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1. Risk factors and clinical impact of multidrug resistance in healthcare-associated bacteraemic urinary tract infections: a post-hoc analysis of a multicentre prospective cohort in Spain

Author

Gómez-Zorrilla, S., Becerra-Aparicio, F., Sendra, E., Zamorano, L., Grau, I., Pintado, V., Padilla, B., Benito, N., Boix-Palop, L., Fariñas, M.C., Peñaranda, M., Gamallo, M.R., Martinez, J.A., Morte-Romea, E., Del Pozo, J.L., López Montesinos, I., Durán-Jordà, X., Ponz, R., Cotarelo, M., Cantón, R., Oliver, A., Ruiz-Garbajosa, P., and Horcajada, J.P.

Published
2024
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6. Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Author

Aguado, J.M., Silva, J.T., Fernández-Ruiz, M., Cordero, E., Fortún, J., Gudiol, C., Martínez-Martínez, L., Vidal, E., Almenar, L., Almirante, B., Cantón, R., Carratalá, J., Caston, J.J., Cercenado, E., Cervera, C., Cisneros, J.M., Crespo-Leiro, M.G., Cuervas-Mons, V., Elizalde-Fernández, J., Fariñas, M.C., Gavaldà, J., Goyanes, M.J., Gutiérrez-Gutiérrez, B., Hernández, D., Len, O., López-Andujar, R., López-Medrano, F., Martín-Dávila, P., Montejo, M., Moreno, A., Oliver, A., Pascual, A., Pérez-Nadales, E., Román-Broto, A., San-Juan, R., Serón, D., Solé-Jover, A., Valerio, M., Muñoz, P., and Torre-Cisneros, J.

Published
2018
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7. Geographical variation in therapy for bloodstream infections due to multidrug-resistant Enterobacteriaceae: a post-hoc analysis of the INCREMENT study

Author

del Toro, M.D., Gálvez, J., Falcone, M., Russob, A., Karaiskos, I., Trecarichi, E.M., Losito, A.R., García-Vázquez, E., Gómez, J., Roilides, E., Iosifidis, E., Pournaras, S., Prim, N., Navarro, F., Mirelis, B., Origüen, J., Juan, R. San, Fernández-Ruiz, M., Almela, M., de la Calle, C., Martínez, J.A., Morata, L., Larrosa, N., Puig-Asensio, M., Bou, G., Molina, J., González, V., Bermejo, J., Rucci, V., de Gopegui, E. Ruiz, Marinescu, C.I., Fariñas, M.C., Cano, M.E., Gozalo, M., Paño-Pardo, J.R., Mora-Rillo, Marta, Gómez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Antoniadou, A., Poulakou, G., Souli, M., Lowman, W., Virmani, D., Torre-Cisneros, Julian, Machuca, I., Gracia-Ahufinger, Irene, Azap, Ö.K., Helvaci, Ö., Sahin, A.O., Cantón, R., Pintado, V., Bartoletti, M., Giannella, M., Peter, S., Hamprecht, A., Badia, C., Xercavins, M., Fontanals, D., Jové, E., Harris, Patrick N.A., Pezzani, M. Diletta, Gutiérrez-Gutiérrez, Belén, Viale, Pierluigi, Hsueh, Po-Ren, Ruiz-Garbajosa, Patricia, Venditti, Mario, Tumbarello, Mario, Navarro-Francisco, Carolina, Calbo, Esther, Akova, Murat, Giamarellou, Helen, Oliver, Antonio, Almirante, Benito, Gasch, Oriol, Martínez-Martínez, Luis, Schwaber, Mitchell J., Daikos, George, Pitout, Johann, Peña, Carmen, Hernández-Torres, Alicia, Doi, Yohei, Pérez, Federico, Tuon, Felipe Francisco, Tacconelli, Evelina, Carmeli, Yehuda, Bonomo, Robert A., Pascual, Álvaro, Paterson, David L., and Rodríguez-Baño, Jesús

Published
2017
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10. A Predictive Model of Mortality in Patients With Bloodstream Infections due to Carbapenemase-Producing Enterobacteriaceae

Author

Gálvez, J., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, E.M., Losito, A.R., García-Vázquez, E., Hernández, A., Gómez, J., Iosifidis, E., Prim, N., Navarro, F., Mirelis, B., Origüen, J., San Juan, R., Fernández-Ruiz, M., Larrosa, N., Puig-Asensio, M., Cisneros, J.M., Molina, J., González, V., Rucci, V., Ruiz de Gopegui, E., Marinescu, C.I., Martínez-Martínez, L., Fariñas, M.C., Cano, M.E., Gozalo, M., Mora-Rillo, M., Navarro-San Francisco, C., Peña, C., Gómez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Azap, Ö.K., Pitout, J., Virmani, D., Torre-Cisneros, J., Natera, C., Helvaci, Ö., Sahin, A.O., Cantón, R., Ruiz, P., Bartoletti, M., Giannella, M., Taconelli, E., Riemenschneider, F., Calbo, E., Badia, C., Xercavins, M., Gasch, E., Fontanals, D., Jové, E., Gutiérrez-Gutiérrez, Belén, Salamanca, Elena, de Cueto, Marina, Hsueh, Po-Ren, Viale, Pierluigi, Paño-Pardo, José Ramón, Venditti, Mario, Tumbarello, Mario, Daikos, George, Pintado, Vicente, Doi, Yohei, Tuon, Felipe Francisco, Karaiskos, Ilias, Machuca, Isabel, Schwaber, Mitchell J., Azap, Özlem Kurt, Souli, Maria, Roilides, Emmanuel, Pournaras, Spyros, Akova, Murat, Pérez, Federico, Bermejo, Joaquín, Oliver, Antonio, Almela, Manel, Lowman, Warren, Almirante, Benito, Bonomo, Robert A., Carmeli, Yehuda, Paterson, David L., Pascual, Alvaro, and Rodríguez-Baño, Jesús

Published
2016
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14. European survey on principles of prudent antibiotic prescribing teaching in undergraduate students

Author

Gyssens, I.C., Jacobs, F., Peetermans, W., Francetić, I., Vlahović-Palčevski, V., Frimodt-Mǿller, N., Høiby, N., Kilian, M., Ader, F., Cazorla, C., Etienne, M., Pulcini, C., Fätkenheuer, G., Kern, W.V., Pletz, M.W., Salzberger, B., Cacopardo, B., Mikulska, M., Mussini, C., Orlando, G., Stefani, S., Lowe, S.H., Nouwen, J.L., Afset, J.E., Bergh, K., Müller, F., Simonsen, G.S., Carevic, B., Horvat, O., Jankovic, S., Beović, B., Gorisek, J.R., Canton, R., Fariñas, M.C., Gudiol, F., Paño Pardo, J.R., Rodríguez Baño, J., Harbarth, S., Zanetti, G., Barlow, G., Brown, N., Healy, B., Nathwani, D., Wencker, F., Frimodt-Møller, N., and Rodríguez-Baño, J.

Published
2015
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26. Multicenter, Prospective Validation of a Phenotypic Algorithm to Guide Carbapenemase Testing in Carbapenem-Resistant Pseudomonas aeruginosa Using the ERACE-PA Global Surveillance Program

Author

Gill, C.M. Aktaþ, E. Alfouzan, W. Bourassa, L. Brink, A. Burnham, C.-A.D. Canton, R. Carmeli, Y. Falcone, M. Kiffer, C. Marchese, A. Martinez, O. Pournaras, S. Satlin, M.J. Seifert, H. Thabit, A.K. Thomson, K.S. Villegas, M.V. Nicolau, D.P.

Subjects
polycyclic compounds, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses
Abstract

Background: Carbapenemase-producing, carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) is a global challenge. However, detection efforts can be laborious because numerous mechanisms produce carbapenem resistance. A minimum inhibitory concentration-based algorithm (imipenem- or meropenem-resistant plus ceftazidime-nonsusceptible plus cefepime-nonsusceptible) was proposed to identify the isolates most likely to harbor a carbapenemase; however, prospective validation in geographies displaying genotypic diversity and varied carbapenemase prevalence is warranted. Methods: CRPA isolates were collected during the Enhancing Rational Antimicrobials for P. aeruginosa (ERACE-PA) global surveillance program from 17 sites in 12 countries. Isolates underwent susceptibility testing following local standards to ceftazidime, cefepime, and ceftolozane/tazobactam. Isolates underwent initial phenotypic carbapenemase screening followed by molecular testing if positive. The primary algorithm criteria were applied, and results were compared with phenotypic carbapenemase results to assess the performance of the algorithm. A secondary criterion, the algorithm criterion or imipenem- or meropenem-resistant plus ceftolozane/tazobactam-nonsusceptible, was assessed. Results: A total of 807 CRPA were assessed, and 464 isolates met the algorithm criteria described above. Overall, testing was reduced by 43% compared with testing all CRPA. Carbapenemase-positive isolates missed by the algorithm were largely driven by Guiana extended spectrum (GES). Addition of the criterion of imipenem- or meropenem-resistant plus ceftolozane/tazobactam-nonsusceptible decreased the number of CP-CRPA missed by the algorithm (21 vs 40 isolates, respectively), reducing number of isolates tested by 39%. Conclusions: Application of the initial algorithm (imipenem- or meropenem-resistant plus ceftazidime-nonsusceptible plus cefepime-nonsusceptible) performed well in a global cohort, with 33% phenotypically carbapenemase-positive isolates. The addition of imipenem- or meropenem-resistant plus ceftolozane/tazobactam-nonsusceptible reduced the number of phenotypically carbapenemase-positive isolates missed and may be useful in areas with a prominence of GES. © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Published
2022

31. Elevated MICs of Susceptible Antipseudomonal Cephalosporins in Non-Carbapenemase-Producing, Carbapenem-Resistant Pseudomonas aeruginosa: Implications for Dose Optimization

Author

Gill, C. M., Aktas, E., Alfouzan, W., Bourassa, L., Brink, A., Burnham, C. -A. D., Canton, R., Carmeli, Y., Falcone, M., Kiffer, C., Marchese, A., Martinez, O., Pournaras, S., Seifert, H., Thabit, A. K., Villegas, M. V., Westblade, L. F., Nicolau, D. P., Wille, J., Rezende, T. T. F., Cekin, Z., Malkocoglu, G., Gijon, D., Tarakmeh, L. A., Chu, C. Y., Opperman, C. J., Tootla, H. D., Moodley, C., Coetzee, J., Vourli, S., Dimopoulos, G., Attallah, D. M., Tiseo, G., Leonildi, A., Giordano, C., Barnini, S., Menichetti, F., Di Pilato, V., Codda, G., Vena, A., Giacobbe, D. R., Satlin, M., Cardona, A., Curtis, L., Fang, F., Thomson, G., and Thomson, K.

Subjects
Carbapenem resistance, medicine.drug_class, Cefepime, Cephalosporin, Ceftazidime, Microbial Sensitivity Tests, Clinical Therapeutics, medicine.disease_cause, Microbiology, Pharmacokinetics, Pharmacodynamics, Pseudomonas aeruginosa, Anti-Bacterial Agents, Azabicyclo Compounds, Carbapenems, Humans, Cephalosporins, Pseudomonas Infections, medicine, Potency, Pharmacology (medical), Pharmacology, business.industry, Carbapenemase producing, Infectious Diseases, business, medicine.drug
Abstract

The present study evaluated the in vitro potency of ceftazidime and cefepime among carbapenem-resistant Pseudomonas aeruginosa isolates collected as part of a global surveillance program and assessed the pharmacodynamic implications using previously published population pharmacokinetics. When susceptible, MICs resulted at the high end of distribution for both ceftazidime and cefepime, thus 6 g/day was required to achieve optimal pharmacodynamic profiles. These findings should be considered in the clinic and for the application of CLSI susceptibility breakpoints.

Published
2021
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38. Impact of Pseudomonas aeruginosa Infection on Patients with Chronic Inflammatory Airway Diseases

Author

Garcia-Clemente, M, de la Rosa, D, Maiz, L, Giron, R, Blanco, M, Olveira, C, Canton, R, Martinez-Garcia, MA, and [Garcia-Clemente,M] Pneumology Department, Hospital Universitario Central de Asturias, Oviedo, Spain. [de la Rosa,D] Pneumology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. [Máiz,L] Servicio de Neumología, Unidad de Fibrosis Quística, Bronquiectasias e Infección Bronquial Crónica, Hospital Ramón y Cajal, Madrid, Spain. [Girón,R] Pneumology Department, Hospital Univesitario la Princesa, Madrid, Spain. [Blanco,M] Servicio de Neumología, Hospital Universitario A Coruña, A Coruña, Spain. [Olveira,S] Servicio de Neumología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain. [Canton,R] Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. [Martinez-García,MA] Pneumology Department, Universitary and Polytechnic La Fe Hospital, Valencia, Spain. [Martinez-García,MA] Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.

Subjects
Phenomena and Processes::Genetic Phenomena::Phenotype [Medical Subject Headings], Diseases::Respiratory Tract Diseases::Bronchial Diseases::Asthma [Medical Subject Headings], Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Pseudomonadaceae::Pseudomonas::Pseudomonas aeruginosa [Medical Subject Headings], Anatomy::Respiratory System [Medical Subject Headings], Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial [Medical Subject Headings], Chronic bronchial infection, Cystic fibrosis, Asthma, Bronchiectasis, respiratory tract diseases, Fibrosis quística, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Diseases::Respiratory Tract Diseases::Lung Diseases::Cystic Fibrosis [Medical Subject Headings], Bronquiectasia, Pseudomonas aeruginosa, COPD, Enfermedad pulmonar obstructiva crónica, Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings], COPD, Pseudomonas aeruginosa, asthma, bronchiectasis, chronic bronchial infection, cystic fibrosis, Asma, Bronquitis crónica, Diseases::Respiratory Tract Diseases::Bronchial Diseases::Bronchiectasis [Medical Subject Headings]
Abstract

Pseudomonas aeruginosa ( P. aeruginosa ) is a ubiquitous and opportunistic microorganism and is considered one of the most significant pathogens that produce chronic colonization and infection of the lower respiratory tract, especially in people with chronic inflammatory airway diseases such as asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), and bronchiectasis. From a microbiological viewpoint, the presence and persistence of P. aeruginosa over time are characterized by adaptation within the host that precludes any rapid, devastating injury to the host. Moreover, this microorganism usually develops antibiotic resistance, which is accelerated in chronic infections especially in those situations where the frequent use of antimicrobials facilitates the selection of "hypermutator P. aeruginosa strain". This phenomenon has been observed in people with bronchiectasis, CF, and the "exacerbator" COPD phenotype. From a clinical point of view, a chronic bronchial infection of P. aeruginosa has been related to more severity and poor prognosis in people with CF, bronchiectasis, and probably in COPD, but little is known on the effect of this microorganism infection in people with asthma. The relationship between the impact and treatment of P. aeruginosa infection in people with airway diseases emerges as an important future challenge and it is the most important objective of this review.

Published
2020

40. Determining the burden of infectious diseases caused by carbapenem-resistant gram-negative bacteria in Spain

Author

Canton R, Huarte R, Morata L, Trillo-Mata J, Munoz R, Gonzalez J, Tort M, and Badia X

Subjects
Gram-Negative bacterial infections, Antibiotic resistance, Gram-negative bacteria, Burden of Disease, Carbapenem-Resistance
Abstract

Objective: To estimate the burden of nosocomial infections induced by carbapenem resistant Gram-negative (CRGN) pathogens in Spain, focusing on both the clinical and economic impact. Methods: The burden of disease was estimated using data from 2017 according to the availability of data sources. The impact, both clinical and economic, of the most frequent CRGN nosocomial infections (those produced by Klebsiella pneumoniae, Pseudomonasaeruginosa and Acinetobacter baumannii) was analysed. Incidence and mortality of CRGN nosocomial infections were estimated, as well as the direct and indirect costs produced by this health problem. Results: Approximately 376,346 patients are believed to have suffered a nosocomial infection in Spain in 2017; 3.2% of them due to CRGN bacilli. Infections by carbapenem-resistant P. aeruginosa produced the highest mortality rates (2578 deaths) when compared with A. baumannii (1571) and K. pneumoniae (415). Total economic costs of CRGN nosocomial infections in Spain were estimated to be (sic)472 million in 2017, with 83% of the total cost caused by direct costs. Conclusion: CRGN nosocomial infections have a high clinical impact on patients' lives, high mortality rates, and represent one of the hospitalisation episodes with the most associated costs. Efforts should be focussed to implement preventive policies in order to avoid infections due to CRGN pathogens and the resulting burden, and to reduce direct costs due to morbimortality, specifically in those infections produced by P. aeruginosa. (C) 2020 Published by Elsevier Espana, S.L.U.

Published
2021

41. Elevated MICs of susceptible antipseudomonal cephalosporins in non-carbapenemase-producing, carbapenem-resistant pseudomonas aeruginosa: Implications for dose optimization

Author

Gill, C.M. Aktaş, E. Alfouzan, W. Bourassa, L. Brink, A. Burnham, C.-A.D. Canton, R. Carmeli, Y. Falcone, M. Kiffer, C. Marchese, A. Martinez, O. Pournaras, S. Seifert, H. Thabit, A.K. Villegas, M.V. Westblade, L.F. Nicolau, D.P. Wille, J. Rezende, T.T.F. Cekin, Z. Malkocoglu, G. Gijón, D. Tarakmeh, L.A. Chu, C.Y. Opperman, C.J. Tootla, H.D. Moodley, C. Coetzee, J. Vourli, S. Dimopoulos, G. Attallah, D.M. Tiseo, G. Leonildi, A. Giordano, C. Barnini, S. Menichetti, F. Di Pilato, V. Codda, G. Vena, A. Giacobbe, D.R. Satlin, M. Cardona, A. Curtis, L. Fang, F. Thomson, G. Thomson, K. the ERACE-PA Global Study Group

Abstract

The present study evaluated the in vitro potency of ceftazidime and cefepime among carbapenem-resistant Pseudomonas aeruginosa isolates collected as part of a global surveillance program and assessed the pharmacodynamic implications using previously published population pharmacokinetics. When susceptible, MICs resulted at the high end of distribution for both ceftazidime and cefepime, thus 6 g/day was required to achieve optimal pharmacodynamic profiles. These findings should be considered in the clinic and for the application of CLSI susceptibility breakpoints. © 2021 American Society for Microbiology.

Published
2021

42. Fundamentals and implementation of Microbiological Diagnostic Stewardship Programs

Author

Bou G, Canton R, Martinez-Martinez L, Navarro D, and Vila J

Abstract

Microbiological diagnostic stewardship programs promote coordinated measures aimed at optimizing the use of diagnostic techniques, thus favouring the adoption of adequate and cost-effective therapeutic, clinical and preventive decisions. The implementation of microbiological diagnostic stewardship relies upon the creation of multidisciplinary committees led by clinical microbiologists for the design of diagnostic algorithms, the adequacy of the laboratory computer system to monitor the relevance of the requested diagnostic tests, the implementation of a quality control system, the design and performance of studies of cost-effectiveness, the training of the petitioner and the technical and nursing staff and the continuous evaluation of the program. The incorporation of microbiological diagnostic stewardship in routine care reports tangible benefits for the patient while strengthening the pivotal role of the clinical microbiologist in the management of infectious diseases. Copyright © 2020 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.

Published
2021

45. Complex clonal and plasmid epidemiology in the first outbreak of enterobacteriaceae infection involving VIM-1 metallo-(beta)-lactamase in Spain: toward endemicity?

Author

Tato, M., Coque, T.M., Ruiz-Garbajosa, P., Pintado, V., Cobo, J., Sader, H.S., Jones, R.N., Baquero, F., and Canton, R.

Subjects
Enterobacter -- Identification and classification, Enterobacteriaceae -- Identification and classification, Epidemics -- Spain, Epidemics -- Research, Beta lactamases -- Health aspects, Beta lactamases -- Genetic aspects, Natural selection -- Analysis, Plasmids -- Research, Health, Health care industry
Published
2007

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