8 results on '"Palacios-Baena, Zaira R."'
Search Results
2. Pseudomonas aeruginosa Bloodstream Infections in Patients with Cancer: Differences between Patients with Hematological Malignancies and Solid Tumors
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Royo-Cebrecos, Cristina, Laporte-Amargós, Julia, Peña, Marta, Ruiz-Camps, Isabel, Puerta-Alcalde, Pedro, Abdala, Edson, Oltolini, Chiara, Akova, Murat, Montejo, Miguel, Mikulska, Malgorzata, Martín-Dávila, Pilar, Herrera, Fabian, Gasch, Oriol, Drgona, Lubos, Morales, Hugo Manuel Paz, Brunel, Anne-Sophie, García, Estefanía, Isler, Burcu, Kern, Winfried V, Palacios-Baena, Zaira R, de la Calle, Guillermo Maestro, Montero, Maria Milagro, Kanj, Souha S, Sipahi, Oguz R, Calik, Sebnem, Márquez-Gómez, Ignacio, Marin, Jorge I, Gomes, Marisa Z R, Hemmatti, Philipp, Araos, Rafael, Peghin, Maddalena, Del Pozo, José Luis, Yáñez, Lucrecia, Tilley, Robert, Manzur, Adriana, Novo, Andrés, Carratalà, Jordi, Gudiol, Carlota, IRONIC study group, and Universidad de Cantabria
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Microbiology (medical) ,Adult ,Neutropenic Patients ,Pseudomonas aeruginosa ,bacteremia ,bloodstream infection ,cancer ,solid tumor ,hematologic malignancy ,Resistance ,Gram-Negative Bacilli ,Bacteremia ,Bloodstream infection ,Immunology and Allergy ,Risk-Factors ,Hematologic malignanc ,Mortality ,Càncer ,Molecular Biology ,Tumors ,Cancer ,General Immunology and Microbiology ,Solid tumor ,Infectious Diseases ,Therapy - Abstract
Objectives: To assess the clinical features and outcomes of Pseudomonas aeruginosa bloodstream infection (PA BSI) in neutropenic patients with hematological malignancies (HM) and with solid tumors (ST), and identify the risk factors for 30-day mortality. Methods: We performed a large multicenter, retrospective cohort study including onco-hematological neutropenic patients with PA BSI conducted across 34 centers in 12 countries (January 2006-May 2018). Episodes occurring in hematologic patients were compared to those developing in patients with ST. Risk factors associated with 30-day mortality were investigated in both groups. Results: Of 1217 episodes of PA BSI, 917 occurred in patients with HM and 300 in patients with ST. Hematological patients had more commonly profound neutropenia (0.1 x 10(9) cells/mm) (67% vs. 44.6%; p < 0.001), and a high risk Multinational Association for Supportive Care in Cancer (MASCC) index score (32.2% vs. 26.7%; p = 0.05). Catheter-infection (10.7% vs. 4.7%; p = 0.001), mucositis (2.4% vs. 0.7%; p = 0.042), and perianal infection (3.6% vs. 0.3%; p = 0.001) predominated as BSI sources in the hematological patients, whereas pneumonia (22.9% vs. 33.7%; p < 0.001) and other abdominal sites (2.8% vs. 6.3%; p = 0.006) were more common in patients with ST. Hematological patients had more frequent BSI due to multidrug-resistant P. aeruginosa (MDRPA) (23.2% vs. 7.7%; p < 0.001), and were more likely to receive inadequate initial antibiotic therapy (IEAT) (20.1% vs. 12%; p < 0.001). Patients with ST presented more frequently with septic shock (45.8% vs. 30%; p < 0.001), and presented worse outcomes, with increased 7-day (38% vs. 24.2%; p < 0.001) and 30-day (49% vs. 37.3%; p < 0.001) case-fatality rates. Risk factors for 30-day mortality in hematologic patients were high risk MASCC index score, IEAT, pneumonia, infection due to MDRPA, and septic shock. Risk factors for 30-day mortality in patients with ST were high risk MASCC index score, IEAT, persistent BSI, and septic shock. Therapy with granulocyte colony-stimulating factor was associated with survival in both groups. Conclusions: The clinical features and outcomes of PA BSI in neutropenic cancer patients showed some differences depending on the underlying malignancy. Considering these differences and the risk factors for mortality may be useful to optimize their therapeutic management. Among the risk factors associated with overall mortality, IEAT and the administration of granulocyte colony-stimulating factor were the only modifiable variables., ESCMID Study Group for Immunocompromised Hosts (ESGICH); Spanish Network for Research in Infectious Diseases; Rio Hortega program of the Instituto de Salud Carlos III; ESCMID Study Group for Bloodstream Infections, Endocarditis, and Sepsis (ESGBIES), We thank the ESCMID Study Group for Bloodstream Infections, Endocarditis, and Sepsis (ESGBIES) and the ESCMID Study Group for Immunocompromised Hosts (ESGICH) for supporting the study. We thank the Centres de Recerca de Catalunya (CERCA) Program and Generalitat de Catalunya for the institutional support. We thank the Spanish Network for Research in Infectious Diseases and the Rio Hortega program of the Instituto de Salud Carlos III for the financial support of pre-doctoral student J. Laporte-Amargos and A. Bergas.
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- 2022
3. CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3
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Cañada García, Javier E., Moure, Zaira, Sola Campoy, Pedro J., Delgado Valverde, Mercedes, Cano, María E., Gijón, Desirèe, González, Mónica, Gracia Ahufinger, Irene, Larrosa, Nieves, Mulet, Xavier, Pitart, Cristina, Rivera, Alba, Bou, Germán, Calvo, Jorge, Cantón, Rafael, González-López, Juan José, Martínez-Martínez, Luis, Navarro, Ferran, Oliver, Antonio, Palacios Baena, Zaira R., Pascual, Alvaro, Ruiz Carrascoso, Guillermo, Vila Estapé, Jordi, Aracil, Belén, Pérez-Vázquez, María, Oteo Iglesias, Jesús, GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group, Instituto de Salud Carlos III, Red Española de Investigación en Patología Infecciosa, European Commission, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (España), Universidad de Sevilla. Departamento de Microbiología, Universidad de Sevilla. CTS210: Resistencia a antimicrobianos., Ministerio de Economía y Competitividad (MINECO). España, Universidad de Cantabria, Institut Català de la Salut, [Cañada-García JE, Moure Z, Sola-Campoy PJ] Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain. [Delgado-Valverde M] Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Instituto de Biomedicina de Sevilla (Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla), Seville, Spain. CIBER de Enfermedades Infecciosas (CIBERINFEC), REIPI, Instituto de Salud Carlos III, Madrid, Spain. [Cano ME] Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain. [Gijón D] CIBER de Enfermedades Infecciosas (CIBERINFEC), REIPI, Instituto de Salud Carlos III, Madrid, Spain. Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. [Larrosa N, González-López JJ] CIBER de Enfermedades Infecciosas (CIBERINFEC), REIPI, Instituto de Salud Carlos III, Madrid, Spain. Servei de Microbiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Bellaterra, Spain, Vall d'Hebron Barcelona Hospital Campus, Plan Nacional de I+D+i (España), Ministerio de Economía y Competitividad (España), Red de Investigación Cooperativa en Investigación en Patología Infecciosa (España), Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF), Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas), and Unión Europea
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Microbiology (medical) ,Enzimologia ,Human genome ,Bacteria::bacterias gramnegativas::bacilos gramnegativos anaerobios facultativos::Enterobacteriaceae::Escherichia::Escherichia coli [ORGANISMOS] ,acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antibacterianos [COMPUESTOS QUÍMICOS Y DROGAS] ,Otros calificadores::Otros calificadores::Otros calificadores::/enzimología [Otros calificadores] ,Carbapenemases ,Genoma humà ,Microbiology ,Enterobacteriàcies ,Klebsiella pneumoniae ,Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Escherichia::Escherichia coli [ORGANISMS] ,Escheríchia coli ,Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Klebsiella::Klebsiella pneumoniae [ORGANISMS] ,Enterobacteriaceae ,Whole genome sequencing ,Bacteria::bacterias gramnegativas::bacilos gramnegativos anaerobios facultativos::Enterobacteriaceae::Klebsiella::Klebsiella pneumoniae [ORGANISMOS] ,Escherichia coli ,Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [CHEMICALS AND DRUGS] ,Antibiòtics betalactàmics ,Medicaments antibacterians ,CARB-ES-19 study ,Other subheadings::Other subheadings::Other subheadings::/enzymology [Other subheadings] ,High-risk clones ,Beta lactam antibiotics - Abstract
CARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain., This research was supported by grants from the Instituto de Salud Carlos III (numbers PI18CIII/00030 and PI21CIII/00039). It was also supported by Plan Nacional de I + D + i 2013–2016, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía y Competitividad, Spanish Network for Research in Infectious Diseases (grants RD16CIII/0004/0002, RD16/0016/0001, RD16/0016/0003, RD16/0016/0004, RD16/0016/0006, RD16/0016/0007, RD16/0016/0008, RD16/0016/0010, and RD16/0016/0011). Cofinanced by the European Development Regional Fund “A way to achieve Europe,” Operative Program Intelligent Growth 2014–2020. CIBER – Consorcio Centro de Investigación Biomédica en Red (CB21/13/00095, CB21/13/00012, CB21/13/00049, CB21/13/00054, CB21/13/00055, CB21/13/00068, CB21/13/00081, CB21/13/00084, and CB21/13/00099) (CIBERINFEC) and Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea – NextGenerationEU also supported this work.
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- 2022
4. PRAISE: providing a roadmap for automated infection surveillance in Europe
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van Mourik, Maaike S M, van Rooden, Stephanie M, Abbas, Mohamed, Aspevall, Olov, Astagneau, Pascal, Bonten, Marc J M, Carrara, Elena, Gomila-Grange, Aina, de Greeff, Sabine C, Gubbels, Sophie, Harrison, Wendy, Humphreys, Hilary, Johansson, Anders, Koek, Mayke B G, Kristensen, Brian, Lepape, Alain, Lucet, Jean-Christophe, Mookerjee, Siddharth, Naucler, Pontus, Palacios-Baena, Zaira R, Presterl, Elisabeth, Pujol, Miquel, Reilly, Jacqui, Roberts, Christopher, Tacconelli, Evelina, Teixeira, Daniel, Tängdén, Thomas, Valik, John Karlsson, Behnke, Michael, Gastmeier, Petra, PRAISE network, ZonMw, Innovative Medicines Initiative, European Commission, European Federation of Pharmaceutical Industries and Associations, VINNOVA (Sweden), Pfizer, Astellas Pharma, University Medical Center [Utrecht], National Institute for Public Health and the Environment [Bilthoven] (RIVM), Geneva University Hospital (HUG), Public Health Agency of Sweden, Centre d'appui pour la prévention des infections associées aux soins [Île-de-France] (Cpias Île-de-France), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Department of Diagnostics and Public Health [Verona] (UNIVR | DDSP), University of Verona (UNIVR), Institut d'Investigació Biomèdica de Bellvitge [Barcelone] (IDIBELL), Statens Serum Institut [Copenhagen], Public Health Wales, Royal College of Surgeons in Ireland (RCSI), Umeå University, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hammersmith Hospital NHS Imperial College Healthcare, Karolinska Institutet [Stockholm], Karolinska University Hospital [Stockholm], Biomedicine Institute of Sevilla [Seville, Spain], Medizinische Universität Wien = Medical University of Vienna, Glasgow Caledonian University (GCU), German Center for Infectious Research - partner site Tübingen [Tübingen, Allemagne] (DZIF), Universitätsklinikum Tübingen - University Hospital of Tübingen, Eberhard Karls Universität Tübingen = Eberhard Karls University of Tuebingen, Uppsala Universitet [Uppsala], Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Freie Universität Berlin, and Humboldt-Universität zu Berlin
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Infektionsmedicin ,Medical care ,MESH: Infection Control ,Automation ,0302 clinical medicine ,MESH: Automation ,Bloodstream infection ,Infection control ,030212 general & internal medicine ,Praise ,media_common ,0303 health sciences ,Cross Infection ,Data ,Surveillance ,virus diseases ,General Medicine ,Quality ,Infeccions ,3. Good health ,Europe ,Infectious Diseases ,Vigilància electrònica ,Epidemiological Monitoring ,Electronic surveillance ,Medical emergency ,Surgical site infection ,Microbiology (medical) ,Healthcare associated infections ,Automated ,Infectious Medicine ,animal structures ,media_common.quotation_subject ,Electronic health record ,Infections ,03 medical and health sciences ,medicine ,Humans ,Healthcare-associated infection ,Infection surveillance ,Infection Control ,MESH: Humans ,030306 microbiology ,business.industry ,MESH: Cross Infection ,medicine.disease ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,MESH: Epidemiological Monitoring ,MESH: Europe ,business - Abstract
[Introduction] Healthcare-associated infections (HAI) are among the most common adverse events of medical care. Surveillance of HAI is a key component of successful infection prevention programmes. Conventional surveillance – manual chart review – is resource intensive and limited by concerns regarding interrater reliability. This has led to the development and use of automated surveillance (AS). Many AS systems are the product of in-house development efforts and heterogeneous in their design and methods. With this roadmap, the PRAISE network aims to provide guidance on how to move AS from the research setting to large-scale implementation, and how to ensure the delivery of surveillance data that are uniform and useful for improvement of quality of care., [Methods] The PRAISE network brings together 30 experts from ten European countries. This roadmap is based on the outcome of two workshops, teleconference meetings and review by an independent panel of international experts., [Results] This roadmap focuses on the surveillance of HAI within networks of healthcare facilities for the purpose of comparison, prevention and quality improvement initiatives. The roadmap does the following: discusses the selection of surveillance targets, different organizational and methodologic approaches and their advantages, disadvantages and risks; defines key performance requirements of AS systems and suggestions for their design; provides guidance on successful implementation and maintenance; and discusses areas of future research and training requirements for the infection prevention and related disciplines. The roadmap is supported by accompanying documents regarding the governance and information technology aspects of implementing AS., [Conclusions] Large-scale implementation of AS requires guidance and coordination within and across surveillance networks. Transitions to large-scale AS entail redevelopment of surveillance methods and their interpretation, intensive dialogue with stakeholders and the investment of considerable resources. This roadmap can be used to guide future steps towards implementation, including designing solutions for AS and practical guidance checklists., This network has been supported under the 7th transnational call within the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR), Network Call on Surveillance (2018) and was thereby funded by ZonMw (grant 549007001). This project also received support from the COMBACTE MAGNET EPI-Net project funded by the Innovative Medicines Initiative Joint Undertaking under grant agreement 115523 | 115620 | 115737 | 777362, resources of which are composed of financial contribution from the European Union Seventh Framework Programme (FP7/2007-2013) and EFPIA companies in kind contribution. J.K.V. was supported by grants from Region Stockholm and Vinnova. H.H. reports grants from Pfizer and Astellas as well as personal fees from Pfizer outside the submitted work.
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- 2021
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5. Governance aspects of large-scale implementation of automated surveillance of healthcare-associated infections
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van Rooden, Stephanie M, Aspevall, Olov, Carrara, Elena, Gubbels, Sophie, Johansson, Anders, Lucet, Jean-Christophe, Mookerjee, Siddharth, Palacios-Baena, Zaira R, Presterl, Elisabeth, Tacconelli, Evelina, Abbas, Mohamed, Behnke, Michael, Gastmeier, Petra, van Mourik, Maaike S M, and PRAISE network
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0301 basic medicine ,Microbiology (medical) ,Healthcare associated infections ,Infectious Medicine ,Scale (ratio) ,Computer science ,030106 microbiology ,Algorithm ,Governance ,Healthcare-associated infections ,Regulation ,Surveillance ,Infektionsmedicin ,Health records ,03 medical and health sciences ,Automation ,0302 clinical medicine ,Humans ,030212 general & internal medicine ,Cross Infection ,Infection Control ,Corporate governance ,General Medicine ,Data science ,Europe ,Infectious Diseases ,Epidemiological Monitoring - Abstract
[Objectives] Surveillance of healthcare-associated infections (HAI) is increasingly automated by applying algorithms to routine-care data stored in electronic health records. Hitherto, initiatives have mainly been confined to single healthcare facilities and research settings, leading to heterogeneity in design. The PRAISE network – Providing a Roadmap for Automated Infection Surveillance in Europe – designed a roadmap to provide guidance on how to move automated surveillance (AS) from the research setting to large-scale implementation. Supplementary to this roadmap, we here discuss the governance aspects of automated HAI surveillance within networks, aiming to support both the coordinating centres and participating healthcare facilities as they set up governance structures and to enhance involvement of legal specialists., [Methods] This article is based on PRAISE network discussions during two workshops. A taskforce was installed that further elaborated governance aspects for AS networks by reviewing documents and websites, consulting experts and organizing teleconferences. Finally, the article has been reviewed by an independent panel of international experts., [Results] Strict governance is indispensable in surveillance networks, especially when manual decisions are replaced by algorithms and electronically stored routine-care data are reused for the purpose of surveillance. For endorsement of AS networks, governance aspects specifically related to AS networks need to be addressed. Key considerations include enabling participation and inclusion, trust in the collection, use and quality of data (including data protection), accountability and transparency., [Conclusions] This article on governance aspects can be used by coordinating centres and healthcare facilities participating in an AS network as a starting point to set up governance structures. Involvement of main stakeholders and legal specialists early in the development of an AS network is important for endorsement, inclusivity and compliance with the laws and regulations that apply.
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- 2021
6. How are trainees in clinical microbiology and infectious diseases supervised in Europe? An international cross-sectional questionnaire survey by the Trainee Association of ESCMID
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Palacios-Baena, Zaira R, Zapf, Thea Christine, Ong, David S Y, Maraolo, Alberto E, Rönnberg, Caroline, Çimen, Cansu, Pulcini, Céline, Rodríguez-Baño, Jesús, Sanguinetti, Maurizio, Trainee Association of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain., Department of Medical Microbiology and Infection Prevention, University Hospital of Marburg, Marburg, Germany., Department of Medical Microbiology and Infection Control, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045 PM, Rotterdam, The Netherlands., Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands., Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples 'Federico II', Naples, Italy., Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden., Infectious Diseases and Clinical Microbiology Clinic, Istanbul Training and Research Hospital, Istanbul, Turkey., CHRU-Nancy, Infectious Diseases Department, Université de Lorraine, 54000, Nancy, France., and Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Institute of Microbiology, Rome, Italy.
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,Attitude of Health Personnel ,media_common.quotation_subject ,[SDV]Life Sciences [q-bio] ,education ,030106 microbiology ,Specialty ,Supervision ,Communicable Diseases ,Likert scale ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Medical Laboratory Science ,Humans ,Quality (business) ,030212 general & internal medicine ,Clinical microbiology ,Survey ,Curriculum ,ComputingMilieux_MISCELLANEOUS ,media_common ,Medical education ,Supervisor ,business.industry ,4. Education ,Internship and Residency ,Questionnaire ,General Medicine ,Trainees ,3. Good health ,Europe ,Eastern european ,Cross-Sectional Studies ,Infectious Diseases ,Organization and Administration ,Publishing ,Infectious diseases ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Clinical Competence ,business ,Psychology - Abstract
The purpose of this study was to map the supervision of European trainees in clinical microbiology and infectious diseases during their training. An international cross-sectional questionnaire survey of 38 questions was distributed among trainees and recently graduated medical specialists from European countries. Descriptive analyses were performed on both the total group of respondents and regionally. In total, 393 respondents from 37 different countries were included. The median of overall satisfaction with the supervisor was 4 (interquartile range 3-4) on a Likert scale (range 1, not satisfied at all-5, completely satisfied). Overall, merely 34% of respondents received constructive feedback from their supervisor on a regularly basis, 36% could evaluate their own supervisor, and just 63% were evaluated on their skills using a written plan. Fifty-two percent did not receive the opportunity to do a part of the specialty training abroad and 63% received support from their supervisors to be involved in research projects or publishing papers. A considerable proportion of trainees, mainly in Southern and Eastern European regions, felt that they did not receive sufficient supervision. This information may be useful in the pursuit of harmonizing the quality of training, achieving a common curriculum, and identifying robust and objective criteria to coach and evaluate trainees in a proper way.
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- 2018
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7. Clinical outcome in solid organ transplant recipients affected by COVID-19 compared to general population: a systematic review and meta-analysis
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Milo Gatti, Matteo Rinaldi, Linda Bussini, Cecilia Bonazzetti, Renato Pascale, Zeno Pasquini, Francesca Faní, Mariana Nunes Pinho Guedes, Anna Maria Azzini, Elena Carrara, Zaira R. Palacios-Baena, Giulia Caponcello, Eduardo Reyna-Villasmil, Evelina Tacconelli, Jesús Rodríguez-Baño, Pierluigi Viale, Maddalena Giannella, Natascia Caroccia, Federica Arbizzani, Maria Eugenia Giacomini, Oana Vatamanu, Elisa Razzaboni, Maria Elena De Rui, Anna Gorska, Natalia Maldonado, Paula Olivares, David Gutiérrez-Campos, Ana Belén Martín-Gutiérrez, Virginia Palomo, Almudena Serna, Gatti, Milo, Rinaldi, Matteo, Bussini, Linda, Bonazzetti, Cecilia, Pascale, Renato, Pasquini, Zeno, Faní, Francesca, Pinho Guedes, Mariana Nune, Azzini, Anna Maria, Carrara, Elena, Palacios-Baena, Zaira R, Caponcello, Giulia, Reyna-Villasmil, Eduardo, Tacconelli, Evelina, Rodríguez-Baño, Jesú, Viale, Pierluigi, and Giannella, Maddalena
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Microbiology (medical) ,Solid organ transplant recipients ,Clinical outcome ,Solid organ transplant recipient ,COVID-19 ,Organ Transplantation ,General Medicine ,30-Day mortality rate ,Superinfections ,Transplant Recipients ,Infectious Diseases ,Humans ,Prospective Studies ,Retrospective Studies - Abstract
Background: A significant increased risk of complications and mortality in immunocompromised patients affected by COVID-19 has been described. However, the impact of COVID-19 in solid organ transplant (SOT) recipients is an issue still on debate, due to conflicting evidence emerged from different observational studies. Objective: We performed a systematic review with meta-analysis to assess the clinical outcome in SOT recipients with COVID-19 compared to general population. Data source: PubMed-MEDLINE and Scopus were independently searched until 13 October 2021. Study eligibility criteria: Prospective or retrospective observational studies comparing clinical outcome in SOT recipients versus general populations affected by COVID-19. Primary endpoint was 30-day mortality. Participants: Patients with confirmed COVID-19. Intervention: Solid organ transplant recipients. Assessment of risk of bias: Quality of included studies was independently assessed according to ROBINS-I tool for observational studies. Methods of data synthesis: Meta-analysis was performed by pooling odds ratio (OR) retrieved from studies providing adjustment for confounders using a random-effect model with inverse variance method. Multiple subgroup and sensitivity analyses were conducted to investigate source of heterogeneity. Results: 3,501 articles were screened, and thirty-one observational studies (N=590,375; 5,759 SOT recipients vs. 584,616 general population) were included in the meta-analyses. No difference in 30-day mortality rate was found in primary analysis including studies providing adjustment for confounders (N=17; 3,752 SOT recipients vs. 159,745 general population; OR 1.13, 95%CI 0.94-1.35; I2=33.9%). No evidence of publication bias was reported. Higher risk of ICU admission (OR 1.56, 95%CI 1.03-2.63) and occurrence of acute kidney injury (OR 2.50 95%CI 1.81-3.45) was found in SOT recipients. Conclusions: No increased risk in mortality was found in SOT recipients affected by COVID-19 compared to general population when adjusted for demographic and clinical features and COVID-19 severity.
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- 2022
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8. Risk factors for carbapenem-resistant Gram-negative bacterial infections: a systematic review
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Katy Wilson, Christopher Longshaw, Pierluigi Viale, Maddalena Giannella, Zaira R. Palacios-Baena, Jesús Rodríguez-Baño, Davide Manissero, Rachael McCool, Sara Lopes, Palacios-Baena, Zaira R., Giannella, Maddalena, Manissero, Davide, Rodríguez-Baño, Jesu, Viale, Pierluigi, Lopes, Sara, Wilson, Katy, McCool, Rachael, Longshaw, Christopher, and Universidad de Sevilla. Departamento de Medicina
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Colonization ,0301 basic medicine ,Carbapenem ,carbapenem resistance, risk factors ,Resistance ,ICU stay ,Antimicrobial resistance ,law.invention ,Mechanical ventilation ,0302 clinical medicine ,Risk Factors ,law ,Prospective Studies ,030212 general & internal medicine ,Cross Infection ,APACHE II ,General Medicine ,Intensive care unit ,Intensive Care Units ,Infectious Diseases ,Systematic review ,medicine.drug ,Microbiology (medical) ,medicine.medical_specialty ,Healthcare exposure ,030106 microbiology ,MEDLINE ,03 medical and health sciences ,Invasive devices ,Antibiotic resistance ,Internal medicine ,Drug Resistance, Bacterial ,Gram-Negative Bacteria ,medicine ,Humans ,Risk factor ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Length of Stay ,Respiration, Artificial ,Risk factors ,Carbapenems ,Case-Control Studies ,Gram-Negative Bacterial Infections ,business ,Dialysis - Abstract
Background Rapid and widespread increases in carbapenem resistance (CR) necessitate identification of risk factors to guide appropriate interventions. Objectives We aimed to identify risk factors for CR Gram-negative infection through a systematic literature review. Data sources We searched MEDLINE (via OvidSP and PubMed) and Embase (via OvidSP) databases and the Cochrane Central Register of Controlled Trials. Study eligibility criteria Prospective or retrospective cohort and case–control studies reporting quantitative data on risk factors associated with infections due to CR Gram-negative pathogens in hospitalized patients were eligible. Participants Studies included hospitalized patients with CR infection caused by Gram-negative bacterial pathogens (Enterobacterales and non-fermenters). Methods Searches were conducted in January 2018/December 2019 to identify studies published since 2007. Risk factor data were extracted and grouped by factor. The primary metric was proportion of studies reporting a significant association with CR infection for each factor. Results In total, 92 studies were identified. Risk factors most frequently reported as significantly associated with CR infection (>10 studies) were previous antibiotic use (91.1%; 72/79 studies); previous carbapenem use (82.6%; 57/69); previous colonization (72.7%; 8/11); mechanical ventilation (66.7%; 36/54); previous intensive care unit stay (64.4%; 38/59); dialysis (61.1%; 11/18); catheter (58.0%; 40/69); length of stay in hospital (54.5%; 30/55); comorbidities (52.7%; 39/74); APACHE II (51.7%; 15/29); and intubation (51.4%; 18/35). Risk factors were mostly consistent across different species and sites of infection. Conclusions Several variables, particularly previous antibiotic use, are strong risk factors for CR infection. Interventions to mitigate against CR infection should target these factors.
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- 2021
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