Tedeschi, Sara, Paul, Mical, Schramm, Christoph, Bruns, Tony, Merli, Manuela, Cobos-Trigueros, Nazaret, Seminari, Elena, Retamar, Pilar, Munoz, Patricia, Tumbarello, Mario, Burra, Patrizia, Cerenzia, Maria Torrani, Barsic, Bruno, Calbo, Ester, Maraolo, Alberto Enrico, Petrosillo, Nicola, Galan-Ladero, Maria Angeles, D'Offizi, Gianpiero, Zak-Doron, Yael, Rodriguez-Bano, Jesus, Baldassarre, Maurizio, Verucchi, Gabriella, Domenicali, Marco, Bernardi, Mauro, Viale, Pierluigi, Campoli, Caterina, Pascale, Renato, Stallmach, Andreas, Venditti, Mario, Lucidi, Cristina, Ludovisi, Serena, de Cueto, Marina, Maria Dolores, Navarro, Cortes Eduardo, Lopez, Bouza, Emilo, Valerio, Maricela, Eworo, Alia, Losito, Raffaella, Senzolo, Marco, Nadal, Elena, Ottobrelli, Antonio, Varguvic, Martina, Badia, Cristina, Guglielmo, Borgia, Gentile, Ivan, Buonomo, Antonio Riccardo, Boumis, Evangelo, Beteta-Lopez, Alicia, Rianda, Alessia, Taliani, Gloria, and Grieco, Stefania

Abstract

Background. We analyzed the impact of continuous/extended infusion (C/EI) vs intermittent infusion of piperacillin-tazobactam (TZP) and carbapenems on 30-day mortality of patients with liver cirrhosis and bloodstream infection (BSI). Methods. The BICRHOME study was a prospective, multicenter study that enrolled 312 cirrhotic patients with BSI. In this secondary analysis, we selected patients receiving TZP or carbapenems as adequate empirical treatment. The 30-day mortality of patients receiving C/EI or intermittent infusion of TZP or carbapenems was assessed with Kaplan-Meier curves, Cox-regression model, and estimation of the average treatment effect (ATE) using propensity score matching. Results. Overall, 119 patients received TZP or carbapenems as empirical treatment. Patients who received C/EI had a significantly lower mortality rate (16% vs 36%, P = .047). In a Cox-regression model, the administration of C/EI was associated with a significantly lower mortality (hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.11-0.936; P = .04) when adjusted for severity of illness and an ATE of 25.6% reduction in 30-day mortality risk (95% CI, 18.9-32.3; P < .0001) estimated with propensity score matching. A significant reduction in 30-day mortality was also observed in the subgroups of patients with sepsis (HR, 0.21; 95% CI, 0.06-0.74), acute-on-chronic liver failure (HR, 0.29; 95% CI, 0.03-0.99), and a model for end-stage liver disease score >= 25 (HR, 0.26; 95% CI, 0.08-0.92). At competing risk analysis, C/EI of beta-lactams was associated with significantly higher rates of hospital discharge (subdistribution hazard [95% CI], 1.62 [1.06-2.47]). Conclusions. C/EI of beta-lactams in cirrhotic patients with BSI may improve outcomes and facilitate earlier discharge.

Published
2019

9. Central nervous system infections in the absence of cerebrospinal fluid pleocytosis

Author

Erdem, Hakan, Ozturk-Engin, Derya, Cag, Yasemin, Senbayrak, Seniha, Inan, Asuman, Kazak, Esra, Savasci, Umit, Elaldi, Nazif, Vahaboglu, Haluk, Hasbun, Rodrigo, Nechifor, Mihai, Tireli, Hulya, Kilicoglu, Gamze, Defres, Sylviane, Gulsun, Serda, Ceran, Nurgul, Crisan, Alexandru, Johansen, Isik Somuncu, Namiduru, Mustafa, Dayan, Saim, Kayabas, Uner, Parlak, Emine, Khalifa, Ahmad, Kursun, Ebru, Sipahi, Oguz Resat, Yemisen, Mucahit, Akbulut, Ayhan, Bitirgen, Mehmet, Popovic, Natasa, Kandemir, Bahar, Luca, Catalina, Parlak, Mehmet, Stahl, Jean Paul, Pehlivanoglu, Filiz, Simeon, Soline, Ulu-Kilic, Aysegul, Yasar, Kadriye, Yilmaz, Gulden, Yilmaz, Emel, Beovic, Bojana, Catroux, Melanie, Lakatos, Botond, Sunbul, Mustafa, Oncul, Oral, Alabay, Selma, Sahin-Horasan, Elif, Kose, Sukran, Shehata, Ghaydaa, Andre, Katell, Dragovac, Gorana, Gul, Hanefi Cem, Karakas, Ahmet, Chadapaud, Stéphane, Hansmann, Yves, Harxhi, Arjan, Kirova, Valerija, Masse-Chabredier, Isabelle, Oncu, Serkan, Sener, Alper, Tekin, Recep, Deveci, Ozcan, Ozkaya, Hacer Deniz, Karabay, Oguz, Agalar, Canan, Gencer, Serap, Karahocagil, Mustafa Kasim, Karsen, Hasan, Kaya, Selcuk, Pekok, Abdullah Umut, Celen, Mustafa Kemal, Deniz, Secil, Ulug, Mehmet, Demirdal, Tuna, Guven, Tumer, Bolukcu, Sibel, Avci, Meltem, Nayman-Alpat, Saygin, Yaşar, Kadriye, Pehlivanoʇlu, Filiz, Ates-Guler, Selma, Mutlu-Yilmaz, Esmeray, Tosun, Selma, Sirmatel, Fatma, Batirel, Ayşe, Öztoprak, Nefise, Kadanali, Ayten, Turgut, Huseyin, Baran, Ali Irfan, Karaahmetoglu, Gokhan, Sunnetcioglu, Mahmut, Haykir-Solay, Asli, Denk, Affan, Ayaz, Celal, Gorenek, Levent, Larsen, Lykke, Poljak, Mario, Barsic, Bruno, Argemi, Xavier, Sørensen, Signe Maj, Bohr, Anne Lisbeth, Tattevin, Pierre, Gunst, Jesper Damsgaard, Baštáková, Lenka, Jereb, Matjaž, Chehri, Mahtab, Beraud, Guillaume, Del Vecchio, Rosa Fontana, Maresca, Mauro, Yilmaz, Hava, Sharif-Yakan, Ahmad, Kanj, Souha Shararah, Korkmaz, Fatime, Komur, Suheyla, Coskuner, Seher Ayten, Ince, Nevin, Akkoyunlu, Yasemin, Halac, Gulistan, Nemli, Salih Atakan, Ak, Oznur, Gunduz, Alper, Gozel, Mustafa G., Hatipoglu, Mustafa, Cicek-Senturk, Gonul, Akcam, Fusun Z., Inkaya, Ahmet C., Sagmak-Tartar, Ayşe, Ersoy, Yasemin, Tuncer-Ertem, Gunay, Balkan, Ilker I., Cetin, Birsen, Ersoz, Gulden, Ozgunes, Nail, Yesilkaya, Aysegul, Erturk, Ayse, Gundes, Sibel, Turhan, Vedat, Yalci, Aysun, Aydin, Emsal, Diktas, Husrev, Ulcay, Asim, Seyman, Derya, Leblebicioglu, Hakan, [Erdem, Hakan -- Savasci, Umit] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Ozturk-Engin, Derya -- Senbayrak, Seniha -- Inan, Asuman] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Cag, Yasemin] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kazak, Esra] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Vahaboglu, Haluk] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Hasbun, Rodrigo] UT Hlth McGovern Med Sch, Dept Infect Dis, Houston, TX 77030 USA, Kart Yasar, Kadriye -- 0000-0003-2963-4894, Larsen, Lykke -- 0000-0002-4113-4182, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Mikrobiyoloji, OMÜ, Çukurova Üniversitesi, Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Kazak, Esra, AAG-8459-2021, and Ege Üniversitesi

Subjects
0301 basic medicine, Male, Leukocytosis, 0302 clinical medicine, CSF, Encephalitis, Leukocyte, Meningitis, Pleocytosis, Neurosyphilis, Diagnosis, Pathology, Medicine, 030212 general & internal medicine, Brucella meningitis, Middle aged, biology, Meningitis, Pneumococcal, General Medicine, Middle Aged, Central nervous system infection, Tıp, ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS, medicine.anatomical_structure, Cerebrospinal fluid, Bacterial Meningitides, Cerebrospinal Fluid, Infectious diseases, Protein cerebrospinal fluid level, Pneumococcal, Female, InformationSystems_MISCELLANEOUS, Human, Microbiology (medical), 030106 microbiology, Central nervous system, Brucella, Outcomes, Cerebrospinal fluid pleocytosis, Tuberculous meningitis, Article, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Humans, lcsh:RC109-216, Leukocytosis/cerebrospinal fluid, Herpes simplex encephalitis, business.industry, ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, Herpetic meningoencephalitis, Central Nervous System Infections/cerebrospinal fluid, Pneumococcal meningitis, Tuberculosis, meningeal, medicine.disease, biology.organism_classification, Meningitis, Pneumococcal/cerebrospinal fluid, ComputingMethodologies_PATTERNRECOGNITION, Tuberculosis, Meningeal/cerebrospinal fluid, Clinical feature, Immunology, business, Central nervous system infections
Abstract

WOS: 000417628500023, PubMed ID: 29081366, Previous multicenter/multinational studies were evaluated to determine the frequency of the absence of cerebrospinal fluid pleocytosis in patients with central nervous system infections, as well as the clinical impact of this condition. It was found that 18% of neurosyphilis, 7.9% of herpetic meningoencephalitis, 3% of tuberculous meningitis, 1.7% of Brucella meningitis, and 0.2% of pneumococcal meningitis cases did not display cerebrospinal fluid pleocytosis. Most patients were not immunosuppressed. Patients without pleocytosis had a high rate of unfavorable outcomes and thus this condition should not be underestimated. (C) 2017 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases., Grant-A-Starr Foundation, Grant-A-Starr Foundation.

Published
2017
Full Text
View/download PDF

12. A prospective multicentre study of the epidemiology and outcomes of bloodstream infection in cirrhotic patients

Author

Bartoletti, Michele, Giannella, Maddalena, Lewis, R., Caraceni, Paolo, Tedeschi, Sara, Paul, Mical, Schramm, Christoph, Bruns, Tony, Merli, Manuela, Cobos-Trigueros, Nazaret, Seminari, Elena María, Retamar Gentil, Pilar, Muñoz García, Patricia, Tumbarello, Mario, Burra, Patrizia, Torrani Cerenzia, M., Barsic, Bruno, Calbo, Esther, Maraolo, Alberto E., Petrosillo, N., Galán-Ladero, M. A., D'Offizi, Gianpiero, Bar Sinai, N., Rodríguez-Baño, Jesús, Verucchi, Gabriella, Bernardi, Mauro, Viale, Pierluigi, Bartoletti, Michele, Giannella, Maddalena, Lewis, R., Caraceni, Paolo, Tedeschi, Sara, Paul, Mical, Schramm, Christoph, Bruns, Tony, Merli, Manuela, Cobos-Trigueros, Nazaret, Seminari, Elena María, Retamar Gentil, Pilar, Muñoz García, Patricia, Tumbarello, Mario, Burra, Patrizia, Torrani Cerenzia, M., Barsic, Bruno, Calbo, Esther, Maraolo, Alberto E., Petrosillo, N., Galán-Ladero, M. A., D'Offizi, Gianpiero, Bar Sinai, N., Rodríguez-Baño, Jesús, Verucchi, Gabriella, Bernardi, Mauro, and Viale, Pierluigi

Abstract

[Objectives] To describe the current epidemiology of bloodstream infection (BSI) in patients with cirrhosis; and to analyse predictors of 30-day mortality and risk factors for antibiotic resistance., [Methods] Cirrhotic patients developing a BSI episode were prospectively included at 19 centres in five countries from September 2014 to December 2015. The discrimination of mortality risk scores for 30-day mortality were compared by area under the receiver operator risk and Cox regression models. Risk factors for multidrug-resistant organisms (MDRO) were assessed with a logistic regression model., [Results] We enrolled 312 patients. Gram-negative bacteria, Gram-positive bacteria and Candida spp. were the cause of BSI episodes in 53%, 47% and 7% of cases, respectively. The 30-day mortality rate was 25% and was best predicted by the Sequential Organ Failure Assessment (SOFA) and Chronic Liver Failure–SOFA (CLIF-SOFA) score. In a Cox regression model, delayed (>24 hours) antibiotic treatment (hazard ratio (HR) 7.58; 95% confidence interval (CI) 3.29–18.67; p < 0.001), inadequate empirical therapy (HR 3.14; 95% CI 1.93–5.12; p < 0.001) and CLIF-SOFA score (HR 1.35; 95% CI 1.28–1.43; p < 0.001) were independently associated with 30-day mortality. Independent risk factors for MDRO (31% of BSIs) were previous antimicrobial exposure (odds ratio (OR) 2.91; 95% CI 1.73–4.88; p < 0.001) and previous invasive procedures (OR 2.51; 95% CI 1.48–4.24; p 0.001), whereas spontaneous bacterial peritonitis as BSI source was associated with a lower odds of MDRO (OR 0.30; 95% CI 0.12–0.73; p 0.008)., [Conclusions] MDRO account for nearly one-third of BSI in cirrhotic patients, often resulting in delayed or inadequate empirical antimicrobial therapy and increased mortality rates. Our data suggest that improved prevention and treatment strategies for MDRO are urgently needed in the liver cirrhosis patients.

Published
2018

15. Results of a multinational study suggests rapid diagnosis and early onset of antiviral treatment in herpetic meningoencephalitis

Author

Erdem, Hakan, Cag, Yasemin, Ozturk-Engin, Derya, Defres, Sylviane, Kaya, Selcuk, Larsen, Lykke, Poljak, Mario, Barsic, Bruno, Argemi, Xavier, Sørensen, Signe Maj, Bohr, Anne Lisbeth, Tattevin, Pierre, Gunst, Jesper Damsgaard, Baštáková, Lenka, Jereb, Matjaž, Somuncu Johansen, Isik, Karabay, Oguz, Pekok, Abdullah Umut, Sipahi, Oguz Resat, Chehri, Mahtab, Beraud, Guillaume, Shehata, Ghaydaa, Fontana del Vecchio, Rosa, Maresca, Mauro, Karsen, Hasan, Sengoz, Gonul, Sunbul, Mustafa, Yilmaz, Gulden, Yilmaz, Hava, Sharif-Yakan, Ahmad, Kanj, Souha, Parlak, Emine, Pehlivanoglu, Filiz, Korkmaz, Fatime, Komur, Suheyla, Kose, Sukran, Ulug, Mehmet, Bolukcu, Sibel, Coskuner, Seher Ayten, Ince, Nevin, Akkoyunlu, Yasemin, Halac, Gulistan, Sahin-Horasan, Elif, Tireli, Hulya, Kilicoglu, Gamze, Al-Mahdawi, Akram, Nemli, Salih Atakan, Inan, Asuman, Senbayrak, Seniha, Stahl, Jean Paul, Vahaboglu, Haluk, Institute of Microbiology and Immunology, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Fonction, structure et inactivation d'ARN bactériens, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institute of Microbiology and Immunology - Inštitut za mikrobiologijo in imunologijo [Ljubljana, Slovenia], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology
Abstract

International audience; Data in the literature regarding the factors that predict unfavorable outcomes in adult herpetic meningoencephalitis (HME) cases are scarce. We conducted a multicenter study in order to provide insights into the predictors of HME outcomes, with special emphasis on the use and timing of antiviral treatment. Samples from 501 patients with molecular confirmation from cerebrospinal fluid were included from 35 referral centers in 10 countries. Four hundred thirty-eight patients were found to be eligible for the analysis. Overall, 232 (52.9%) patients experienced unfavorable outcomes, 44 died, and 188 survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome.

Published
2015
Full Text
View/download PDF

16. The association between vegetation size and surgical treatment on 6-month mortality in left-sided infective endocarditis.

Author

Fosbøl, Emil L, Park, Lawrence P, Chu, Vivian H, Athan, Eugene, Delahaye, Francois, Freiberger, Tomas, Lamas, Cristiane, Miro, Jose M, Strahilevitz, Jacob, Tribouilloy, Christophe, Durante-Mangoni, Emanuele, Pericas, Juan M, Fernández-Hidalgo, Nuria, Nacinovich, Francisco, Rizk, Hussein, Barsic, Bruno, Giannitsioti, Efthymia, Hurley, John P, Hannan, Margaret M, and Wang, Andrew

Abstract

Aims In left-sided infective endocarditis (IE), a large vegetation >10 mm is associated with higher mortality, yet it is unknown whether surgery during the acute phase opposed to medical therapy is associated with improved survival. We assessed the association between surgery and 6-month mortality as related to vegetation size. Methods and results Patients with definite, left-sided IE (2008–2012) from The International Collaboration on Endocarditis prospective, multinational registry were included. We compared clinical characteristics and 6-month mortality (by Cox regression with inverse propensity of treatment weighting) between patients with vegetation size ≤10 mm vs. >10 mm in maximum length by surgical treatment strategy. A total of 1006 patients with left sided IE were included; 422 with a vegetation size ≤10 mm (median age 66.0 years, 33% women) and 584 (median age 58.4 years, 34% women) patients with a large vegetation >10 mm. Operative risk by STS-IE score was similar between groups. Embolic events occurred in 28.4% vs. 44.3% (P  < 0.001), respectively. Patients with a vegetation >10 mm was associated with higher 6-month mortality (25.1% vs. 19.4% for small vegetation, P  = 0.035). However, after propensity adjustment, the association with higher mortality persisted only in patients with a large vegetation >10 mm vs. ≤10 mm: hazard ratio (HR) 1.55 (1.27–1.90); but only in patients with large vegetation managed medically [HR 1.86 (1.48–2.34)] rather than surgically [HR 1.01 (0.69–1.49)]. Conclusion Left-sided IE with vegetation size >10 mm was associated with an increased mortality at 6 months in this observational study but was dependent on treatment strategy. For patients with large vegetation undergoing surgical treatment, survival was similar to patients with smaller vegetation size. [ABSTRACT FROM AUTHOR]

Published
2019
Full Text
View/download PDF

17. Validated Risk Score for Predicting 6‐Month Mortality in Infective Endocarditis

Author

Park, Lawrence P., primary, Chu, Vivian H., additional, Peterson, Gail, additional, Skoutelis, Athanasios, additional, Lejko‐Zupa, Tatjana, additional, Bouza, Emilio, additional, Tattevin, Pierre, additional, Habib, Gilbert, additional, Tan, Ren, additional, Gonzalez, Javier, additional, Altclas, Javier, additional, Edathodu, Jameela, additional, Fortes, Claudio Querido, additional, Siciliano, Rinaldo Focaccia, additional, Pachirat, Orathai, additional, Kanj, Souha, additional, Wang, Andrew, additional, Clara, Liliana, additional, Sanchez, Marisa, additional, Casabé, José, additional, Cortes, Claudia, additional, Nacinovich, Francisco, additional, Fernandez Oses, Pablo, additional, Ronderos, Ricardo, additional, Sucari, Adriana, additional, Thierer, Jorge, additional, Kogan, Silvia, additional, Spelman, Denis, additional, Athan, Eugene, additional, Harris, Owen, additional, Kennedy, Karina, additional, Gordon, David, additional, Papanicolas, Lito, additional, Korman, Tony, additional, Kotsanas, Despina, additional, Dever, Robyn, additional, Jones, Phillip, additional, Konecny, Pam, additional, Lawrence, Richard, additional, Rees, David, additional, Ryan, Suzanne, additional, Feneley, Michael P., additional, Harkness, John, additional, Post, Jeffrey, additional, Reinbott, Porl, additional, Gattringer, Rainer, additional, Wiesbauer, Franz, additional, Andrade, Adriana Ribas, additional, de Brito, Ana Cláudia Passos, additional, Guimarães, Armenio Costa, additional, Grinberg, Max, additional, Mansur, Alfredo José, additional, Strabelli, Tania Mara Varejao, additional, Vieira, Marcelo Luiz Campos, additional, de Medeiros Tranchesi, Regina Aparecida, additional, Paiva, Marcelo Goulart, additional, de Oliveira Ramos, Auristela, additional, Weksler, Clara, additional, Ferraiuoli, Giovanna, additional, Golebiovski, Wilma, additional, Lamas, Cristiane, additional, Karlowsky, James A., additional, Keynan, Yoav, additional, Morris, Andrew M., additional, Rubinstein, Ethan, additional, Jones, Sandra Braun, additional, Garcia, Patricia, additional, Fica, Alberto, additional, Mella, Rodrigo Montagna, additional, Fernandez, Ricardo, additional, Franco, Liliana, additional, Jaramillo, Astrid Natalia, additional, Barsic, Bruno, additional, Bukovski, Suzana, additional, Krajinovic, Vladimir, additional, Pangercic, Ana, additional, Rudez, Igor, additional, Vincelj, Josip, additional, Freiberger, Tomas, additional, Pol, Jiri, additional, Zaloudikova, Barbora, additional, Ashour, Zainab, additional, El Kholy, Amani, additional, Mishaal, Marwa, additional, Osama, Dina, additional, Rizk, Hussien, additional, Aissa, Neijla, additional, Alauzet, Corentine, additional, Alla, Francois, additional, Campagnac, Catherine, additional, Doco‐Lecompte, Thanh, additional, Selton‐Suty, Christine, additional, Casalta, Jean‐Paul, additional, Fournier, Pierre‐Edouard, additional, Raoult, Didier, additional, Thuny, Franck, additional, Delahaye, Francois, additional, Delahaye, Armelle, additional, Vandenesch, Francois, additional, Donal, Erwan, additional, Donnio, Pierre Yves, additional, Flecher, Erwan, additional, Michelet, Christian, additional, Revest, Matthieu, additional, Chevalier, Florent, additional, Jeu, Antoine, additional, Rémadi, Jean Paul, additional, Rusinaru, Dan, additional, Tribouilloy, Christophe, additional, Bernard, Yvette, additional, Chirouze, Catherine, additional, Hoen, Bruno, additional, Leroy, Joel, additional, Plesiat, Patrick, additional, Naber, Christoph, additional, Neuerburg, Carl, additional, Mazaheri, Bahram, additional, Athanasia, Sophia, additional, Deliolanis, Ioannis, additional, Giamarellou, Helen, additional, Thomas, Tsaganos, additional, Giannitsioti, Efthymia, additional, Mylona, Elena, additional, Paniara, Olga, additional, Papanicolaou, Konstantinos, additional, Pyros, John, additional, Papanikolaou, Konstantinos, additional, Sharma, Gautam, additional, Francis, Johnson, additional, Nair, Lathi, additional, Thomas, Vinod, additional, Venugopal, Krishnan, additional, Hannan, Margaret M., additional, Hurley, John P., additional, Cahan, Amos, additional, Gilon, Dan, additional, Israel, Sarah, additional, Korem, Maya, additional, Strahilevitz, Jacob, additional, Durante‐Mangoni, Emanuele, additional, Mattucci, Irene, additional, Pinto, Daniela, additional, Agrusta, Federica, additional, Senese, Alessandra, additional, Ragone, Enrico, additional, Utili, Riccardo, additional, Cecchi, Enrico, additional, De Rosa, Francesco, additional, Forno, Davide, additional, Imazio, Massimo, additional, Trinchero, Rita, additional, Grossi, Paolo, additional, Lattanzio, Mariangela, additional, Toniolo, Antonio, additional, Goglio, Antonio, additional, Raglio, Annibale, additional, Ravasio, Veronica, additional, Rizzi, Marco, additional, Suter, Fredy, additional, Carosi, Giampiero, additional, Magri, Silvia, additional, Signorini, Liana, additional, Kanafani, Zeina, additional, Kanj, Souha S., additional, Sharif‐Yakan, Ahmad, additional, Abidin, Imran, additional, Tamin, Syahidah Syed, additional, Martínez, Eduardo Rivera, additional, Soto Nieto, Gabriel Israel, additional, van der Meer, Jan T.M., additional, Chambers, Stephen, additional, Holland, David, additional, Morris, Arthur, additional, Raymond, Nigel, additional, Read, Kerry, additional, Murdoch, David R., additional, Dragulescu, Stefan, additional, Ionac, Adina, additional, Mornos, Cristian, additional, Butkevich, O.M., additional, Chipigina, Natalia, additional, Kirill, Ozerecky, additional, Vadim, Kulichenko, additional, Vinogradova, Tatiana, additional, Halim, Magid, additional, Liew, Yee‐Yun, additional, Tan, Ru‐San, additional, Logar, Mateja, additional, Mueller‐Premru, Manica, additional, Commerford, Patrick, additional, Commerford, Anita, additional, Deetlefs, Eduan, additional, Hansa, Cass, additional, Ntsekhe, Mpiko, additional, Almela, Manuel, additional, Armero, Yolanda, additional, Azqueta, Manuel, additional, Castañeda, Ximena, additional, Cervera, Carlos, additional, Falces, Carlos, additional, Garcia‐de‐la‐Maria, Cristina, additional, Fita, Guillermina, additional, Gatell, Jose M., additional, Heras, Magda, additional, Llopis, Jaime, additional, Marco, Francesc, additional, Mestres, Carlos A., additional, Miró, José M., additional, Moreno, Asuncion, additional, Ninot, Salvador, additional, Paré, Carlos, additional, Pericas, Juan M., additional, Ramirez, Jose, additional, Rovira, Irene, additional, Sitges, Marta, additional, Anguera, Ignasi, additional, Font, Bernat, additional, Guma, Joan Raimon, additional, Bermejo, Javier, additional, Garcia Fernández, Miguel Angel, additional, Gonzalez‐Ramallo, Victor, additional, Marín, Mercedes, additional, Muñoz, Patricia, additional, Pedromingo, Miguel, additional, Roda, Jorge, additional, Rodríguez‐Créixems, Marta, additional, Solis, Jorge, additional, Almirante, Benito, additional, Fernandez‐Hidalgo, Nuria, additional, Tornos, Pilar, additional, de Alarcón, Arístides, additional, Parra, Ricardo, additional, Alestig, Eric, additional, Johansson, Magnus, additional, Olaison, Lars, additional, Snygg‐Martin, Ulrika, additional, Pachirat, Pimchitra, additional, Pussadhamma, Burabha, additional, Senthong, Vichai, additional, Casey, Anna, additional, Elliott, Tom, additional, Lambert, Peter, additional, Watkin, Richard, additional, Eyton, Christina, additional, Klein, John L., additional, Bradley, Suzanne, additional, Kauffman, Carol, additional, Bedimo, Roger, additional, Corey, G. Ralph, additional, Crowley, Anna Lisa, additional, Douglas, Pamela, additional, Drew, Laura, additional, Fowler, Vance G., additional, Holland, Thomas, additional, Lalani, Tahaniyat, additional, Mudrick, Daniel, additional, Samad, Zaniab, additional, Sexton, Daniel, additional, Stryjewski, Martin, additional, Woods, Christopher W., additional, Lerakis, Stamatios, additional, Cantey, Robert, additional, Steed, Lisa, additional, Wray, Dannah, additional, Dickerman, Stuart A., additional, Bonilla, Hector, additional, DiPersio, Joseph, additional, Salstrom, Sara‐Jane, additional, Baddley, John, additional, Patel, Mukesh, additional, Stancoven, Amy, additional, Levine, Donald, additional, Riddle, Jonathan, additional, Rybak, Michael, additional, Cabell, Christopher H., additional, Baloch, Khaula, additional, Dixon, Christy C., additional, Harding, Tina, additional, Jones‐Richmond, Marian, additional, Sanderford, Bob, additional, Stafford, Judy, additional, Anstrom, Kevin, additional, Bayer, Arnold S., additional, Karchmer, A. W., additional, Sexton, Daniel J., additional, Chu, Vivian, additional, Durack, David T., additional, Eykyn, Susannah, additional, and Moreillon, Phillipe, additional

Published
2016
Full Text
View/download PDF

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

Author

Barsic, Bruno, Dickerman, Stuart, Krajinovic, Vladimir, Pappas, Paul, Altclas, Javier, Carosi, Giampiero, Casabé, José H., Chu, Vivian H., Delahaye, Francois, Edathodu, Jameela, Fortes, Claudio Querido, Olaison, Lars, Pangercic, Ana, Patel, Mukesh, Rudez, Igor, Tamin, Syahidah Syed, Vincelj, Josip, Bayer, Arnold S., Wang, Andrew, Clara, Liliana, Sanchez, Marisa, Nacinovich, Francisco, Oses, Pablo Fernandez, Ronderos, Ricardo, Sucari, Adriana, Thierer, Jorge, Casabé, José, Cortes, Claudia, Kogan, Silvia, Spelman, Denis, Athan, Eugene, Harris, Owen, Kennedy, Karina, Tan, Ren, Gordon, David, Papanicolas, Lito, Eisen, Damon, Grigg, Leeanne, Street, Alan, Korman, Tony, Kotsanas, Despina, Dever, Robyn, Jones, Phillip, Konecny, Pam, Lawrence, Richard, Rees, David, Ryan, Suzanne, Feneley, Michael P., Harkness, John, Post, Jeffrey, Reinbott, Porl, Gattringer, Rainer, Wiesbauer, Franz, Andrade, Adriana Ribas, De Brito, Ana Cláudia Passos, Guimarães, Armenio Costa, Grinberg, Max, Mansur, Alfredo José, Siciliano, Rinaldo Focaccia, Strabelli, Tania Mara Varejao, Vieira, Marcelo Luiz Campos, De Medeiros Tranchesi, Regina Aparecida, Paiva, Marcelo Goulart, De Oliveira Ramos, Auristela, Ferraiuoli, Giovanna, Golebiovski, Wilma, Lamas, Cristiane, Santos, Marisa, Weksler, Clara, Karlowsky, James A., Keynan, Yoav, Morris, Andrew M., Rubinstein, Ethan, Jones, Sandra Braun, Garcia, Patricia, Cereceda, M., Fica, Alberto, Mella, Rodrigo Montagna, Bukovski, Suzana, Freiberger, Tomas, Pol, Jiri, Zaloudikova, Barbora, Ashour, Zainab, Kholy, Amani El, Mishaal, Marwa, Rizk, Hussien, Aissa, Neijla, Alauzet, Corentine, Alla, Francois, Campagnac, Catherine, Doco Lecompte, Thanh, Selton Suty, Christine, Casalta, Jean Paul, Fournier, Pierre Edouard, Habib, Gilbert, Raoult, Didier, Thuny, Franck, Delahaye, Armelle, Vandenesch, Francois, Donal, Erwan, Donnio, Pierre Yves, Michelet, Christian, Revest, Matthieu, Tattevin, Pierre, Violette, Jérémie, Chevalier, Florent, Jeu, Antoine, Rusinaru, Dan, Sorel, Claire, Tribouilloy, Christophe, Bernard, Yvette, Chirouze, Catherine, Hoen, Bruno, Leroy, Joel, Plesiat, Patrick, Naber, Germa Christoph, Neuerburg, Carl, Mazaheri, Bahram, Naber, Christoph, Athanasia, Sofia, Giannitsioti, Efthymia, Mylona, Elena, Paniara, Olga, Papanicolaou, Konstantinos, Pyros, John, Skoutelis, Athanasios, Sharma, Gautam, Francis, Johnson, Nair, Lathi, Thomas, D. M. Vinod, Venugopal, Krishnan, Hannan, Margaret, Hurley, John, Cahan, Amos, Gilon, Dan, Israel, Sarah, Korem, Maya, Strahilevitz, Jacob, Tripodi, Marie Françoise, Casillo, Roberta, Cuccurullo, Susanna, Dialetto, Giovanni, Durante Mangoni, Emanuele, Irene, Mattucci, Ragone, Enrico, Utili, Riccardo, Cecchi, Enrico, Rosa, Francesco De, Forno, Davide, Imazio, Massimo, Trinchero, Rita, Tebini, Alessandro, Grossi, PAOLO ANTONIO, Lattanzio, Mariangela, Toniolo, Antonio, Goglio, Antonio, Raglio, Annibale, Ravasio, Veronica, Rizzi, Marco, Suter, Fredy, Magri, Silvia, Signorini, Liana, Baban, Tania, Kanafani, Zeina, Kanj, Souha S., Sfeir, Jad, Yasmine, Mohamad, Abidin, Imran, Martínez, Eduardo Rivera, Nieto, Gabriel Israel Soto, Van Der Meer, Jan T. M., Chambers, Stephen, Murdoch, David R., Holland, David, Morris, Arthur, Raymond, Nigel, Read, Kerry, Dragulescu, Stefan, Ionac, Adina, Mornos, Cristian, Butkevich, O. M., Chipigina, Natalia, Kirill, Ozerecky, Vadim, Kulichenko, Vinogradova, Tatiana, Halim, Magid, Lum, Luh Nah, Tan, Ru San, Lejko Zupanc, Tatjana, Logar, Mateja, Mueller Premru, Manica, Commerford, Patrick, Commerford, Anita, Deetlefs, Eduan, Hansa, Cass, Ntsekhe, Mpiko, Almela, Manuel, Armero, Yolanda, Azqueta, Manuel, Castañeda, Ximena, Cervera, Carlos, Del Rio, Ana, Falces, Carlos, Garcia De La Maria, Cristina, Fita, Guillermina, Gatell, Jose M., Marco, Francesc, Mestres, Carlos A., Miró, José M., Moreno, Asuncion, Ninot, Salvador, Paré, Carlos, Pericas, Joan, Ramirez, Jose, Rovira, Irene, Sitges, Marta, Anguera, Ignasi, Font, Bernat, Guma, Joan Raimon, Bermejo, Javier, Bouza, Emilio, Fernández, Miguel Angel Garcia, Gonzalez Ramallo, Victor, Marín, Mercedes, Muñoz, Patricia, Pedromingo, Miguel, Roda, Jorge, Rodríguez Créixems, Marta, Solis, Jorge, Almirante, Benito, Fernandez Hidalgo, Nuria, Tornos, Pilar, De Alarcón, Arístides, Parra, Ricardo, Alestig, Eric, Johansson, Magnus, Snygg Martin, Ulrika, Pachirat, Orathai, Pachirat, Pimchitra, Pussadhamma, Burabha, Senthong, Vichai, Casey, Anna, Elliott, Tom, Lambert, Peter, Watkin, Richard, Eyton, Christina, Klein, John L., Bradley, Suzanne, Kauffman, Carol, Bedimo, Roger, Corey, G. Ralph, Crowley, Anna Lisa, Douglas, Pamela, Drew, Laura, Fowler, Vance G., Holland, Thomas, Lalani, Tahaniyat, Mudrick, Daniel, Samad, Zaniab, Sexton, Daniel, Stryjewski, Martin, Woods, Christopher W., Lerakis, Stamatios, Cantey, Robert, Steed, Lisa, Wray, Dannah, Dickerman, Stuart A., Bonilla, Hector, Di Persio, Joseph, Salstrom, Sara Jane, Baddley, John, Peterson, Gail, Stancoven, Amy, Afonso, Luis, Kulman, Theresa, Levine, Donald, Rybak, Michael, Cabell, Christopher H., Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie (Hôpital Louis Pradel), Hospices Civils de Lyon (HCL), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators, Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Male, MESH: Endocarditis, Time Factors, Medizin, 030204 cardiovascular system & hematology, endocarditis, valve replacement, surgery, Cohort Studies, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 030212 general & internal medicine, Hospital Mortality, MESH: Inpatients, Stroke, MESH: Cohort Studies, MESH: Aged, MESH: Middle Aged, MESH: Cardiac Surgical Procedures, Endocarditis, Mortality rate, Hazard ratio, Middle Aged, stroke, 3. Good health, Cardiac surgery, Infectious Diseases, Infective endocarditis, Female, Cohort study, Adult, Microbiology (medical), medicine.medical_specialty, MESH: Stroke, 03 medical and health sciences, medicine, Humans, MESH: Hospital Mortality, Cardiac Surgical Procedures, Aged, Inpatients, MESH: Humans, Proportional hazards model, business.industry, MESH: Time Factors, MESH: Adult, Odds ratio, medicine.disease, MESH: Male, Surgery, business, MESH: Female
Abstract

International audience; 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.

Published
2013
Full Text
View/download PDF

19. HACEK Infective Endocarditis: Characteristics and Outcomes from a Large, Multi-National Cohort

Author

Chambers, Stephen T, Murdoch, David, Morris, Arthur, Holland, David, Pappas, Paul, Almela, Manel, Fernández Hidalgo, Nuria, Almirante, Benito, Bouza, Emilio, Forno, Davide, Rio, Ana del, Hannan, Margaret M., Harkness, John, Kanafani, Zeina A., Lalani, Tahaniyat, Lang, Selwyn, Raymond, Nigel, Read, Kerry, Vinogradova, Tatiana, Woods, Christopher W., Wray, Dannah, Corey, G. Ralph, Chu, Vivian H., Clara, Liliana, Sanchez, Marisa, Nacinovich, Francisco, Oses, Pablo Fernandez, Ronderos, Ricardo, Sucari, Adriana, Thierer, Jorge, Casabé, José, Cortes, Claudia, Altclas, Javier, Silvia Kogan, Sanatorio, Spelman, Denis, Athan, Eugene, Harris, Owen, Kennedy, Karina, Tan, Ren, Gordon, David, Papanicolas, Lito, Eisen, Damon, Grigg, Leeanne, Street, Alan, Korman, Tony, Kotsanas, Despina, Dever, Robyn, Jones, Phillip, Konecny, Pam, Lawrence, Richard, Rees, David, Ryan, Suzanne, Feneley, Michael P., Post, Jeffrey, Reinbott, Porl, Gattringer, Rainer, Wiesbauer, Franz, Andrade, Adriana Ribas, de Brito, Ana Cláudia Passos, Guimarães, Armenio Costa, Grinberg, Max, Mansur, Alfredo José, Siciliano, Rinaldo Focaccia, Strabelli, Tania Mara Varejao, Vieira, Marcelo Luiz Campos, de Medeiros Tranchesi, Regina Aparecida, Paiva, Marcelo Goulart, Fortes, Claudio Querido, de Oliveira Ramos, Auristela, Ferraiuoli, Giovanna, Golebiovski, Wilma, Lamas, Cristiane, Santos, Marisa, Weksler, Clara, Karlowsky, James A., Keynan, Yoav, Morris, Andrew M., Rubinstein, Ethan, Jones, Sandra Braun, Garcia, Patricia, Cereceda, M., Fica, Alberto, Mella, Rodrigo Montagna, Barsic, Bruno, Bukovski, Suzana, Krajinovic, Vladimir, Pangercic, Ana, Rudez, Igor, Vincelj, Josip, Freiberger, Tomas, Pol, Jiri, Zaloudikova, Barbora, Ashour, Zainab, Kholy, Amani El, Mishaal, Marwa, Rizk, Hussien, Aissa, Neijla, Alauzet, Corentine, Alla, Francois, Campagnac, Catherine, Doco Lecompte, Thanh, Selton Suty, Christine, Casalta, Jean Paul, Fournier, Pierre Edouard, Habib, Gilbert, Raoult, Didier, Thuny, Franck, Delahaye, Francois, Delahaye, Armelle, Vandenesch, Francois, Donal, Erwan, Donnio, Pierre Yves, Michelet, Christian, Revest, Matthieu, Tattevin, Pierre, Violette, Jérémie, Chevalier, Florent, Jeu, Antoine, Rusinaru, Dan M. D., Sorel, Claire, Tribouilloy, Christophe, Bernard, Yvette, Chirouze, Catherine, Hoen, Bruno, Leroy, Joel, Plesiat, Patrick, Naber, Christoph, Neuerburg, Carl, Mazaheri, Bahram, Athanasia, Sofia, Giannitsioti, Efthymia, Mylona, Elena, Paniara, Olga, Papanicolaou, Konstantinos, Pyros, John, Skoutelis, Athanasios, Sharma, Gautam, Francis, Johnson, Nair, Lathi, Thomas, Vinod, Venugopal, Krishnan, Hannan, Margaret, Hurley, John, Gilon, Dan, Israel, Sarah, Korem, Maya, Strahilevitz, Jacob, Tripodi, Marie Françoise, Casillo, Roberta, Cuccurullo, Susanna, Dialetto, Giovanni, Durante Mangoni, Emanuele, Irene, Mattucci, Ragone, Enrico, Utili, Riccardo, Cecchi, Enrico, De Rosa, Francesco, Imazio, Massimo, Trinchero, Rita, Tebini, Alessandro, Grossi, PAOLO ANTONIO, Lattanzio, Mariangela, Toniolo, Antonio, Goglio, Antonio, Raglio, Annibale, Ravasio, Veronica, Rizzi, Marco, Suter, Fredy, Carosi, Giampiero, Magri, Silvia, Signorini, Liana, Baban, Tania, Kanafani, Zeina, Kanj, Souha S., Sfeir, Jad, Yasmine, Mohamad, Abidin, Imran, Tamin, Syahidah Syed, Martínez, Eduardo Rivera, Nieto, Gabriel Israel Soto, van der Meer, Jan T. M., Chambers, Stephen, Murdoch, David R., Dragulescu, Stefan, Ionac, Adina, Mornos, Cristian, Butkevich, O. M., Chipigina, Natalia, Kirill, Ozerecky, Vadim, Kulichenko, Edathodu, Jameela, Halim, Magid, Lum, Luh Nah, Tan, Ru San, Lejko Zupanc, Tatjana, Logar, Mateja, Mueller Premru, Manica, Commerford, Patrick, Commerford, Anita, Deetlefs, Eduan, Hansa, Cass, Ntsekhe, Mpiko, Almela, Manuel, Armero, Yolanda, Azqueta, Manuel, Castañeda, Ximena, Cervera, Carlos, Falces, Carlos, Garcia de la Maria, Cristina, Fita, Guillermina, Gatell, Jose M., Marco, Francesc, Mestres, Carlos A., Miró, José M., Moreno, Asuncion, Ninot, Salvador, Paré, Carlos, Pericas, Joan, Ramirez, Jose, Rovira, Irene, Sitges, Marta, Anguera, Ignasi, Font, Bernat, Guma, Joan Raimon, Bermejo, Javier, Fernández, Miguel Angel Garcia, Gonzalez Ramallo, Victor, Marín, Mercedes, Muñoz, Patricia, Pedromingo, Miguel, Roda, Jorge, Rodríguez Créixems, Marta, Solis, Jorge, Fernandez Hidalgo, Nuria, Tornos, Pilar, de Alarcón, Arístides, Parra, Ricardo, Alestig, Eric, Johansson, Magnus, Olaison, Lars, Snygg Martin, Ulrika, Pachirat, Orathai, Pachirat, Pimchitra, Pussadhamma, Burabha, Senthong, Vichai, Casey, Anna, Elliott, Tom, Lambert, Peter, Watkin, Richard, Eyton, Christina, Klein, John L., Bradley, Suzanne, Kauffman, Carol, Bedimo, Roger, Crowley, Anna Lisa, Douglas, Pamela, Drew, Laura, Fowler, Vance G., Holland, Thomas, Mudrick, Daniel, Samad, Zaniab, Sexton, Daniel, Stryjewski, Martin, Wang, Andrew, Lerakis, Stamatios, Cantey, Robert, Steed, Lisa, Dickerman, Stuart A., Bonilla, Hector, Dipersio, Joseph, Salstrom, Sara Jane, Baddley, John, Patel, Mukesh, Peterson, Gail, Stancoven, Amy, Afonso, Luis, Kulman, Theresa, Levine, Donald, Rybak, Michael, Cabell, Christopher H., Baloch, Khaula, Dixon, Christy C., Vance G., Fowler J. r., Harding, Tina, Jones Richmond, Marian, Park, Lawrence P., Redick, Thomas, Stafford, Judy, Anstrom, Kevin, Bayer, Arnold S., Karchmer, A. W., Sexton, Daniel J., Cabell, Christopher H, Chu, Vivian, Durack, David T., Eykyn, Susannah, Moreillon, Phillipe, Universitat de Barcelona, University of Otago [Dunedin, Nouvelle-Zélande], Auckland City Hospital, Microbiology Laboratory, Middlemore Hospital, Duke University Medical Center, Clinical and experimental neuroimmunology [IDIBAPS], Institut d'Investigacions Biomèdiques August Pi i Sunyer, Vall d'Hebron University Hospital [Barcelona], Hospital Universitario Gregorio Maranon, Hospital Universitario Gregorio Marañón, Cardiologie, Maria Vittoria Hospital [Turin], Mater Hospitals, University of New South Wales [Sydney] (UNSW), American University of Beirut [Beyrouth] (AUB), Uniformed Services University of the Health Sciences (USUHS), Wellington Hospital Private, Royal North Shore Hospital (RNSH), Russian State Medical University, Durham VA Medical Center, and University of South Carolina [Columbia]

Subjects
Aortic valve, Bacterial Diseases, Genetics and Molecular Biology (all), Valvular Disease, Medizin, Eikenella corrodens, Cardiobacterium, Infection control, Cardiovascular, American-heart-association, Biochemistry, Antimicrobial therapy, Cohort Studies, 0302 clinical medicine, Control d'infeccions, Diagnosis, Odds Ratio, Prevalence, 030212 general & internal medicine, Prospective cohort study, Haemophilus Influenzae, 0303 health sciences, Multidisciplinary, biology, Endocarditis, Medicine (all), Statistics, Congenital Heart Disease, Age Factors, Bacterial, 3. Good health, Management, Stroke, medicine.anatomical_structure, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Treatment Outcome, Infective endocarditis, Cohort, [SDV.IMM]Life Sciences [q-bio]/Immunology, Medicine, Profile, Health-care professionals, Kingella, Cardiobacterium-hominis, Cohort study, Research Article, medicine.medical_specialty, Drugs and Devices, Science, Haemophilus, Referral bias, Statistics, Nonparametric, Medical Devices, 03 medical and health sciences, Internal medicine, Kingella Kingae Infection, medicine, Humans, Nonparametric, Aggregatibacter, Endocarditis, Bacterial, Biochemistry, Genetics and Molecular Biology (all), Agricultural and Biological Sciences (all), Staphylococcus-aureus, Heart Failure, 030306 microbiology, business.industry, Acute Cardiovascular Problems, Bloodstream Infections, medicine.disease, biology.organism_classification, Surgery, Valve endocarditis, Cardiobacterium hominis, business
Abstract

International audience; The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens. Of 5591 patients enrolled, 77 (1.4%) had HE. HE was associated with a younger age (47 vs. 61 years; p < 0.001), a higher prevalence of immunologic/vascular manifestations (32% vs. 20%; p < 0.008) and stroke (25% vs. 17% p = 0.05) but a lower prevalence of congestive heart failure (15% vs. 30%; p = 0.004), death in-hospital (4% vs. 18%; p = 0.001) or after 1 year follow-up (6% vs. 20%; p = 0.01) than IE due to other pathogens (n = 5514). On multivariable analysis, stroke was associated with mitral valve vegetations (OR 3.60; CI 1.34-9.65; p < 0.01) and younger age (OR 0.62; CI 0.49-0.90; p < 0.01). The overall outcome of HE was excellent with the in-hospital mortality (4%) significantly better than for non-HE (18%; p < 0.001). Prosthetic valve endocarditis was more common in HE (35%) than non-HE (24%). The outcome of prosthetic valve and native valve HE was excellent whether treated medically or with surgery. Current treatment is very successful for the management of both native valve prosthetic valve HE but further studies are needed to determine why HE has a predilection for younger people and to cause stroke. The small number of patients and observational design limit inferences on treatment strategies. Self selection of study sites limits epidemiological inferences.

Published
2013
Full Text
View/download PDF

20. Candida infective endocarditis: an observational cohort study with a focus on therapy

Author

Arnold, Christopher J., Johnson, Melissa, Bayer, Arnold S., Bradley, Suzanne, Giannitsioti, Efthymia, Miró, José M., Tornos, Pilar, Tattevin, Pierre, Strahilevitz, Jacob, Spelman, Denis, Athan, Eugene, Nacinovich, Francisco, Fortes, Claudio Q., Lamas, Cristiane, Barsic, Bruno, Fernández-Hidalgo, Nuria, Muñoz, Patricia, Chu, Vivian H., Arnold, Christopher J., Johnson, Melissa, Bayer, Arnold S., Bradley, Suzanne, Giannitsioti, Efthymia, Miró, José M., Tornos, Pilar, Tattevin, Pierre, Strahilevitz, Jacob, Spelman, Denis, Athan, Eugene, Nacinovich, Francisco, Fortes, Claudio Q., Lamas, Cristiane, Barsic, Bruno, Fernández-Hidalgo, Nuria, Muñoz, Patricia, and Chu, Vivian H.

Abstract

Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. This prospective cohort study was based on 70 cases of Candida infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.

Published
2015

21. Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis

Author

Erdem, Hakan, primary, Cag, Yasemin, additional, Ozturk-Engin, Derya, additional, Defres, Sylviane, additional, Kaya, Selcuk, additional, Larsen, Lykke, additional, Poljak, Mario, additional, Barsic, Bruno, additional, Argemi, Xavier, additional, Sørensen, Signe Maj, additional, Bohr, Anne Lisbeth, additional, Tattevin, Pierre, additional, Gunst, Jesper Damsgaard, additional, Baštáková, Lenka, additional, Jereb, Matjaž, additional, Johansen, Isik Somuncu, additional, Karabay, Oguz, additional, Pekok, Abdullah Umut, additional, Sipahi, Oguz Resat, additional, Chehri, Mahtab, additional, Beraud, Guillaume, additional, Shehata, Ghaydaa, additional, Del Vecchio, Rosa Fontana, additional, Maresca, Mauro, additional, Karsen, Hasan, additional, Sengoz, Gonul, additional, Sunbul, Mustafa, additional, Yilmaz, Gulden, additional, Yilmaz, Hava, additional, Sharif-Yakan, Ahmad, additional, Kanj, Souha Shararah, additional, Parlak, Emine, additional, Pehlivanoglu, Filiz, additional, Korkmaz, Fatime, additional, Komur, Suheyla, additional, Kose, Sukran, additional, Ulug, Mehmet, additional, Bolukcu, Sibel, additional, Coskuner, Seher Ayten, additional, Ince, Nevin, additional, Akkoyunlu, Yasemin, additional, Halac, Gulistan, additional, Sahin-Horasan, Elif, additional, Tireli, Hulya, additional, Kilicoglu, Gamze, additional, Al-Mahdawi, Akram, additional, Nemli, Salih Atakan, additional, Inan, Asuman, additional, Senbayrak, Seniha, additional, Stahl, Jean Paul, additional, and Vahaboglu, Haluk, additional

Published
2015
Full Text
View/download PDF

22. Candida Infective Endocarditis: an Observational Cohort Study with a Focus on Therapy

Author

Arnold, Christopher J., primary, Johnson, Melissa, additional, Bayer, Arnold S., additional, Bradley, Suzanne, additional, Giannitsioti, Efthymia, additional, Miró, José M., additional, Tornos, Pilar, additional, Tattevin, Pierre, additional, Strahilevitz, Jacob, additional, Spelman, Denis, additional, Athan, Eugene, additional, Nacinovich, Francisco, additional, Fortes, Claudio Q., additional, Lamas, Cristiane, additional, Barsic, Bruno, additional, Fernández-Hidalgo, Nuria, additional, Muñoz, Patricia, additional, and Chu, Vivian H., additional

Published
2015
Full Text
View/download PDF

24. Clinical Experience of Colistin-Glycopeptide Combination in Critically Ill Patients Infected with Gram-Negative Bacteria

Author

Petrosillo, Nicola, primary, Giannella, Maddalena, additional, Antonelli, Massimo, additional, Antonini, Mario, additional, Barsic, Bruno, additional, Belancic, Laura, additional, Inkaya A., Cagkan, additional, De Pascale, Gennaro, additional, Grilli, Elisabetta, additional, Tumbarello, Mario, additional, and Akova, Murat, additional

Published
2014
Full Text
View/download PDF

25. Current features of infective endocarditis in elderly patients: results of the International Collaboration on Endocarditis Prospective Cohort Study.

Author

Durante-Mangoni, Emanuele, Bradley, Suzanne, Selton-Suty, Christine, Tripodi, Marie-Francoise, Barsic, Bruno, Bouza, Emilio, Cabell, Christopher H, Ramos, Auristela I D O, Fowler, Vance, Hoen, Bruno, Koneçny, Pam, Moreno, Asuncion, Murdoch, David, Pappas, Paul, Sexton, Daniel J, Spelman, Denis, Tattevin, Pierre, Miró, Jose M, van der Meer, Jan T M, Utili, Riccardo, International Collaboration on Endocarditis Prospective Cohort Study Group, Durante-Mangoni, Emanuele, Bradley, Suzanne, Selton-Suty, Christine, Tripodi, Marie-Francoise, Barsic, Bruno, Bouza, Emilio, Cabell, Christopher H, Ramos, Auristela I D O, Fowler, Vance, Hoen, Bruno, Koneçny, Pam, Moreno, Asuncion, Murdoch, David, Pappas, Paul, Sexton, Daniel J, Spelman, Denis, Tattevin, Pierre, Miró, Jose M, van der Meer, Jan T M, Utili, Riccardo, and International Collaboration on Endocarditis Prospective Cohort Study Group

Abstract

BACKGROUND: Elderly patients are emerging as a population at high risk for infective endocarditis (IE). However, adequately sized prospective studies on the features of IE in elderly patients are lacking. METHODS: In this multinational, prospective, observational cohort study within the International Collaboration on Endocarditis, 2759 consecutive patients were enrolled from June 15, 2000, to December 1, 2005; 1056 patients with IE 65 years or older were compared with 1703 patients younger than 65 years. Risk factors, predisposing conditions, origin, clinical features, course, and outcome of IE were comprehensively analyzed. RESULTS: Elderly patients reported more frequently a hospitalization or an invasive procedure before IE onset. Diabetes mellitus and genitourinary and gastrointestinal cancer were the major predisposing conditions. Blood culture yield was higher among elderly patients with IE. The leading causative organism was Staphylococcus aureus, with a higher rate of methicillin resistance. Streptococcus bovis and enterococci were also significantly more prevalent. The clinical presentation of elderly patients with IE was remarkable for lower rates of embolism, immune-mediated phenomena, or septic complications. At both echocardiography and surgery, fewer vegetations and more abscesses were found, and the gain in the diagnostic yield of transesophageal echocardiography was significantly larger. Significantly fewer elderly patients underwent cardiac surgery (38.9% vs 53.5%; P < .001). Elderly patients with IE showed a higher rate of in-hospital death (24.9% vs 12.8%; P < .001), and age older than 65 years was an independent predictor of mortality. CONCLUSIONS: In this large prospective study, increasing age emerges as a major determinant of the clinical characteristics of IE. Lower rates of surgical treatment and high mortality are the most prominent features of elderly patients with IE. Efforts should be made to prevent health care-associated acquisition an

Published
2008

26. Staphylococcus aureus endocarditis: a consequence of medical progress

Author

Fowler, Vance G., Miro, Jose M., Hoen, Bruno, Cabell, Cristopher H., Abrutyn, Elias, Rubinstein, Ethan, Corey, G. Ralph, Spelman, Denis, Bradley, Suzanne F., Barsic, Bruno, Pappas, Paul A., Anstrom, Kevin J., Wray, Dannah, Fortes, Claudio Q., Anguera, Ignasi, Athan, Eugene, Jones, Philip, van der Meer, Jan T. M., Elliott, Tom S. J., Levine, Donald P., Bayer, Arnold S., Fowler, Vance G., Miro, Jose M., Hoen, Bruno, Cabell, Cristopher H., Abrutyn, Elias, Rubinstein, Ethan, Corey, G. Ralph, Spelman, Denis, Bradley, Suzanne F., Barsic, Bruno, Pappas, Paul A., Anstrom, Kevin J., Wray, Dannah, Fortes, Claudio Q., Anguera, Ignasi, Athan, Eugene, Jones, Philip, van der Meer, Jan T. M., Elliott, Tom S. J., Levine, Donald P., and Bayer, Arnold S.

Published
2005

29. CandidaInfective Endocarditis: an Observational Cohort Study with a Focus on Therapy

Author

Arnold, Christopher J., Johnson, Melissa, Bayer, Arnold S., Bradley, Suzanne, Giannitsioti, Efthymia, Miró, José M., Tornos, Pilar, Tattevin, Pierre, Strahilevitz, Jacob, Spelman, Denis, Athan, Eugene, Nacinovich, Francisco, Fortes, Claudio Q., Lamas, Cristiane, Barsic, Bruno, Fernández-Hidalgo, Nuria, Muñoz, Patricia, and Chu, Vivian H.

Abstract

ABSTRACTCandidainfective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candidainfective endocarditis. This prospective cohort study was based on 70 cases of Candidainfective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candidainfective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.

Published
2015
Full Text
View/download PDF

30. Clinical Experience of Colistin-Glycopeptide Combination in Critically Ill Patients Infected with Gram-Negative Bacteria

Author

Petrosillo, Nicola, Giannella, Maddalena, Antonelli, Massimo, Antonini, Mario, Barsic, Bruno, Belancic, Laura, Inkaya A., Cagkan, De Pascale, Gennaro, Grilli, Elisabetta, Tumbarello, Mario, and Akova, Murat

Abstract

ABSTRACTA colistin-glycopeptide combination (CGC) has been shown in vitroto be synergistic against multidrug-resistant Gram-negative bacteria (MDR GNB), especially Acinetobacter baumannii, and to prevent further resistance. However, clinical data are lacking. We carried out a retrospective multicenter study of patients hospitalized in intensive care units (ICUs) who received colistin for GNB infection over a 1-year period, to assess the rates of nephrotoxicity and 30-day mortality after treatment onset among patients treated with and without CGC for ≥48 h. Of the 184 patients treated with colistin, GNB infection was documented for 166. The main causative agents were MDR A. baumannii(59.6%), MDR Pseudomonas aeruginosa(18.7%), and carbapenem-resistant Klebsiella pneumoniae(14.5%); in 16.9% of patients, a Gram-positive bacterium (GPB) coinfection was documented. Overall, 68 patients (40.9%) received CGC. Comparison of patients treated with and without CGC showed significant differences for respiratory failure (39.7% versus 58.2%), ventilator-associated pneumonia (54.4% versus 71.4%), MDR A. baumanniiinfection (70.6% versus 52%), and GPB coinfection (41.2% versus 0%); there were no differences for nephrotoxicity (11.8% versus 13.3%) and 30-day mortality (33.8% versus 29.6%). Cox analysis performed on patients who survived for ≥5 days after treatment onset showed that the Charlson index (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.01 to 1.44; P= 0.001) and MDR A. baumanniiinfection (HR, 2.51; 95% CI, 1.23 to 5.12; P= 0.01) were independent predictors of 30-day mortality, whereas receiving CGC for ≥5 days was a protective factor (HR, 0.42; 95% CI, 0.19 to 0.93; P= 0.03). We found that CGC was not associated with higher nephrotoxicity and was a protective factor for mortality if administered for ≥5 days.

Published
2013
Full Text
View/download PDF

31. Listeria Monocytogenes Meningitis in a Renal Transplant Recipient - A Case Report.

Author

Mesar, Ines, Kes, Petar, Bubic-Filipi, Ljubica, Barsic, Bruno, and Basic-Jukic, Nikolina

Subjects
LISTERIA monocytogenes, LISTERIA, MENINGITIS, CENTRAL nervous system diseases, KIDNEY transplantation
Abstract

Gastrointestinal tract is the main entry for Listeria monocytogenes. Thus, the most common manifestation of infection is enteritis, but meningitis and meningoencephalitis may also occur. Unless recognized and treated, Listeria infections can result in significant morbidity and mortality, especially in immunocompromised hosts. We report a case of Listeria monocytogenes meningitis in a renal transplant recipient successfully treated with ampicilin. The patient recovered completely with stable graft function. [ABSTRACT FROM AUTHOR]

Published
2012

32. Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children

Author

Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística, Andabaka, Tea, Nickerson, Jason W., Rojas Reyes, Maria Ximena, Rueda, Juan David, Bacic Vrca, Vesna, Barsic, Bruno, Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística, Andabaka, Tea, Nickerson, Jason W., Rojas Reyes, Maria Ximena, Rueda, Juan David, Bacic Vrca, Vesna, and Barsic, Bruno

33. Extended infusion of β-lactams for bloodstream infection in patients with liver cirrhosis: an observational multicenter study

Author

Paolo Caraceni, Tony Bruns, Maria Torrani Cerenzia, Mical Paul, Pilar Retamar, Mario Tumbarello, Michele Bartoletti, Gianpiero D'Offizi, Gabriella Verucchi, Christoph Schramm, Nicola Petrosillo, Bruno Baršić, Pierluigi Viale, Patrizia Burra, Elena Seminari, Alberto Enrico Maraolo, Yael Zak-Doron, Marco Domenicali, Sara K. Tedeschi, Maddalena Giannella, Ester Calbo, Nazaret Cobos-Trigueros, Maria Angeles Galan-Ladero, Jesús Rodríguez-Baño, Maurizio Baldassarre, Esgbis, Manuela Merli, Mauro Bernardi, Russell E. Lewis, Patricia Muñoz, Bartoletti, Michele, Giannella, Maddalena, Lewis, Russell E, Caraceni, Paolo, Tedeschi, Sara, Paul, Mical, Schramm, Christoph, Bruns, Tony, Merli, Manuela, Cobos-Trigueros, Nazaret, Seminari, Elena, Retamar, Pilar, Muñoz, Patricia, Tumbarello, Mario, Burra, Patrizia, Cerenzia, Maria Torrani, Barsic, Bruno, Calbo, Ester, Maraolo, Alberto Enrico, Petrosillo, Nicola, Galan-Ladero, Maria Angele, D'Offizi, Gianpiero, Zak-Doron, Yael, Rodriguez-Baño, Jesu, Baldassarre, Maurizio, Verucchi, Gabriella, Domenicali, Marco, Bernardi, Mauro, Viale, Pierluigi, Torrani Cerenzia, Maria, Instituto de Salud Carlos III, European Commission, and Ministerio de Economía, Industria y Competitividad (España)

Subjects
Male, beta-lattamici, Continuous infusion, Microbiology (medical), Tazobactam, medicine.medical_specialty, Carbapenem, Cirrhosis, Bacteremia, bloodstream infection, beta-Lactams, Gastroenterology, Liver cirrhosi, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Internal medicine, β-lactam antibiotics, extended infusio beta-lactams, Severity of illness, antibiotic therapy, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Infusions, Intravenous, Aged, Retrospective Studies, Piperacillin, business.industry, Hazard ratio, Middle Aged, medicine.disease, continuous infusion, bacterial infections and mycoses, beta-lattamici, antibiotic therapy, liver cirrhosis, Confidence interval, Anti-Bacterial Agents, Treatment Outcome, Infectious Diseases, Liver cirrhosis, Propensity score matching, Piperacillin/tazobactam, Female, 030211 gastroenterology & hepatology, Bloodstream infections, business, medicine.drug
Abstract

For the ESGBIS/BICHROME study group., [Background] We analyzed the impact of continuous/extended infusion (C/EI) vs intermittent infusion of piperacillin-tazobactam (TZP) and carbapenems on 30-day mortality of patients with liver cirrhosis and bloodstream infection (BSI). [Methods] The BICRHOME study was a prospective, multicenter study that enrolled 312 cirrhotic patients with BSI. In this secondary analysis, we selected patients receiving TZP or carbapenems as adequate empirical treatment. The 30-day mortality of patients receiving C/EI or intermittent infusion of TZP or carbapenems was assessed with Kaplan-Meier curves, Cox-regression model, and estimation of the average treatment effect (ATE) using propensity score matching. [Results] Overall, 119 patients received TZP or carbapenems as empirical treatment. Patients who received C/EI had a significantly lower mortality rate (16% vs 36%, P = .047). In a Cox-regression model, the administration of C/EI was associated with a significantly lower mortality (hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.11–0.936; P = .04) when adjusted for severity of illness and an ATE of 25.6% reduction in 30-day mortality risk (95% CI, 18.9–32.3; P < .0001) estimated with propensity score matching. A significant reduction in 30-day mortality was also observed in the subgroups of patients with sepsis (HR, 0.21; 95% CI, 0.06–0.74), acute-on-chronic liver failure (HR, 0.29; 95% CI, 0.03–0.99), and a model for end-stage liver disease score ≥25 (HR, 0.26; 95% CI, 0.08–0.92). At competing risk analysis, C/EI of beta-lactams was associated with significantly higher rates of hospital discharge (subdistribution hazard [95% CI], 1.62 [1.06–2.47]). [Conclusions] C/EI of beta-lactams in cirrhotic patients with BSI may improve outcomes and facilitate earlier discharge., J. R.-B. and P. R. receive funds for research from Plan Nacional de I+D+i 2013‐2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001), cofinanced by European Development Regional Fund “A Way to Achieve Europe,” Operative Programme Intelligent Growth 2014–2020.

Published
2019

34. Clinical Experience of Colistin-Glycopeptide Combination in Critically Ill Patients Infected with Gram-Negative Bacteria

Author

Maddalena Giannella, Nicola Petrosillo, Elisabetta Grilli, A Cagkan Inkaya, Mario Antonini, Laura Belancic, Murat Akova, Gennaro De Pascale, Bruno Baršić, Mario Tumbarello, Massimo Antonelli, İç Hastalıkları, Petrosillo, Nicola, Giannella, Maddalena, Antonelli, Massimo, Antonini, Mario, Barsic, Bruno, Belanci, Laura, Cagkan, Inkaya A., De Pascale, Gennaro, Grilli, Elisabetta, Tumbarello, Mario, and Akova, Murat

Subjects
Acinetobacter baumannii, Male, Kidney, Gastroenterology, Pharmacology (medical), Pharmacology & Pharmacy, biology, Hazard ratio, Glycopeptides, Pneumonia, Ventilator-Associated, Middle Aged, Anti-Bacterial Agents, glycopeptide, Klebsiella pneumoniae, Infectious Diseases, Treatment Outcome, Pseudomonas aeruginosa, Coinfection, Critical Illne, Drug Therapy, Combination, Female, Survival Analysi, medicine.drug, Human, colistin, vancomycin, MRSA, medicine.medical_specialty, Critical Illness, Clinical Therapeutics, Settore MED/17 - MALATTIE INFETTIVE, Microbiology, Nephrotoxicity, Pharmacotherapy, Intensive care, Internal medicine, Anti-Bacterial Agent, medicine, Gram-Negative Bacterial Infection, Humans, Aged, Proportional Hazards Models, Pharmacology, critically, business.industry, Colistin, medicine.disease, biology.organism_classification, gram negaative, Survival Analysis, Respiratory failure, Proportional Hazards Model, business, Gram-Negative Bacterial Infections
Abstract

A colistin-glycopeptide combination (CGC) has been shown in vitro to be synergistic against multidrug-resistant Gram-negative bacteria (MDR GNB), especially Acinetobacter baumannii , and to prevent further resistance. However, clinical data are lacking. We carried out a retrospective multicenter study of patients hospitalized in intensive care units (ICUs) who received colistin for GNB infection over a 1-year period, to assess the rates of nephrotoxicity and 30-day mortality after treatment onset among patients treated with and without CGC for ≥48 h. Of the 184 patients treated with colistin, GNB infection was documented for 166. The main causative agents were MDR A. baumannii (59.6%), MDR Pseudomonas aeruginosa (18.7%), and carbapenem-resistant Klebsiella pneumoniae (14.5%); in 16.9% of patients, a Gram-positive bacterium (GPB) coinfection was documented. Overall, 68 patients (40.9%) received CGC. Comparison of patients treated with and without CGC showed significant differences for respiratory failure (39.7% versus 58.2%), ventilator-associated pneumonia (54.4% versus 71.4%), MDR A. baumannii infection (70.6% versus 52%), and GPB coinfection (41.2% versus 0%); there were no differences for nephrotoxicity (11.8% versus 13.3%) and 30-day mortality (33.8% versus 29.6%). Cox analysis performed on patients who survived for ≥5 days after treatment onset showed that the Charlson index (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.01 to 1.44; P = 0.001) and MDR A. baumannii infection (HR, 2.51; 95% CI, 1.23 to 5.12; P = 0.01) were independent predictors of 30-day mortality, whereas receiving CGC for ≥5 days was a protective factor (HR, 0.42; 95% CI, 0.19 to 0.93; P = 0.03). We found that CGC was not associated with higher nephrotoxicity and was a protective factor for mortality if administered for ≥5 days.

Published
2014

35. Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children.

Author

Andabaka T, Nickerson JW, Rojas-Reyes MX, Rueda JD, Bacic Vrca V, and Barsic B

Subjects
Child, Preschool, Hospitalization statistics & numerical data, Humans, Infant, Infant, Newborn, Palivizumab, Randomized Controlled Trials as Topic, Antibodies, Monoclonal, Humanized therapeutic use, Antiviral Agents therapeutic use, Respiratory Syncytial Virus Infections prevention & control
Abstract

Background: Respiratory syncytial virus (RSV) is one of the most important viral pathogens causing acute respiratory infections in children. It results in about 3.4 million hospitalisations annually in children under five. Palivizumab is an anti-RSV monoclonal antibody, administered intramuscularly at a dose of 15 mg/kg once every 30 days. The efficacy and safety of palivizumab has been evaluated in multicentre, randomised controlled trials (RCTs) and a large number of economic evaluations (EEs) have tested its cost-effectiveness., Objectives: To assess the effectiveness and safety of palivizumab prophylaxis compared with placebo, or another type of prophylaxis, in reducing the risk of complications (hospitalisation due to RSV infection) in high-risk infants and children. To assess the cost-effectiveness (or cost-utility) of palivizumab prophylaxis compared with no prophylaxis in infants and children in different risk groups., Search Methods: We searched CENTRAL 2012, Issue 7, MEDLINE (1996 to July week 4, 2012), EMBASE (1996 to August 2012), CINAHL (1996 to August 2012) and LILACS (1996 to August 2012) for studies of effectiveness and safety. We searched the NHS Economic Evaluations Database (NHS EED 2012, Issue 4), Health Economics Evaluations Database (HEED, 9 August 2012) and Paediatric Economic Database Evaluations (PEDE, 1980 to 2009), MEDLINE (1996 to July week 4, 2012) and EMBASE (1996 to August 2012) for economic evaluations., Selection Criteria: We included RCTs comparing palivizumab prophylaxis with a placebo, no prophylaxis or another type of prophylaxis in preventing serious lower respiratory tract disease caused by RSV in paediatric patients at high risk. We included cost-effectiveness analyses and cost-utility analyses comparing palivizumab prophylaxis with no prophylaxis., Data Collection and Analysis: Two review authors independently assessed risk of bias for the included studies and extracted data for both the RCTs and EEs. We calculated risk ratios (RRs) and their associated 95% confidence intervals (CIs) for dichotomous outcomes and for adverse events (AEs). We provided a narrative summary of results for continuous outcomes, due to missing data on standard deviations. We performed fixed-effect meta-analyses for the estimation of pooled effects whenever there was no indication of heterogeneity between included RCTs. We summarised the results reported in included EEs, such as incremental costs, incremental effectiveness, and incremental cost-effectiveness and/or cost-utility ratios (ICERs), and we calculated ICER present values in 2011 Euros for all studies., Main Results: Of the seven available RCTs, three compared palivizumab with a placebo in a total of 2831 patients, and four compared palivizumab with motavizumab in a total of 8265 patients. All RCTs were sponsored by the drug manufacturing company. The overall quality of RCTs was good, but for most of the outcomes assessed only data from two studies contributed to the analysis. Palivizumab prophylaxis was associated with a statistically significant reduction in RSV hospitalisations (RR 0.49, 95% CI 0.37 to 0.64) when compared to placebo. When compared to motavizumab, palivizumab recipients showed a non-significant increase in the risk of RSV hospitalisations (RR 1.36, 95% CI 0.97 to 1.90). In both cases, the proportion of children with any AE or any AE related to the study drug was similar between the two groups.In terms of economic evidence, we included 34 studies that reported cost-effectiveness and/or cost-utility data for palivizumab prophylaxis compared with no prophylaxis, in high-risk children with different underlying medical conditions. The overall quality of EEs was good, but the variations in modelling approaches were considerable across the studies, leading to big differences in cost-effectiveness results. The cost-effectiveness of palivizumab prophylaxis depends on the consumption of resources taken into account by the study authors; and on the cost-effectiveness threshold set by the healthcare sector in each country., Authors' Conclusions: There is evidence that palivizumab prophylaxis is effective in reducing the frequency of hospitalisations due to RSV infection, i.e. in reducing the incidence of serious lower respiratory tract RSV disease in children with chronic lung disease, congenital heart disease or those born preterm.Results from economic evaluations of palivizumab prophylaxis are inconsistent, implying that economic findings must be interpreted with caution. ICER values varied considerably across studies, from highly cost-effective to not cost-effective. The availability of low-cost palivizumab would reduce its inequitable distribution, so that RSV prophylaxis would be available to the poorest countries where children are at greatest risk.

Published
2013
Full Text
View/download PDF

36. Virological and immunological characteristics of fatal Epstein-Barr virus mononucleosis in a 17-year-old Caucasian male presenting with meningoencephalitis and hemophagocytic syndrome.

Author

Vince A, Lepej SZ, Kurelac I, Barsic B, Kozic S, Klinar I, and Zarkovic K

Subjects
Adolescent, Biopsy, Brain pathology, Brain virology, Humans, Infectious Mononucleosis pathology, Interferon-gamma metabolism, Lymphocyte Subsets immunology, Lymphocyte Subsets metabolism, Lymphohistiocytosis, Hemophagocytic pathology, Male, Meningoencephalitis pathology, Herpesvirus 4, Human immunology, Infectious Mononucleosis immunology, Lymphohistiocytosis, Hemophagocytic immunology, Lymphohistiocytosis, Hemophagocytic virology, Meningoencephalitis immunology, Meningoencephalitis virology
Abstract

In this report, the authors present a detailed immunological and virological assessment of an immunocompetent 17-year-old Caucasian male with a fatal Epstein-Barr virus (EBV) infectious mononucleosis presenting with meningoencephalitis and hemophagocytic syndrome. The patient with serologically confirmed EBV infectious mononucleosis was admitted to the hospital because of 3 weeks' fever. Fine-needle aspiration of lymph nodes showed reactive hyperplasia with prominent hemophagocytosis. Percentages of intracellular interferon-gamma (IFN-gamma) in CD4(+) and CD8(+) T cells in the peripheral blood progressively increased during the course of disease (10.2% and 8.5% on day 35; 30.1% and 53.2% on day 44; 42.2% and 75.2% on day 50; 36.1% and 50.6% on day 59, respectively). On day 50, the patient developed meningoencephalitis. Brain computed tomography (CT) was normal. Brain magnetic resonance imaging (MRI) showed multifocal inflammatory lesions in frontal and temporal cortex of the right hemisphere as well as severe perivascular inflammatory reaction. The patient was treated with steroids, cyclosporin A, and methotrexate intratecally. Following treatment, EBV viremia in the blood and cerebrospinal fluid (CSF) decreased from pretreatment values (54,490 copies of EBV DNA/ml and 39,500 copies/ml, respectively) to 8715 copies/ml in the blood and 14,690 in the CSF. Despite treatment, the patient remained unconscious and died of sepsis and pneumonia 3 months after initial symptoms. Immunohistochemical staining showed the presence of EBV in both perivascular infiltrates and grey matter. Enhanced Th1 response as shown by high levels of IFN-gamma in peripheral blood lymphocytes may be a predictor of severe complications during acute EBV infection. Early implementation of immunosuppressive therapy in these patients should be considered.

Published
2007
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results