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152 results on '"Cotogni P"'

1. Mask and Compress: Efficient Skeleton-based Action Recognition in Continual Learning

Author

Mosconi, Matteo, Sorokin, Andriy, Panariello, Aniello, Porrello, Angelo, Bonato, Jacopo, Cotogni, Marco, Sabetta, Luigi, Calderara, Simone, and Cucchiara, Rita

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Artificial Intelligence
Abstract

The use of skeletal data allows deep learning models to perform action recognition efficiently and effectively. Herein, we believe that exploring this problem within the context of Continual Learning is crucial. While numerous studies focus on skeleton-based action recognition from a traditional offline perspective, only a handful venture into online approaches. In this respect, we introduce CHARON (Continual Human Action Recognition On skeletoNs), which maintains consistent performance while operating within an efficient framework. Through techniques like uniform sampling, interpolation, and a memory-efficient training stage based on masking, we achieve improved recognition accuracy while minimizing computational overhead. Our experiments on Split NTU-60 and the proposed Split NTU-120 datasets demonstrate that CHARON sets a new benchmark in this domain. The code is available at https://github.com/Sperimental3/CHARON., Comment: Accepted at ICPR 2024

Published
2024

2. Is Retain Set All You Need in Machine Unlearning? Restoring Performance of Unlearned Models with Out-Of-Distribution Images

Author

Bonato, Jacopo, Cotogni, Marco, and Sabetta, Luigi

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Artificial Intelligence, Computer Science - Machine Learning
Abstract

In this paper, we introduce Selective-distillation for Class and Architecture-agnostic unleaRning (SCAR), a novel approximate unlearning method. SCAR efficiently eliminates specific information while preserving the model's test accuracy without using a retain set, which is a key component in state-of-the-art approximate unlearning algorithms. Our approach utilizes a modified Mahalanobis distance to guide the unlearning of the feature vectors of the instances to be forgotten, aligning them to the nearest wrong class distribution. Moreover, we propose a distillation-trick mechanism that distills the knowledge of the original model into the unlearning model with out-of-distribution images for retaining the original model's test performance without using any retain set. Importantly, we propose a self-forget version of SCAR that unlearns without having access to the forget set. We experimentally verified the effectiveness of our method, on three public datasets, comparing it with state-of-the-art methods. Our method obtains performance higher than methods that operate without the retain set and comparable w.r.t the best methods that rely on the retain set.

Published
2024

3. DUCK: Distance-based Unlearning via Centroid Kinematics

Author

Cotogni, Marco, Bonato, Jacopo, Sabetta, Luigi, Pelosin, Francesco, and Nicolosi, Alessandro

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Machine Learning
Abstract

Machine Unlearning is rising as a new field, driven by the pressing necessity of ensuring privacy in modern artificial intelligence models. This technique primarily aims to eradicate any residual influence of a specific subset of data from the knowledge acquired by a neural model during its training. This work introduces a novel unlearning algorithm, denoted as Distance-based Unlearning via Centroid Kinematics (DUCK), which employs metric learning to guide the removal of samples matching the nearest incorrect centroid in the embedding space. Evaluation of the algorithm's performance is conducted across various benchmark datasets in two distinct scenarios, class removal, and homogeneous sampling removal, obtaining state-of-the-art performance. We also introduce a novel metric, called Adaptive Unlearning Score (AUS), encompassing not only the efficacy of the unlearning process in forgetting target data but also quantifying the performance loss relative to the original model. Additionally, we conducted a thorough investigation of the unlearning mechanism in DUCK, examining its impact on the organization of the feature space and employing explainable AI techniques for deeper insights.

Published
2023

4. Predicting Tweet Engagement with Graph Neural Networks

Author

Arazzi, Marco, Cotogni, Marco, Nocera, Antonino, and Virgili, Luca

Subjects
Computer Science - Social and Information Networks, Computer Science - Artificial Intelligence, Computer Science - Machine Learning
Abstract

Social Networks represent one of the most important online sources to share content across a world-scale audience. In this context, predicting whether a post will have any impact in terms of engagement is of crucial importance to drive the profitable exploitation of these media. In the literature, several studies address this issue by leveraging direct features of the posts, typically related to the textual content and the user publishing it. In this paper, we argue that the rise of engagement is also related to another key component, which is the semantic connection among posts published by users in social media. Hence, we propose TweetGage, a Graph Neural Network solution to predict the user engagement based on a novel graph-based model that represents the relationships among posts. To validate our proposal, we focus on the Twitter platform and perform a thorough experimental campaign providing evidence of its quality., Comment: Accepted in ACM ICMR2023

Published
2023
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5. Exemplar-free Continual Learning of Vision Transformers via Gated Class-Attention and Cascaded Feature Drift Compensation

Author

Cotogni, Marco, Yang, Fei, Cusano, Claudio, Bagdanov, Andrew D., and van de Weijer, Joost

Subjects
Computer Science - Computer Vision and Pattern Recognition
Abstract

We propose a new method for exemplar-free class incremental training of ViTs. The main challenge of exemplar-free continual learning is maintaining plasticity of the learner without causing catastrophic forgetting of previously learned tasks. This is often achieved via exemplar replay which can help recalibrate previous task classifiers to the feature drift which occurs when learning new tasks. Exemplar replay, however, comes at the cost of retaining samples from previous tasks which for many applications may not be possible. To address the problem of continual ViT training, we first propose gated class-attention to minimize the drift in the final ViT transformer block. This mask-based gating is applied to class-attention mechanism of the last transformer block and strongly regulates the weights crucial for previous tasks. Importantly, gated class-attention does not require the task-ID during inference, which distinguishes it from other parameter isolation methods. Secondly, we propose a new method of feature drift compensation that accommodates feature drift in the backbone when learning new tasks. The combination of gated class-attention and cascaded feature drift compensation allows for plasticity towards new tasks while limiting forgetting of previous ones. Extensive experiments performed on CIFAR-100, Tiny-ImageNet and ImageNet100 demonstrate that our exemplar-free method obtains competitive results when compared to rehearsal based ViT methods.

Published
2022

6. Explaining Image Enhancement Black-Box Methods through a Path Planning Based Algorithm

Author

Cotogni, Marco and Cusano, Claudio

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Multimedia
Abstract

Nowadays, image-to-image translation methods, are the state of the art for the enhancement of natural images. Even if they usually show high performance in terms of accuracy, they often suffer from several limitations such as the generation of artifacts and the scalability to high resolutions. Moreover, their main drawback is the completely black-box approach that does not allow to provide the final user with any insight about the enhancement processes applied. In this paper we present a path planning algorithm which provides a step-by-step explanation of the output produced by state of the art enhancement methods, overcoming black-box limitation. This algorithm, called eXIE, uses a variant of the A* algorithm to emulate the enhancement process of another method through the application of an equivalent sequence of enhancing operators. We applied eXIE to explain the output of several state-of-the-art models trained on the Five-K dataset, obtaining sequences of enhancing operators able to produce very similar results in terms of performance and overcoming the huge limitation of poor interpretability of the best performing algorithms.

Published
2022

7. Offset equivariant networks and their applications

Author

Cotogni, Marco and Cusano, Claudio

Subjects
Computer Science - Computer Vision and Pattern Recognition
Abstract

In this paper we present a framework for the design and implementation of offset equivariant networks, that is, neural networks that preserve in their output uniform increments in the input. In a suitable color space this kind of networks achieves equivariance with respect to the photometric transformations that characterize changes in the lighting conditions. We verified the framework on three different problems: image recognition, illuminant estimation, and image inpainting. Our experiments show that the performance of offset equivariant networks are comparable to those in the state of the art on regular data. Differently from conventional networks, however, equivariant networks do behave consistently well when the color of the illuminant changes., Comment: 13 pages

Published
2022
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9. TreEnhance: A Tree Search Method For Low-Light Image Enhancement

Author

Cotogni, Marco and Cusano, Claudio

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Graphics
Abstract

In this paper we present TreEnhance, an automatic method for low-light image enhancement capable of improving the quality of digital images. The method combines tree search theory, and in particular the Monte Carlo Tree Search (MCTS) algorithm, with deep reinforcement learning. Given as input a low-light image, TreEnhance produces as output its enhanced version together with the sequence of image editing operations used to obtain it. During the training phase, the method repeatedly alternates two main phases: a generation phase, where a modified version of MCTS explores the space of image editing operations and selects the most promising sequence, and an optimization phase, where the parameters of a neural network, implementing the enhancement policy, are updated. Two different inference solutions are proposed for the enhancement of new images: one is based on MCTS and is more accurate but more time and memory consuming; the other directly applies the learned policy and is faster but slightly less precise. As a further contribution, we propose a guided search strategy that "reverses" the enhancement procedure that a photo editor applied to a given input image. Unlike other methods from the state of the art, TreEnhance does not pose any constraint on the image resolution and can be used in a variety of scenarios with minimal tuning. We tested the method on two datasets: the Low-Light dataset and the Adobe Five-K dataset obtaining good results from both a qualitative and a quantitative point of view., Comment: Accepted in Pattern Recognition

Published
2022

13. Nutritional support for cancer patients: still a neglected right?

Author

Caccialanza, Riccardo, De Lorenzo, Francesco, Gianotti, Luca, Zagonel, Vittorina, Gavazzi, Cecilia, Farina, Gabriella, Cotogni, Paolo, Cinieri, Saverio, Cereda, Emanuele, Marchetti, Paolo, Nardi, Mariateresa, Iannelli, Elisabetta, Santangelo, Claudia, Traclò, Francesca, Pinto, Carmine, and Pedrazzoli, Paolo

Published
2017
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21. Recommendations for the use of vascular access in the COVID-19 patients: an Italian perspective

Author

Pittiruti, M, Pinelli, F, Annetta, M, Bertoglio, S, Biasucci, D, Biffi, R, Biondi, S, Brescia, F, Buononato, M, Capozzoli, G, Cotogni, P, Deganello, E, Dolcetti, L, Elisei, D, Elli, S, Giustivi, D, Iacobone, E, La Greca, A, Lamperti, M, Maspero, G, Scoppettuolo, G, Vailati, D, and Vezzali, D

Subjects
medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Vascular access, Disease Association, Critical Care and Intensive Care Medicine, Catheterization, Patient safety, Intensive care, medicine, Humans, Pandemics, business.industry, Perspective (graphical), lcsh:Medical emergencies. Critical care. Intensive care. First aid, COVID-19, lcsh:RC86-88.9, Central venous catheters, Italy, Settore MED/41, Family medicine, Practice Guidelines as Topic, Commentary, Vascular access devices, Coronavirus Infections, business, Blood sampling
Published
2020
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22. Changes in food habits in cancer patients in Italy: An AIOM-SINPE-FAVO survey

Author

Gavazzi, C, Sieri, S, Traclo, F, Sproviero, A, Vandoni, G, Ricci, R, Stragliotto, S, Zagonel, V, Pinto, C, Farina, G, Pedrazzoli, P, Gianotti, L, Caccialanza, R, Cotogni, P, Nardi, M, De Lorenzo, F, Iannelli, E, Santangelo, C, Gavazzi C., Sieri S., Traclo F., Sproviero A., Vandoni G., Ricci R., Stragliotto S., Zagonel V., Pinto C., Farina G., Pedrazzoli P., Gianotti L., Caccialanza R., Cotogni P., Nardi M., De Lorenzo F., Iannelli E., Santangelo C., Gavazzi, C, Sieri, S, Traclo, F, Sproviero, A, Vandoni, G, Ricci, R, Stragliotto, S, Zagonel, V, Pinto, C, Farina, G, Pedrazzoli, P, Gianotti, L, Caccialanza, R, Cotogni, P, Nardi, M, De Lorenzo, F, Iannelli, E, Santangelo, C, Gavazzi C., Sieri S., Traclo F., Sproviero A., Vandoni G., Ricci R., Stragliotto S., Zagonel V., Pinto C., Farina G., Pedrazzoli P., Gianotti L., Caccialanza R., Cotogni P., Nardi M., De Lorenzo F., Iannelli E., and Santangelo C.

Abstract

Objectives: The aim of this study was to investigate the prevalence of cancer patients changing their diet in relation to cancer site, sex, age and geographic distribution. Furthermore, we aimed to explore the rationale behind dietary changes and to identify sources of information in order to plan specific educational training. Methods: Patients ≥18 y of age who accessed the Italian Cancer Patients, Families and Friends Association information points were invited to participate. An ad hoc self-report questionnaire was used. The questionnaire asked patients about changes made to the major food groups. A minimum sample of 100 patients for the most common cancers was planned. We analyzed 1257 questionnaires. We assessed the prevalence of, reasons for, and type of dietary changes. Logistic regression was used to analyze the main determinants of dietary changes. Results: Of the 1257 patients, 705 (56.1%) reported changes since receiving the diagnosis of cancer. On the logistic regression analysis, age and tumor site were significantly associated with dietary changes (P < 0.001), mainly in patients <50 y of age and in those with upper gastrointestinal cancers. Slightly more than half (50.8%) of patients adopted a healthier diet, with 31.3% doing so to deal with eating-related side effects and 17.9% due to cancer sites. Regardless of the reasons for changing, the most common food items to result in a decrease in consumption were alcohol, red and processed meats, and sugary drinks. Only 15% of patients reported receiving specific nutrition indication. Conclusion: Italian patients are attentive to the importance of diet during cancer treatment. Personal choices reflect some indications for cancer prevention as there is still a shortage of guidelines for a correct diet during treatment. Nutrition indications are rarely given within the oncologic center.

Published
2018

24. Changes in food habits in cancer patients in Italy: An AIOM-SINPE-FAVO survey

Author

Gavazzi C., Sieri S., Traclo F., Sproviero A., Vandoni G., Ricci R., Stragliotto S., Zagonel V., Pinto C., Farina G., Pedrazzoli P., Gianotti L., Caccialanza R., Cotogni P., Nardi M., De Lorenzo F., Iannelli E., Santangelo C., Gavazzi, C, Sieri, S, Traclo, F, Sproviero, A, Vandoni, G, Ricci, R, Stragliotto, S, Zagonel, V, Pinto, C, Farina, G, Pedrazzoli, P, Gianotti, L, Caccialanza, R, Cotogni, P, Nardi, M, De Lorenzo, F, Iannelli, E, and Santangelo, C

Subjects
Nutrition information, Cancer survivor, Food habits’ survey, Cancer patient, Dietary change
Abstract

Objectives: The aim of this study was to investigate the prevalence of cancer patients changing their diet in relation to cancer site, sex, age and geographic distribution. Furthermore, we aimed to explore the rationale behind dietary changes and to identify sources of information in order to plan specific educational training. Methods: Patients ≥18 y of age who accessed the Italian Cancer Patients, Families and Friends Association information points were invited to participate. An ad hoc self-report questionnaire was used. The questionnaire asked patients about changes made to the major food groups. A minimum sample of 100 patients for the most common cancers was planned. We analyzed 1257 questionnaires. We assessed the prevalence of, reasons for, and type of dietary changes. Logistic regression was used to analyze the main determinants of dietary changes. Results: Of the 1257 patients, 705 (56.1%) reported changes since receiving the diagnosis of cancer. On the logistic regression analysis, age and tumor site were significantly associated with dietary changes (P < 0.001), mainly in patients

Published
2018

25. Home parenteral nutrition versus artificial hydration in malnourished patients with cancer in palliative care: a prospective, cohort survival study

Author

Cotogni, Paolo, Ossola, Marta, Passera, Roberto, Monge, Taira, Fadda, Maurizio, De Francesco, Antonella, and Bozzetti, Federico

Abstract

ObjectiveThe evidence base for home parenteral nutrition (HPN) in patients with advanced cancer is lacking. To compare the survival of malnourished patients with cancer undergoing palliative care who received HPN with a homogeneous group of patients, equally eligible for HPN, who did not receive HPN.DesignProspective, cohort study; tertiary university hospital, home care, hospice.MethodsPatients were assessed for HPN eligibility according to the guidelines. In the eligible population, who received both HPN and chemotherapy was excluded, while who received only HPN was included in the HPN+ group and who received neither HPN nor chemotherapy but artificial hydration (AH) was included in the HPN− group.Results301 patients were assessed for HPN eligibility and 86 patients (28.6%) were excluded for having severe organ dysfunction or Karnofsky performance status <50. In outcome analysis, 90 patients (29.9%) were excluded for receiving both HPN and chemotherapy, while 125 (41.5%) were included, 89 in HPN+ group (29.5%) and 36 in HPN− group (12%). The survival of the two groups showed a significant difference favouring patients receiving HPN (median overall survival: 4.3 vs 1.5 months, p<0.001). The multivariate analysis of the risk factors for mortality showed that not receiving HPN accounted for the strongest one (HR 25.72, 95% CI 13·65 to 48.44).ConclusionsComparative survival associated with the use of HPN versus AH showed significantly longer survival in malnourished patients with advanced cancer receiving HPN. These data support the guideline recommendation that HPN should be considered when malnutrition represents the overriding threat for the survival of these patients.

Published
2022
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26. Asymmetry at Disease Onset Is Not a Predictor of Parkinson’s Disease Progression

Author

Cotogni, Marco, Sacchi, Lucia, Sadikov, Aleksander, and Georgiev, Dejan

Abstract

Background: Even though a significant fraction of Parkinson’s disease (PD) patients presents with only minor or no motor asymmetry, the motor symptoms in PD typically start on one side of the body and worse symptoms on the side of the disease onset usually persist long after the disease has become clinically bilateral. The asymmetric presentation of PD has been studied over the years, with some studies showing slower progression in PD subjects with asymmetric disease presentation. In other studies, however, it was not possible to relate the asymmetry to disease progression.Objective: The main objective of the present study was to assess the effect of asymmetry at disease onset on disease progression.Methods: Using the data available in the Parkinson’s Progression Markers Initiative (PPMI) database, at baseline, 423 subjects with de-novoPD were included in the study. Instead of dichotomizing the subjects in asymmetric and symmetric, we kept the asymmetry index and the non-motor, disability, and motor progression at one-, three-, and five-year follow-up continuous. Pearson’s rcorrelational analysis and the coefficient of determination R2were used to correlate asymmetry indices and disease progression.Results: There was no correlation between neither clinically, nor DatSCAN defined asymmetry and non-motor, motor, and disability progression in the de-novoPD subjects with a 5-year follow-up.Conclusion: Asymmetry at disease onset does not predict progression of PD. Further studies are needed to investigate whether early detection of asymmetry on clinical grounds could successfully distinguish between PD and symmetric types of atypical parkinsonism in the early stages of the disease.

Published
2021
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29. Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levels

Author

Michalopoulos, A., Groeneveld, J., Lev, A., Sprung, C., Vakalos, A., Kotanidou, A., Zakynthinos, E., Filos, K., Pneumatikos, I., Moraiti, A., Clouva-molyvdas, P., Mandragos, K., Kyriazopoulos, G., Karampela, I., Koulenti, D., Myrianthefs, P., Ioannidou, E., Mouloudi, E., Chalkiadaki, A., Bitzani, M., Routsi, C., Armaganidis, A., Sofianos, E., Harjola, V., Berezowicz, P., Jacobsen, K., Espersen, K., Fogh, B., Betsch, H., Vincent, Jean-Louis, Vanhems, Philippe, Walther, Sten M., Sakr, Yasser, Rello, Jordi, Leone, Marc, Pickkers, P., Lipman, Jeffrey, Holmbom, Martin, Antonelli, Massimo, Hanberger, Håkan, Kocak, S., Ulger, F., Guven, H., Turkmen, A., Dogruer, K., Adanir, T., Demirkiran, O., Tugrul, S., Cakar, N., Akinci, I., Uzel, N., Togal, T., Topeli, A., Turkoglu, M., Guven, M., Akan, M., Bodur, H., Bosnak, M., Kizilkaya, M., Ozgencil, E., Kaya, A., Fistikci, H., Ates, C., Atalan, K., Jacobson, S., Owall, A., Kokinsky, E., Rudenstam, J., Häggqvist, J., Hulting, J., Sellgren, J., Arvidsson, S., Schindele, M., Hammarskjöld, F., Friberg, H., Petersson, J., Paulsson, A., Lindström, I., Stiernstrom, H., Peterzén, B., Blomqvist, H., Petersen, P., Soto Ibáñez, J., González, J., Izura, J., Corcobado Márquez, C., Rico-Feijoo, J., Sierra, R., Rello, J., Posada, P., Briones Lopez, M., Jara, R., Luis, V., Maria Jesus, H., de la Torre-Prados, M., Felices, F., Sanchez Garcia, M., Macias Pingarrón, J., Garcia-Fuentes, C., Cerdá, E., Serrano, N., Barcenilla-Gaite, F., Sirvent, J., Montejo González, J., Guerrero Gomez, F., Amador Amerigo, J., Borges, M., Sánchez-Olmedo, J., López Ciudad, V., Moreno, M., Esteban, E., Vallés, J., De Rojas Román, J., Yuste, I., Ugarte Peña, P., Sole-violán, J., Bustinza, A., Albaya, A., Latour-Perez, J., Navarro, J., Garcia, F., Martin Delgado, M., Rovira, A., Ramos-gómez, L., Garro, P., Silva, J., Iglesias, L., María Jesús, L., Pueyo, L., Lorente, C., Martinon-Torres, F., Aguilar, G., Martinez-Sagasti, F., Blesa Malpica, A., Valencia, M., Zavala, E., Bustamante Munguira, E., Arribas, M., Insausti, J., Vegas Pinto, R., Bocero, L., Estella, A., Esteban-Reboll, F., Lopez Camps, V., Antón Caraballo, E., Muñoz, E., Olaechea, P., Escriba, A., Santos, I., Campiñez, Burgueño., Moreira, P., Pizzamiglio, M., Conti, V., Kahveci, A., Nydahl, A., Lind, D., Caballero Zirena, A., Guerrero, F., Palomar, M., Einar, V., Agvald-Ohman, C., Wyon, N., Johansson, L., Gil, B., Mariscal, F., Galvan, B., Espinosa, E., Lesmes Serrano, A., Mesalles Sanjuan, E., Manzano Ramirez, A., Quintana Tort-Martorell, E., Monton Dito, J., Ibañez, A., Garcia del Valle, S., Alemparte-Pardavila, E., Monedero, P., Naveira-Abeigón, E., Jorda, R., Alvarez, M., Rubio, O., Bouw, M., Afonso, Susana, Matos, Ricardo, Carneiro, A., Amaro, P., Ribeiro, R., Paiva, J., Galdos-Anuncibay, P., Nieto, M., Ruiz, J., Perez Calvo, C., Mañez, R., França, C., Moreno, R., Dias, C., Sousa, A., Rezende, A., Mourão, L., Ponce, P., Oliveira, T., Esteves, F., Den Boer, S., Bakker, J., Van Berkel, G., Borg, M., Gullo, A., Gianesello, L., Martinelli, L., Antonelli, M., Bassetti, M., Telo, L., Alves, M., Almeida, E., Leite, A., Pádua, F., Costa, H., Póvoa, P., Lopes, V., Carmo, E., Febra, C., Martins, A., Castelo-Branco Sousa, M., Bártolo, A., Junker, A., Erno, P., Klepstad, P., Loevstad, R., Bergmans, D., Rodgers, M., Pham, C., Speelberg, B., Wesselink, R., Ammann, J., Vet, J., Gille, A., Kuiper, M., Kieft, H., Blom, H., Vogelaar, J., Corsten, S., Ten Cate, J., Rosseel, P., De Pont, A., Della Rocca, G., Biancofiore, G., Morelli, A., Ranieri, MV., Cotogni, P., Alessandro, D., Clementi, S., Ferraro, F., Giuseppe, N., Sforza, D., Castiglione, G., Marino, G., Fumagalli, R., Santagostino, G., De Negri, P., De Gasperi, A., Oggioni, R., Conte, V., Sicignano, A., Marri, I., Locicero, M., Guadagnucci, A., Chieregato, A., Fiore, G., Sorbara, C., Munch, C., Ruatti, H., Lorella, P., Borrelli, F., Panella, L., De Blasi, R., Ceriani, R., Colonna, S., Abbruzzese, C., Rosano, A., Caspani, M., Emmi, V., Stelian, E., Scolz, S., Guberti, A., Margarit, O., Giarratano, A., Rosi, R., Marzorati, S., De blasio, E., Minerva, M., Petrucci, N., Mangani, V., Lazzero, A., Sapuppo, M., Cecilia, P., Borelli, M., Greco, S., Vesconi, S., Sofer, S., Cohen, J., Kishinevsky, E., Selçuk Üniversitesi, Hanberger, H, Antonelli, M, Holmbom, M, Lipman, J, Pickkers, P, Leone, M, Rello, J, Sakr, Y, Walther, S, Vanhems, P, Vincent, J, Betsch, H, Fogh, B, Espersen, K, Jacobsen, K, Berezowicz, P, Harjola, V, Sofianos, E, Armaganidis, A, Routsi, C, Bitzani, M, Chalkiadaki, A, Michalopoulos, A, Mouloudi, E, Ioannidou, E, Myrianthefs, P, Koulenti, D, Karampela, I, Kyriazopoulos, G, Mandragos, K, Clouva molyvdas, P, Moraiti, A, Pneumatikos, I, Filos, K, Zakynthinos, E, Kotanidou, A, Vakalos, A, Sprung, C, Lev, A, Kishinevsky, E, Cohen, J, Sofer, S, Vesconi, S, Greco, S, Borelli, M, Cecilia, P, Sapuppo, M, Lazzero, A, Mangani, V, Petrucci, N, Minerva, M, De blasio, E, Marzorati, S, Rosi, R, Giarratano, A, Margarit, O, Guberti, A, Scolz, S, Stelian, E, Emmi, V, Caspani, M, Rosano, A, Abbruzzese, C, Colonna, S, Ceriani, R, De Blasi, R, Panella, L, Borrelli, F, Lorella, P, Ruatti, H, Munch, C, Sorbara, C, Fiore, G, Chieregato, A, Conti, V, Guadagnucci, A, Pizzamiglio, M, Locicero, M, Marri, I, Sicignano, A, Conte, V, Oggioni, R, De Gasperi, A, De Negri, P, Santagostino, G, Fumagalli, R, Marino, G, Castiglione, G, Sforza, D, Giuseppe, N, Bassetti, M, Ferraro, F, Clementi, S, Alessandro, D, Cotogni, P, Ranieri, M, Martinelli, L, Gianesello, L, Gullo, A, Morelli, A, Biancofiore, G, Della Rocca, G, Borg, M, De Pont, A, Rosseel, P, Ten Cate, J, Van Berkel, G, Corsten, S, Bakker, J, Vogelaar, J, Blom, H, Kieft, H, Kuiper, M, Gille, A, Vet, J, Ammann, J, Den Boer, S, Wesselink, R, Speelberg, B, Pham, C, Rodgers, M, Bergmans, D, Groeneveld, J, Loevstad, R, Klepstad, P, Erno, P, Junker, A, Bártolo, A, Castelo Branco Sousa, M, Esteves, F, Martins, A, Oliveira, T, Ponce, P, Mourão, L, Febra, C, Carmo, E, Lopes, V, Póvoa, P, Rezende, A, Costa, H, Moreira, P, Pádua, F, Leite, A, Almeida, E, Alves, M, Sousa, A, Telo, L, Dias, C, Paiva, J, Ribeiro, R, Amaro, P, Carneiro, A, Moreno, R, Matos, R, Afonso, S, Bouw, M, França, C, Rubio, O, Mañez, R, Campiñez, B, Alvarez, M, Jorda, R, Naveira Abeigón, E, Monedero, P, Alemparte Pardavila, E, Garcia del Valle, S, Perez Calvo, C, Palomar, M, Guerrero, F, Caballero Zirena, A, Arribas, M, Bustamante Munguira, E, Ruiz, J, Iglesias, L, Zavala, E, Valencia, M, Blesa Malpica, A, Martinez Sagasti, F, Nieto, M, Aguilar, G, Martinon Torres, F, Lorente, C, Insausti, J, Vegas Pinto, R, Santos, I, Escriba, A, Olaechea, P, Muñoz, E, Antón Caraballo, E, Galdos Anuncibay, P, Lopez Camps, V, Esteban Reboll, F, Estella, A, Bocero, L, Ibañez, A, Pueyo, L, María Jesús, L, Silva, J, Garro, P, Ramos gómez, L, Rovira, A, Martin Delgado, M, Monton Dito, J, Garcia, F, Navarro, J, Latour Perez, J, Albaya, A, Bustinza, A, Sole violán, J, Ugarte Peña, P, Yuste, I, De Rojas Román, J, Vallés, J, Esteban, E, Quintana Tort Martorell, E, Moreno, M, López Ciudad, V, Manzano Ramirez, A, Sánchez Olmedo, J, Borges, M, Amador Amerigo, J, Guerrero Gomez, F, Montejo González, J, Sirvent, J, Mesalles Sanjuan, E, Barcenilla Gaite, F, Serrano, N, Cerdá, E, Lesmes Serrano, A, Garcia Fuentes, C, Macias Pingarrón, J, Espinosa, E, Sanchez Garcia, M, Felices, F, de la Torre Prados, M, Maria Jesus, H, Luis, V, Jara, R, Briones Lopez, M, Posada, P, Galvan, B, Mariscal, F, Gil, B, Sierra, R, Rico Feijoo, J, Corcobado Márquez, C, Izura, J, González, J, Soto Ibáñez, J, Petersen, P, Johansson, L, Blomqvist, H, Peterzén, B, Wyon, N, Stiernstrom, H, Lindström, I, Paulsson, A, Agvald Ohman, C, Petersson, J, Friberg, H, Einar, V, Hammarskjöld, F, Schindele, M, Arvidsson, S, Sellgren, J, Hulting, J, Häggqvist, J, Rudenstam, J, Lind, D, Kokinsky, E, Owall, A, Jacobson, S, Nydahl, A, Atalan, K, Ates, C, Kahveci, A, Fistikci, H, Kaya, A, Ozgencil, E, Kizilkaya, M, Bosnak, M, Bodur, H, Akan, M, Guven, M, Turkoglu, M, Topeli, A, Togal, T, Uzel, N, Akinci, I, Cakar, N, Tugrul, S, Demirkiran, O, Adanir, T, Dogruer, K, Turkmen, A, Guven, H, Ulger, F, Kocak, S, İç Hastalıkları, and OMÜ

Subjects
Male, Pediatrics, Cross-sectional study, health care facilities, manpower, and services, Antibiotics, Resistance, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Prevalence, Drug Resistance, law.invention, Medical microbiology, law, Pathologie maladies infectieuses, Antibiotic, Critically ill, Infection, Aged, Anti-Bacterial Agents, Bacteria, Bacterial Infections, Cross-Sectional Studies, Europe, Female, Hospitalization, Humans, Middle Aged, Treatment Outcome, Drug Resistance, Bacterial, Intensive Care Units, Infectious Diseases, Critically ill -- Care, Mortality rate, Bacterial, Intensive care unit, SAPS II, Beta lactam antibiotics, Research Article, Human, medicine.medical_specialty, medicine.drug_class, Intensive Care Unit, Bacterial Infection, Antibiotic resistance, Internal medicine, Settore MED/41 - ANESTESIOLOGIA, Anti-Bacterial Agent, medicine, Cross-Sectional Studie, business.industry, Aminopeptidases -- Analysis, Klinisk medicin, Polypeptides, Bacterial diseases -- Diagnosis, Antibiotics -- Therapeutic use, Clinical Medicine, business
Abstract

Background: Antimicrobial resistance is an increasing concern in ICUs worldwide. Infection with an antibiotic resistant (ABR) strain of an organism is associated with greater mortality than infection with the non-resistant strain, but there are few data assessing whether being admitted to an intensive care unit (ICU) with high levels of antimicrobial resistance is associated with a worse outcome than being admitted to an ICU with low rates of resistance. The aim of this study was, therefore, to compare the characteristics of infections and antibiotic treatments and patient outcomes in patients admitted to ICUs in countries considered as having high levels of antibiotic resistance and those admitted to ICUs in countries considered as having low levels of antibiotic resistance.Methods: Data from the large, international EPIC II one-day point prevalence study on infections in patients hospitalized in ICUs were used. For the current study, we compared the data obtained from patients from two groups of countries: countries with reported MRSA rates of ≥ 25% (highABR: Greece, Israel, Italy, Malta, Portugal, Spain, and Turkey) and countries with MRSA rates of < 5% (lowABR: Denmark, Finland, Netherlands, Norway, and Sweden).Results: On the study day, 1187/2204 (53.9%) patients in the HighABR ICUs were infected and 255/558 (45.7%) in the LowABR ICUs (P < 0.01). Patients in the HighABR ICUs were more severely ill than those in the LowABR ICUs, as reflected by a higher SAPS II score (35.6 vs 32.7, P < 0.05) and had longer median ICU (12 days vs 5 days) and hospital (24 days vs 16 days) lengths of stay. They also had higher crude ICU (20.0% vs 15.4%) and hospital (27.0% vs 21.5%) mortality rates (both P < 0.05). However, after multivariable adjustment and matched pair analysis there were no differences in ICU or hospital mortality rates between High or LowABR ICU patients overall or among those with infections.Conclusions: Being hospitalized in an ICU in a region with high levels of antimicrobial resistance is not associated per se with a worse outcome., 0, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2014

30. Nutritional support for cancer patients: still a neglected right?

Author

Caccialanza, R, De Lorenzo, F, Gianotti, L, Zagonel, V, Gavazzi, C, Farina, G, Cotogni, P, Cinieri, S, Cereda, E, Marchetti, P, Nardi, M, Iannelli, E, Santangelo, C, Traclò, F, Pinto, C, Pedrazzoli, P, GAVAZZI, CECILIA, Caccialanza, R, De Lorenzo, F, Gianotti, L, Zagonel, V, Gavazzi, C, Farina, G, Cotogni, P, Cinieri, S, Cereda, E, Marchetti, P, Nardi, M, Iannelli, E, Santangelo, C, Traclò, F, Pinto, C, Pedrazzoli, P, and GAVAZZI, CECILIA

Published
2017

34. Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levels

Author

Hanberger, H. Antonelli, M. Holmbom, M. Lipman, J. Pickkers, P. Leone, M. Rello, J. Sakr, Y. Walther, S.M. Vanhems, P. Vincent, J.-L. Betsch, H. Fogh, B. Espersen, K. Jacobsen, K. Berezowicz, P. Harjola, V. Sofianos, E. Armaganidis, A. Routsi, C. Bitzani, M. Chalkiadaki, A. Michalopoulos, A. Mouloudi, E. Ioannidou, E. Myrianthefs, P. Koulenti, D. Karampela, I. Kyriazopoulos, G. Mandragos, K. Clouva-molyvdas, P. Moraiti, A. Pneumatikos, I. Filos, K. Zakynthinos, E. Kotanidou, A. Vakalos, A. Sprung, C. Lev, A. Kishinevsky, E. Cohen, J. Sofer, S. Vesconi, S. Greco, S. Borelli, M. Cecilia, P. Sapuppo, M. Lazzero, A. Mangani, V. Petrucci, N. Minerva, M. De blasio, E. Marzorati, S. Rosi, R. Giarratano, A. Margarit, O. Guberti, A. Scolz, S. Stelian, E. Emmi, V. Caspani, M. Rosano, A. Abbruzzese, C. Colonna, S. Ceriani, R. De Blasi, R. Panella, L. Borrelli, F. Lorella, P. Ruatti, H. Munch, C. Sorbara, C. Fiore, G. Chieregato, A. Conti, V. Guadagnucci, A. Pizzamiglio, M. Locicero, M. Marri, I. Sicignano, A. Conte, V. Oggioni, R. De Gasperi, A. De Negri, P. Santagostino, G. Fumagalli, R. Marino, G. Castiglione, G. Sforza, D. Giuseppe, N. Bassetti, M. Ferraro, F. Clementi, S. Alessandro, D. Cotogni, P. Ranieri, MV. Antonelli, M. Martinelli, L. Gianesello, L. Gullo, A. Morelli, A. Biancofiore, G. Della Rocca, G. Borg, M. De Pont, A. Rosseel, P. Ten Cate, J. Van Berkel, G. Corsten, S. Bakker, J. Vogelaar, J. Blom, H. Kieft, H. Kuiper, M. Gille, A. Pickkers, P. Vet, J. Ammann, J. Den Boer, S. Wesselink, R. Speelberg, B. Pham, C. Rodgers, M. Bergmans, D. Groeneveld, J. Loevstad, R. Klepstad, P. Erno, P. Junker, A. Bártolo, A. Castelo-Branco Sousa, M. Esteves, F. Martins, A. Oliveira, T. Ponce, P. Mourão, L. Febra, C. Carmo, E. Lopes, V. Póvoa, P. Rezende, A. Costa, H. Moreira, P. Pádua, F. Leite, A. Almeida, E. Alves, M. Sousa, A. Telo, L. Dias, C. Paiva, J. Ribeiro, R. Amaro, P. Carneiro, A. Moreno, R. Matos, R. Afonso, S. Bouw, M. França, C. Rubio, O. Mañez, R. Campiñez, M. Alvarez, M. Jorda, R. Naveira-Abeigón, E. Monedero, P. Alemparte-Pardavila, E. Garcia del Valle, S. Perez Calvo, C. Palomar, M. Guerrero, F. Caballero Zirena, A. Arribas, M. Bustamante Munguira, E. Ruiz, J. Iglesias, L. Zavala, E. Valencia, M. Blesa Malpica, A. Martinez-Sagasti, F. Nieto, M. Aguilar, G. Martinon-Torres, F. Lorente, C. Insausti, J. Vegas Pinto, R. Santos, I. Escriba, A. Olaechea, P. Muñoz, E. Antón Caraballo, E. Galdos-Anuncibay, P. Lopez Camps, V. Esteban-Reboll, F. Estella, A. Bocero, L. Ibañez, A. Pueyo, L. María Jesús, L. Iglesias, L. Silva, J. Garro, P. Ramos-gómez, L. Rovira, A. Martin Delgado, M. Monton Dito, J. Garcia, F. Navarro, J. Latour-Perez, J. Albaya, A. Bustinza, A. Sole-violán, J. Ugarte Peña, P. Yuste, I. De Rojas Román, J. Vallés, J. Esteban, E. Quintana Tort-Martorell, E. Moreno, M. López Ciudad, V. Manzano Ramirez, A. Sánchez-Olmedo, J. Borges, M. Amador Amerigo, J. Guerrero Gomez, F. Montejo González, J. Sirvent, J. Mesalles Sanjuan, E. Barcenilla-Gaite, F. Serrano, N. Cerdá, E. Lesmes Serrano, A. Garcia-Fuentes, C. Macias Pingarrón, J. Espinosa, E. Sanchez Garcia, M. Felices, F. de la Torre-Prados, M. Maria Jesus, H. Luis, V. Jara, R. Briones Lopez, M. Posada, P. Galvan, B. Mariscal, F. Gil, B. Sierra, R. Rico-Feijoo, J. Corcobado Márquez, C. Izura, J. González, J. Soto Ibáñez, J. Petersen, P. Johansson, L. Blomqvist, H. Peterzén, B. Wyon, N. Stiernstrom, H. Lindström, I. Paulsson, A. Agvald-Ohman, C. Petersson, J. Friberg, H. Einar, V. Hammarskjöld, F. Schindele, M. Arvidsson, S. Sellgren, J. Hulting, J. Häggqvist, J. Rudenstam, J. Lind, D. Kokinsky, E. Owall, A. Jacobson, S. Nydahl, A. Atalan, K. Ates, C. Kahveci, A. Fistikci, H. Kaya, A. Ozgencil, E. Kizilkaya, M. Bosnak, M. Bodur, H. Akan, M. Guven, M. Turkoglu, M. Topeli, A. Togal, T. Uzel, N. Akinci, I. Cakar, N. Tugrul, S. Demirkiran, O. Adanir, T. Dogruer, K. Turkmen, A. Guven, H. Ulger, F. Kocak, S. the EPIC II Group of Investigators

Subjects
health care facilities, manpower, and services
Abstract

Background: Antimicrobial resistance is an increasing concern in ICUs worldwide. Infection with an antibiotic resistant (ABR) strain of an organism is associated with greater mortality than infection with the non-resistant strain, but there are few data assessing whether being admitted to an intensive care unit (ICU) with high levels of antimicrobial resistance is associated with a worse outcome than being admitted to an ICU with low rates of resistance. The aim of this study was, therefore, to compare the characteristics of infections and antibiotic treatments and patient outcomes in patients admitted to ICUs in countries considered as having high levels of antibiotic resistance and those admitted to ICUs in countries considered as having low levels of antibiotic resistance.Methods: Data from the large, international EPIC II one-day point prevalence study on infections in patients hospitalized in ICUs were used. For the current study, we compared the data obtained from patients from two groups of countries: countries with reported MRSA rates of ≥ 25% (highABR: Greece, Israel, Italy, Malta, Portugal, Spain, and Turkey) and countries with MRSA rates of < 5% (lowABR: Denmark, Finland, Netherlands, Norway, and Sweden).Results: On the study day, 1187/2204 (53.9%) patients in the HighABR ICUs were infected and 255/558 (45.7%) in the LowABR ICUs (P < 0.01). Patients in the HighABR ICUs were more severely ill than those in the LowABR ICUs, as reflected by a higher SAPS II score (35.6 vs 32.7, P < 0.05) and had longer median ICU (12 days vs 5 days) and hospital (24 days vs 16 days) lengths of stay. They also had higher crude ICU (20.0% vs 15.4%) and hospital (27.0% vs 21.5%) mortality rates (both P < 0.05). However, after multivariable adjustment and matched pair analysis there were no differences in ICU or hospital mortality rates between High or LowABR ICU patients overall or among those with infections.Conclusions: Being hospitalized in an ICU in a region with high levels of antimicrobial resistance is not associated per se with a worse outcome. © 2014 Hanberger et al.; licensee BioMed Central Ltd.

Published
2014

37. Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

Author

Keth, Th, Azoulay, E, Echeverria, Pm, Vincent, Jl, Collaboratorsmargarit, A, Valentini, R, Alan Javier, Z, Bevilacqua, C, Curone, M, Rabuffetti, R, Comignani, P, Torres Boden, M, Chertcoff, F, Cardonatti, G, Adén, F, Marcos, L, Dónofrio, M, Fernández, R, Lamberghini, R, Balasini, S, Teves, J, Las Heras, M, Sinner, J, Ceraso, D, Curcio, D, Aguilar, L, Weller, C, Cardonnet, L, Santa Cruz, R, Manrique, E, Bernardez, D, Iolster, T, Chiappero, G, Ramos, P, Vergara, J, Moine, I, Ilutovich, S, Jannello, G, Waschbusch, M, Rios Picaza, G, Raimondi, A, Miriam, M, Lovesio, C, Caridi, M, Leong, T, Orford, N, Reece, G, Ernest, D, Hawker, F, Tan, J, Giannellis, C, Ihle, B, Bersten, A, Mcinnes, J, Tallott, M, Mcfadyen, B, Vibert, J, Parr, M, Tran, K, Sutton, J, Webb, S, Groves, N, Cole, L, Long, D, Bass, F, Erickson, S, Lipman, J, Delzoppo, C, Thomas, J, Dobb, G, Daley, M, Roberts, B, Santamaria, J, Young, J, Festa, M, Holland, R, Mullany, D, Williams, P, Corkeron, M, Gales, M, Banerjee, A, Yung, M, Mutz, N, Hiesmayr, M, Faybik, P, Fitzgerald, R, Firlinger, F, Zasmeta, G, Zink, M, Sieber, W, Hildegard, J, Bakondy, R, Schlieber, J, Filzwieser, G, Beer, R, Joannidis, M, Schuster, R, Scherzer, W, Smolle, K, Fitzal, S, Manzoor, R, Brunain, J, D'Hondt, A, Huylenbroeck, G, Van der Schueren, M, 't Kindt, H, Slock, E, Rijckaert, D, Raemaekers, J, Bourgeois, M, Van Cotthem, I, Nackaerts, G, Gusu, D, Gadisseux, P, Vancollie, O, Lignian, H, Michel, P, Fraipont, V, Vander Stappen, M, Forêt, F, De Bels, D, Devriendt, J, Massaut, J, Biston, P, Roman, A, Lambermont, B, De Meulder, A, Frederic, V, Sottiaux, T, Ruyffelaere, P, Collin, V, Anane, S, Kleiren, P, Simon, M, Machayekhi, S, Frans, E, Leroy, G, Berghmans, T, Joseph, R, Eerens, J, Laterre, P, Lagrou, B, Rutsaert, R, Pisarek, W, Dive, A, De Waele, J, Spapen, H, Damas, P, Malbrain, M, Hidalgo, J, Baptista, M, Salgado, D, Braga, M, Avila, C, Westphal, G, Caser, E, Alves, A, Friedman, G, Luz, M, Assuncao, M, Reis, H, Gomes, A, Silva, U, Nogueira Fh, W, El Dash, S, Valiatti, J, Barbosa, A, Coelho, C, Knibel, M, Minelli, C, Caovilla, J, Teixeira, G, Hovnanian, A, Rea Neto, A, Lobo, S, Lugarinho, M, Souza, P, Ferreira, D, Duarte, P, Oliveira, M, Marques, J, Machado, R, Rehder, P, Mataloun, S, Grilo, M, Quesado, P, Moock, M, Ferreira, F, Teles, J, Silva, E, Morais, A, Bruzzi de Carvalho, F, Wanderley, M, Velasco, M, Brandão da Silva, N, Feijó, J, Souza Dantas, V, Costa Filho, R, Japiassú, A, Villela, D, Santos, C, Passos, R, Alheira Rocha, R, Silva, R, Houly, J, Aldrighi, J, Hatum, R, Suparregui Dias, F, Ferreira, L, Ferro, L, Gomez, J, Fleury, R, David, C, Resener, T, Mendes, C, Germano, A, De Marco, F, Lage, S, Salluh, J, Torelly, A, Sad, R, Oliveira, G, Lima, R, Paranhos, J, Rocha, M, Bitencourt, W, Grion, C, Forte, D, Guimarães, H, Piras, C, Stephanova, L, Lyubenov, L, Tsarianski, G, Dimov, G, Green, R, Levasseur, J, Ward, R, Lesur, O, Poirier, G, Wax, R, Wood, G, Cook, D, Marshall, J, Herridge, M, Ferguson, N, Espinoza, M, Valdés jimenez, S, Bruhn, A, Micolich, J, Fricke, G, Galvez, S, Escamilla Leon, I, Zhan, Q, Xu, Y, Zhao, Y, Zhang, L, Qin, T, Du, B, Li, M, Wang, X, Jing, Y, Zhang, Z, Xianyao, W, Li, F, Congshan, Y, Rebolledo, C, Diaz, D, Murillo Arboleda, R, Arias Antun, A, Montenegro, G, Granados, M, Dueñas, C, Perez, N, Libreros Duque, G, Coral, M, Ortiz, G, Rodriguez, D, Barsic, B, Cubrilo Turek, M, Gornik, I, Grljusic, M, Caballero lopez, A, Iraola Ferrer, M, Pavlik, P, Manak, J, Radej, J, Belohlavek, J, Sevcik, P, Blahut, L, Tyl, D, Steinbach, J, Herold, I, Zykova, I, Prchal, D, Bartosik, T, Kolarova, M, Hájek, R, Kohoutová, J, Marek, O, Hon, P, Chytra, I, Betsch, H, Fogh, B, Espersen, K, Jacobsen, K, Berezowicz, P, Andrade, C, Guerrero, F, Salgado, E, Barahona, D, Del Pozo Sanchez, H, Jibaja, M, Alansary, A, Reintam, A, Starkopf, J, Harjola, V, Tual, L, Leone, M, Serge, M, Leroy, O, Mallet, L, Marc, B, Dormoy, D, Pascal, H, Tronchon, L, Garrigues, B, Santré, C, Dupont, H, Duranteau, J, Leon, A, Henry, L, Canevet, C, Dube, L, Julien, H, Nadia, A, Francois, B, Gérard, J, Freysz, M, Remy, G, Blanloeil, Y, Squara, P, Korach, Jm, Durand, M, Gabriel, C, Eric, P, Jacobs, F, Bronchard, R, Kipnis, E, Moussa, M, Launoy, A, Guérin, C, Vanhems, P, Wynckel, A, Clair, B, Fulgencio, J, Gottwalles, Y, Krummel, T, Lepape, A, Lesieur, O, Payen, D, Hérvé, O, Farkas, J, Cougot, P, Mallédant, Y, Joannes Boyau, O, Standl, T, Sierig, U, Geiseler, J, Hopf, H, Conrad Opel, E, Hermann, C, Ventzke, M, Henneberg, T, Esposito, F, Loeser, H, Spies, C, Zuckermann Becker, H, Voegeler, S, Scherer, R, Pauer, A, Kljucar, S, Delfs, K, Blank, E, Busch, J, Wendt, K, Lessmann, J, Bach, F, Sakr, Y, Berlet, T, Kernchen, A, Quintel, M, Holst, D, Kilger, E, Holubarsch, T, Raufhake, C, Stolt, C, Lubasch, A, Meier Hellmann, A, Woebker, G, Scharnofske, C, Breyer, M, Risch, T, Manhold, C, Goethe, Jw, Meininger, D, Greive, C, Rau, J, Seibel, A, Henn beilharz, A, Wolbert, R, Scherke, T, Martin, J, Rudolph, M, Gleissner, J, Wolf, M, Schleibach, F, Jaschinski, U, Lunkeit, A, Welte, M, Bingold, T, Kogelmann, K, Fischer, F, Fischer, B, Schmid, M, Klein, M, Bechtold, A, Bodmann, K, Klasen, J, Meyrl, H, Goetz, J, Geldner, G, Helmes, T, Jensen, N, Eickmeyer, H, Lengfelder, W, Langenstein, B, Bogdanski, R, Jelen Esselborn, S, Umgelter, A, Dörr, F, Lüttje, K, Heinemeyer, D, Uhl, M, Schirle, P, Benad, H, Glaser, M, Panzer, W, Huettemann, E, Stierwaldt, R, Schappacher, M, Müller, E, Stadlmeyer, W, Fantini, M, Dummer, B, Thörner, M, Jost, V, Loerbroks, T, Glück, T, Zimmermann, R, Clement, R, Hering, R, Klinger, T, Mehl, J, Polozek, H, Rothhammer, A, Seidler, R, Lorenz, P, Mueritz, W, Lutze, M, Euler, M, Heintz, M, Winkler, M, Angstwurm, M, Krohe, K, Treu, T, Steiner, T, Locher, S, Walz, A, Zahn, P, Brandt, W, Marks, M, Henning, F, Janssens, U, Luethgens, M, Theelen, W, Sydow, M, Weber, M, Meiser, A, Deutschmann, C, Buttner, C, Jokiel, M, Bozzetti, C, Jürgen, B, Fiedler, F, Wresch, K, 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Locicero, Mt, Marri, I, Sicignano, A, Conte, V, Oggioni, R, De Gasperi, A, De negri, P, Santagostino, G, Roberto, F, Marino, G, Castiglione, G, Sforza, D, Camillo, S, Giuseppe, N, Bassetti, Matteo, Napoli, D, Ferraro, F, Clementi, S, Di Filippo, A, Cotogni, P, Ranieri, Mv, Antonelli, M, Martinelli, L, Gianesello, L, Gullo, A, Morelli, A, Biancofiore, G, DELLA ROCCA, Giorgio, Hashimoto, S, Onodera, M, Kobayashi, A, Shinozuka, T, Imanaka, H, Ikeda, T, Yaguchi, A, Misane, I, Piebalga, A, Moughaghab, A, Pilvinis, V, Vosylius, S, Balciunas, M, Kekstas, G, Margaret, H, Klop, M, Grozdanovski, K, Eftimova, B, Wafa, S, Lim, C, Mat nor, M, Tai, L, Syed Mohd Tahir, S, Idris, N, Tan, C, Borg, M, Manzo, E, Gutierrez Morales, H, Miguel, P, Villagomez, A, Bassols, A, Aguirre, G, Cerón, U, Lopez ramos, J, Monjardín, J, Bermudez Aceves, E, Gonzalez Salazar, F, Rodriguez Gonzalez, D, Poblano Morales, M, Ramirez, F, Cetina, M, Navarro, J, Villagomez Ortiz, A, Sanchez, V, Chavarria, U, Fernandez Ponce, O, Serna secundino, H, Leonardo, O, Diego Manuel, R, Mijangos, J, Vazquez de Anda, G, Martin, E, Gutierrez, P, López Islas, I, Soberanes, L, Pejakov, L, Sbihi, A, Ouahid, B, Naoufel, M, De Pont, A, Rosseel, P, Ten Cate, J, Van Berkel, G, Corsten, S, Bakker, J, Vogelaar, J, Blom, H, Kieft, H, Kuiper, M, Gille, A, Pickkers, P, Vet, J, Ammann, J, Den Boer, S, Wesselink, R, Speelberg, B, Pham, C, Rodgers, M, Bergmans, D, Groeneveld, J, Mcarthur, C, Parke, R, Mehrtens, J, Celi, L, Freebairn, R, Rankin, N, Heffernan, C, Mchugh, G, Beca, J, Van haren, F, Barry, B, Kalkoff, M, Loevstad, R, Klepstad, P, Erno, P, Junker, A, Naqvi, S, Javed, I, Sinclair, J, Rivera, R, Chavez, C, Donayre Taber, Z, Quispe Sierra, R, Muñoz, J, Galvez Ruiz, J, Fang Li, J, Candiotti Herrera, M, Arroyo, A, Becerra, R, Meza, J, Mayorga, M, Garba, P, Kot, J, Gaszynski, T, Piechota, M, Renata, S, Müller, P, Stepinska, J, Jacek, K, Cieniawa, T, Mikstacki, A, Tamowicz, B, Bartkowska Sniatkowska, A, Karpel, E, Kusza, K, Smuszkiewicz, P, Mikaszewska Sokolewicz, M, Goraj, R, Kubler, A, Bártolo, A, Castelo Branco Sousa, M, Esteves, F, Martins, A, João, Hs, Oliveira, T, Ponce, P, Mourão, L, Febra, C, Carmo, E, Lopes, V, Póvoa, P, Rezende, A, Costa, H, Moreira, P, Pádua, F, Leite, A, Almeida, E, Alves, M, Sousa, A, Telo, L, João, S, Dias, C, Paiva, J, Ribeiro, R, Amaro, P, Carneiro, A, Moreno, R, Matos, R, Afonso, S, Bouw, M, França, C, Ibrahim, A, Tabacaru, R, Ionita, V, Tulbure, D, Filipescu, D, Pascanu, S, Grigoras, I, Copotoiu, S, Popov, D, Lebedev, E, Olga, I, Yaroshetskiy, A, Lugovkina, T, Dmitry, B, Malinin, O, Lekmanov, A, Abulmagd, M, Arabi, Y, Alhashemi, J, Ali, A, Maghrabi, K, Debek, A, Malik, M, Jankovic, R, Palibrk, I, Maravic stojkovic, V, Malenkovic, V, Surbatovic, M, Bumbasirevic, V, Lim, N, Loh, T, Tan, H, Sekeresova, H, Koutun, J, Firment, J, Malik, P, Trenkler, S, Muzlovic, I, Kosec, L, Ozek, B, Kasnik, D, Tomic, V, Knafelj, R, Svigelj, V, Du Plessis, H, Raine, R, Bhagwanjee, S, Richards, G, Goosen, J, De Jager, J, Schleicher, G, Rubio, O, Mañez, R, Burgueño Campiñez, M, Alvarez, M, Jorda, R, Naveira Abeigón, E, Monedero, P, Alemparte Pardavila, E, Garcia del Valle, S, Perez Calvo, C, Palomar, M, Caballero Zirena, A, Arribas, M, Bustamante Munguira, E, Ruiz, J, Blanco Vicente, A, Zavala, E, Valencia, M, Blesa Malpica, A, Martinez Sagasti, F, Nieto, M, Aguilar, G, Martinon Torres, F, Lorente, C, Insausti, J, Vegas Pinto, R, Santos, I, Escriba, A, Olaechea, P, Muñoz, E, Antón Caraballo, E, Galdos Anuncibay, P, Lopez Camps, V, Esteban Reboll, F, Estella, A, Bocero, L, Ibañez, A, Yagüe, G, Pueyo, L, María Jesús, L, Iglesias Fraile, L, Silva, J, Garro, P, Palma, L, Ramos gómez, L, Rovira, A, Martin Delgado, M, Monton Dito, J, Garcia, F, Latour Perez, J, Albaya, A, Bustinza, A, Sole violán, J, Ugarte Peña, P, Yuste, I, De Rojas Román, J, Vallés, J, Esteban, E, Quintana Tort Martorell, E, Moreno, M, López Ciudad, V, Manzano Ramirez, A, Sánchez Olmedo, J, Borges, M, Amador Amerigo, J, Guerrero Gomez, F, Montejo González, J, Sirvent, J, Pujol, I, Mesalles Sanjuan, E, Barcenilla Gaite, F, Serrano, N, Cerdá, E, Lesmes Serrano, A, Garcia Fuentes, C, Macias Pingarrón, J, Espinosa, E, Sanchez Garcia, M, Felices, F, de la Torre Prados, M, Maria Jesus, H, Luis, V, Jara, R, Briones Lopez, M, Posada, P, Galvan, B, Mariscal, F, Rello, J, Gil, B, Sierra, R, Rico Feijoo, J, Izura, J, González, J, Soto Ibáñez, J, Agabani, H, Petersen, P, Johansson, L, Blomqvist, H, Peterzén, B, Wyon, N, Lindström, I, Paulsson, A, Agvald Ohman, C, Petersson, J, Friberg, H, Einar, V, Hammarskjöld, F, Schindele, M, Arvidsson, S, Sellgren, S, Hulting, J, Häggqvist, J, Rudenstam, J, Lind, D, Kokinsky, E, Owall, A, Jacobson, S, Stiernstrom, H, Nydahl, A, Eggimann, P, Stocker, R, Loderer, G, Loetscher, R, Heer, K, Zender, H, Cottini, S, Pagnamenta, A, Eich, G, Felleiter, P, Marco, M, Pugin, J, Shu Hui, W, Hsieh, K, Toomtong, P, Khwannimit, B, Kietdumrongwong, P, Khaldi, A, Messadi, A, 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Rhodes, A, Mahambrey, T, Cameron, L, Thornton, J, Stotz, M, Russell, M, Longmate, A, Kitson, R, Browne, B, Thorniley, A, Gonzalez, I, Swart, M, Singer, M, Gautam, N, Prasad, V, Watson, D, Szakmany, T, Cardy, J, Binning, A, Loveland, R, Gannon, J, Martinelli, G, Nightingale, P, Howes, J, Steingrub, J, Ammons, L, Fisher, M, Gandhi, N, Martin, G, Deutschman, C, Dean, N, Michetti, C, Belzberg, H, Hutchinson, K, Van der kloot, T, Afessa, B, Kaufman, D, Iqbal, J, Ost, D, Afifi, S, West, M, Wunderink, R, Stein, S, Hagg, D, Jimenez, E, Blosser, S, Chhangani, S, Kleinpell, R, Reich, H, Fields, E, Willms, D, Castellanos Mateus, P, Melnik, L, Oud, L, Chi, E, Halfon, R, Badr, A, Restrepo, M, Pohlman, A, Branson, R, Simpson, S, Kett, D, Jacobs, T, Park, P, Wahl, W, Patricia, C, Hammersley, J, Papadimos, T, Sawyer, R, Freire, A, Rodriguez, W, Ryan, A, Margolis, B, Groth, M, Escanda, H, Baraibar, J, Paciel, D, Bagnulo, H, Hitta, F, Nadales, P, Albornoz, H, Salmen, Z, Pacheco, C, Bui, T, Potie, F, and Nguyen Huu, C.

Published
2011

40. Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levels

Author

Hanberger, H. Antonelli, M. Holmbom, M. Lipman, J. Pickkers, P. Leone, M. Rello, J. Sakr, Y. Walther, S.M. Vanhems, P. Vincent, J.-L. Betsch, H. Fogh, B. Espersen, K. Jacobsen, K. Berezowicz, P. Harjola, V. Sofianos, E. Armaganidis, A. Routsi, C. Bitzani, M. Chalkiadaki, A. Michalopoulos, A. Mouloudi, E. Ioannidou, E. Myrianthefs, P. Koulenti, D. Karampela, I. Kyriazopoulos, G. Mandragos, K. Clouva-molyvdas, P. Moraiti, A. Pneumatikos, I. Filos, K. Zakynthinos, E. Kotanidou, A. Vakalos, A. Sprung, C. Lev, A. Kishinevsky, E. Cohen, J. Sofer, S. Vesconi, S. Greco, S. Borelli, M. Cecilia, P. Sapuppo, M. Lazzero, A. Mangani, V. Petrucci, N. Minerva, M. De blasio, E. Marzorati, S. Rosi, R. Giarratano, A. Margarit, O. Guberti, A. Scolz, S. Stelian, E. Emmi, V. Caspani, M. Rosano, A. Abbruzzese, C. Colonna, S. Ceriani, R. De Blasi, R. Panella, L. Borrelli, F. Lorella, P. Ruatti, H. Munch, C. Sorbara, C. Fiore, G. Chieregato, A. Conti, V. Guadagnucci, A. Pizzamiglio, M. Locicero, M. Marri, I. Sicignano, A. Conte, V. Oggioni, R. De Gasperi, A. De Negri, P. Santagostino, G. Fumagalli, R. Marino, G. Castiglione, G. Sforza, D. Giuseppe, N. Bassetti, M. Ferraro, F. Clementi, S. Alessandro, D. Cotogni, P. Ranieri, MV. Antonelli, M. Martinelli, L. Gianesello, L. Gullo, A. Morelli, A. Biancofiore, G. Della Rocca, G. Borg, M. De Pont, A. Rosseel, P. Ten Cate, J. Van Berkel, G. Corsten, S. Bakker, J. Vogelaar, J. Blom, H. Kieft, H. Kuiper, M. Gille, A. Pickkers, P. Vet, J. Ammann, J. Den Boer, S. Wesselink, R. Speelberg, B. Pham, C. Rodgers, M. Bergmans, D. Groeneveld, J. Loevstad, R. Klepstad, P. Erno, P. Junker, A. Bártolo, A. Castelo-Branco Sousa, M. Esteves, F. Martins, A. Oliveira, T. Ponce, P. Mourão, L. Febra, C. Carmo, E. Lopes, V. Póvoa, P. Rezende, A. Costa, H. Moreira, P. Pádua, F. Leite, A. Almeida, E. Alves, M. Sousa, A. Telo, L. Dias, C. Paiva, J. Ribeiro, R. Amaro, P. Carneiro, A. Moreno, R. Matos, R. Afonso, S. Bouw, M. França, C. Rubio, O. Mañez, R. Campiñez, M. Alva and Hanberger, H. Antonelli, M. Holmbom, M. Lipman, J. Pickkers, P. Leone, M. Rello, J. Sakr, Y. Walther, S.M. Vanhems, P. Vincent, J.-L. Betsch, H. Fogh, B. Espersen, K. Jacobsen, K. Berezowicz, P. Harjola, V. Sofianos, E. Armaganidis, A. Routsi, C. Bitzani, M. Chalkiadaki, A. Michalopoulos, A. Mouloudi, E. Ioannidou, E. Myrianthefs, P. Koulenti, D. Karampela, I. Kyriazopoulos, G. Mandragos, K. Clouva-molyvdas, P. Moraiti, A. Pneumatikos, I. Filos, K. Zakynthinos, E. Kotanidou, A. Vakalos, A. Sprung, C. Lev, A. Kishinevsky, E. Cohen, J. Sofer, S. Vesconi, S. Greco, S. Borelli, M. Cecilia, P. Sapuppo, M. Lazzero, A. Mangani, V. Petrucci, N. Minerva, M. De blasio, E. Marzorati, S. Rosi, R. Giarratano, A. Margarit, O. Guberti, A. Scolz, S. Stelian, E. Emmi, V. Caspani, M. Rosano, A. Abbruzzese, C. Colonna, S. Ceriani, R. De Blasi, R. Panella, L. Borrelli, F. Lorella, P. Ruatti, H. Munch, C. Sorbara, C. Fiore, G. Chieregato, A. Conti, V. Guadagnucci, A. Pizzamiglio, M. Locicero, M. Marri, I. Sicignano, A. Conte, V. Oggioni, R. De Gasperi, A. De Negri, P. Santagostino, G. Fumagalli, R. Marino, G. Castiglione, G. Sforza, D. Giuseppe, N. Bassetti, M. Ferraro, F. Clementi, S. Alessandro, D. Cotogni, P. Ranieri, MV. Antonelli, M. Martinelli, L. Gianesello, L. Gullo, A. Morelli, A. Biancofiore, G. Della Rocca, G. Borg, M. De Pont, A. Rosseel, P. Ten Cate, J. Van Berkel, G. Corsten, S. Bakker, J. Vogelaar, J. Blom, H. Kieft, H. Kuiper, M. Gille, A. Pickkers, P. Vet, J. Ammann, J. Den Boer, S. Wesselink, R. Speelberg, B. Pham, C. Rodgers, M. Bergmans, D. Groeneveld, J. Loevstad, R. Klepstad, P. Erno, P. Junker, A. Bártolo, A. Castelo-Branco Sousa, M. Esteves, F. Martins, A. Oliveira, T. Ponce, P. Mourão, L. Febra, C. Carmo, E. Lopes, V. Póvoa, P. Rezende, A. Costa, H. Moreira, P. Pádua, F. Leite, A. Almeida, E. Alves, M. Sousa, A. Telo, L. Dias, C. Paiva, J. Ribeiro, R. Amaro, P. Carneiro, A. Moreno, R. Matos, R. Afonso, S. Bouw, M. França, C. Rubio, O. Mañez, R. Campiñez, M. Alva

Abstract

Background: Antimicrobial resistance is an increasing concern in ICUs worldwide. Infection with an antibiotic resistant (ABR) strain of an organism is associated with greater mortality than infection with the non-resistant strain, but there are few data assessing whether being admitted to an intensive care unit (ICU) with high levels of antimicrobial resistance is associated with a worse outcome than being admitted to an ICU with low rates of resistance. The aim of this study was, therefore, to compare the characteristics of infections and antibiotic treatments and patient outcomes in patients admitted to ICUs in countries considered as having high levels of antibiotic resistance and those admitted to ICUs in countries considered as having low levels of antibiotic resistance.Methods: Data from the large, international EPIC II one-day point prevalence study on infections in patients hospitalized in ICUs were used. For the current study, we compared the data obtained from patients from two groups of countries: countries with reported MRSA rates of ≥ 25% (highABR: Greece, Israel, Italy, Malta, Portugal, Spain, and Turkey) and countries with MRSA rates of < 5% (lowABR: Denmark, Finland, Netherlands, Norway, and Sweden).Results: On the study day, 1187/2204 (53.9%) patients in the HighABR ICUs were infected and 255/558 (45.7%) in the LowABR ICUs (P < 0.01). Patients in the HighABR ICUs were more severely ill than those in the LowABR ICUs, as reflected by a higher SAPS II score (35.6 vs 32.7, P < 0.05) and had longer median ICU (12 days vs 5 days) and hospital (24 days vs 16 days) lengths of stay. They also had higher crude ICU (20.0% vs 15.4%) and hospital (27.0% vs 21.5%) mortality rates (both P < 0.05). However, after multivariable adjustment and matched pair analysis there were no differences in ICU or hospital mortality rates between High or LowABR ICU patients overall or among those with infections.Conclusions: Being hospitalized in an ICU in a region wit

Published
2014

41. Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levels

Author

Hanberger, H, Antonelli, M, Holmbom, M, Lipman, J, Pickkers, P, Leone, M, Rello, J, Sakr, Y, Walther, S, Vanhems, P, Vincent, J, Betsch, H, Fogh, B, Espersen, K, Jacobsen, K, Berezowicz, P, Harjola, V, Sofianos, E, Armaganidis, A, Routsi, C, Bitzani, M, Chalkiadaki, A, Michalopoulos, A, Mouloudi, E, Ioannidou, E, Myrianthefs, P, Koulenti, D, Karampela, I, Kyriazopoulos, G, Mandragos, K, Clouva molyvdas, P, Moraiti, A, Pneumatikos, I, Filos, K, Zakynthinos, E, Kotanidou, A, Vakalos, A, Sprung, C, Lev, A, Kishinevsky, E, Cohen, J, Sofer, S, Vesconi, S, Greco, S, Borelli, M, Cecilia, P, Sapuppo, M, Lazzero, A, Mangani, V, Petrucci, N, Minerva, M, De blasio, E, Marzorati, S, Rosi, R, Giarratano, A, Margarit, O, Guberti, A, Scolz, S, Stelian, E, Emmi, V, Caspani, M, Rosano, A, Abbruzzese, C, Colonna, S, Ceriani, R, De Blasi, R, Panella, L, Borrelli, F, Lorella, P, Ruatti, H, Munch, C, Sorbara, C, Fiore, G, Chieregato, A, Conti, V, Guadagnucci, A, Pizzamiglio, M, Locicero, M, Marri, I, Sicignano, A, Conte, V, Oggioni, R, De Gasperi, A, De Negri, P, Santagostino, G, Fumagalli, R, Marino, G, Castiglione, G, Sforza, D, Giuseppe, N, Bassetti, M, Ferraro, F, Clementi, S, Alessandro, D, Cotogni, P, Ranieri, M, Martinelli, L, Gianesello, L, Gullo, A, Morelli, A, Biancofiore, G, Della Rocca, G, Borg, M, De Pont, A, Rosseel, P, Ten Cate, J, Van Berkel, G, Corsten, S, Bakker, J, Vogelaar, J, Blom, H, Kieft, H, Kuiper, M, Gille, A, Vet, J, Ammann, J, Den Boer, S, Wesselink, R, Speelberg, B, Pham, C, Rodgers, M, Bergmans, D, Groeneveld, J, Loevstad, R, Klepstad, P, Erno, P, Junker, A, Bártolo, A, Castelo Branco Sousa, M, Esteves, F, Martins, A, Oliveira, T, Ponce, P, Mourão, L, Febra, C, Carmo, E, Lopes, V, Póvoa, P, Rezende, A, Costa, H, Moreira, P, Pádua, F, Leite, A, Almeida, E, Alves, M, Sousa, A, Telo, L, Dias, C, Paiva, J, Ribeiro, R, Amaro, P, Carneiro, A, Moreno, R, Matos, R, Afonso, S, Bouw, M, França, C, Rubio, O, Mañez, R, Campiñez, B, Alvarez, M, Jorda, R, Naveira Abeigón, E, Monedero, P, Alemparte Pardavila, E, Garcia del Valle, S, Perez Calvo, C, Palomar, M, Guerrero, F, Caballero Zirena, A, Arribas, M, Bustamante Munguira, E, Ruiz, J, Iglesias, L, Zavala, E, Valencia, M, Blesa Malpica, A, Martinez Sagasti, F, Nieto, M, Aguilar, G, Martinon Torres, F, Lorente, C, Insausti, J, Vegas Pinto, R, Santos, I, Escriba, A, Olaechea, P, Muñoz, E, Antón Caraballo, E, Galdos Anuncibay, P, Lopez Camps, V, Esteban Reboll, F, Estella, A, Bocero, L, Ibañez, A, Pueyo, L, María Jesús, L, Silva, J, Garro, P, Ramos gómez, L, Rovira, A, Martin Delgado, M, Monton Dito, J, Garcia, F, Navarro, J, Latour Perez, J, Albaya, A, Bustinza, A, Sole violán, J, Ugarte Peña, P, Yuste, I, De Rojas Román, J, Vallés, J, Esteban, E, Quintana Tort Martorell, E, Moreno, M, López Ciudad, V, Manzano Ramirez, A, Sánchez Olmedo, J, Borges, M, Amador Amerigo, J, Guerrero Gomez, F, Montejo González, J, Sirvent, J, Mesalles Sanjuan, E, Barcenilla Gaite, F, Serrano, N, Cerdá, E, Lesmes Serrano, A, Garcia Fuentes, C, Macias Pingarrón, J, Espinosa, E, Sanchez Garcia, M, Felices, F, de la Torre Prados, M, Maria Jesus, H, Luis, V, Jara, R, Briones Lopez, M, Posada, P, Galvan, B, Mariscal, F, Gil, B, Sierra, R, Rico Feijoo, J, Corcobado Márquez, C, Izura, J, González, J, Soto Ibáñez, J, Petersen, P, Johansson, L, Blomqvist, H, Peterzén, B, Wyon, N, Stiernstrom, H, Lindström, I, Paulsson, A, Agvald Ohman, C, Petersson, J, Friberg, H, Einar, V, Hammarskjöld, F, Schindele, M, Arvidsson, S, Sellgren, J, Hulting, J, Häggqvist, J, Rudenstam, J, Lind, D, Kokinsky, E, Owall, A, Jacobson, S, Nydahl, A, Atalan, K, Ates, C, Kahveci, A, Fistikci, H, Kaya, A, Ozgencil, E, Kizilkaya, M, Bosnak, M, Bodur, H, Akan, M, Guven, M, Turkoglu, M, Topeli, A, Togal, T, Uzel, N, Akinci, I, Cakar, N, Tugrul, S, Demirkiran, O, Adanir, T, Dogruer, K, Turkmen, A, Guven, H, Ulger, F, Kocak, S, Kocak, S., FUMAGALLI, ROBERTO, Hanberger, H, Antonelli, M, Holmbom, M, Lipman, J, Pickkers, P, Leone, M, Rello, J, Sakr, Y, Walther, S, Vanhems, P, Vincent, J, Betsch, H, Fogh, B, Espersen, K, Jacobsen, K, Berezowicz, P, Harjola, V, Sofianos, E, Armaganidis, A, Routsi, C, Bitzani, M, Chalkiadaki, A, Michalopoulos, A, Mouloudi, E, Ioannidou, E, Myrianthefs, P, Koulenti, D, Karampela, I, Kyriazopoulos, G, Mandragos, K, Clouva molyvdas, P, Moraiti, A, Pneumatikos, I, Filos, K, Zakynthinos, E, Kotanidou, A, Vakalos, A, Sprung, C, Lev, A, Kishinevsky, E, Cohen, J, Sofer, S, Vesconi, S, Greco, S, Borelli, M, Cecilia, P, Sapuppo, M, Lazzero, A, Mangani, V, Petrucci, N, Minerva, M, De blasio, E, Marzorati, S, Rosi, R, Giarratano, A, Margarit, O, Guberti, A, Scolz, S, Stelian, E, Emmi, V, Caspani, M, Rosano, A, Abbruzzese, C, Colonna, S, Ceriani, R, De Blasi, R, Panella, L, Borrelli, F, Lorella, P, Ruatti, H, Munch, C, Sorbara, C, Fiore, G, Chieregato, A, Conti, V, Guadagnucci, A, Pizzamiglio, M, Locicero, M, Marri, I, Sicignano, A, Conte, V, Oggioni, R, De Gasperi, A, De Negri, P, Santagostino, G, Fumagalli, R, Marino, G, Castiglione, G, Sforza, D, Giuseppe, N, Bassetti, M, Ferraro, F, Clementi, S, Alessandro, D, Cotogni, P, Ranieri, M, Martinelli, L, Gianesello, L, Gullo, A, Morelli, A, Biancofiore, G, Della Rocca, G, Borg, M, De Pont, A, Rosseel, P, Ten Cate, J, Van Berkel, G, Corsten, S, Bakker, J, Vogelaar, J, Blom, H, Kieft, H, Kuiper, M, Gille, A, Vet, J, Ammann, J, Den Boer, S, Wesselink, R, Speelberg, B, Pham, C, Rodgers, M, Bergmans, D, Groeneveld, J, Loevstad, R, Klepstad, P, Erno, P, Junker, A, Bártolo, A, Castelo Branco Sousa, M, Esteves, F, Martins, A, Oliveira, T, Ponce, P, Mourão, L, Febra, C, Carmo, E, Lopes, V, Póvoa, P, Rezende, A, Costa, H, Moreira, P, Pádua, F, Leite, A, Almeida, E, Alves, M, Sousa, A, Telo, L, Dias, C, Paiva, J, Ribeiro, R, Amaro, P, Carneiro, A, Moreno, R, Matos, R, Afonso, S, Bouw, M, França, C, Rubio, O, Mañez, R, Campiñez, B, Alvarez, M, Jorda, R, Naveira Abeigón, E, Monedero, P, Alemparte Pardavila, E, Garcia del Valle, S, Perez Calvo, C, Palomar, M, Guerrero, F, Caballero Zirena, A, Arribas, M, Bustamante Munguira, E, Ruiz, J, Iglesias, L, Zavala, E, Valencia, M, Blesa Malpica, A, Martinez Sagasti, F, Nieto, M, Aguilar, G, Martinon Torres, F, Lorente, C, Insausti, J, Vegas Pinto, R, Santos, I, Escriba, A, Olaechea, P, Muñoz, E, Antón Caraballo, E, Galdos Anuncibay, P, Lopez Camps, V, Esteban Reboll, F, Estella, A, Bocero, L, Ibañez, A, Pueyo, L, María Jesús, L, Silva, J, Garro, P, Ramos gómez, L, Rovira, A, Martin Delgado, M, Monton Dito, J, Garcia, F, Navarro, J, Latour Perez, J, Albaya, A, Bustinza, A, Sole violán, J, Ugarte Peña, P, Yuste, I, De Rojas Román, J, Vallés, J, Esteban, E, Quintana Tort Martorell, E, Moreno, M, López Ciudad, V, Manzano Ramirez, A, Sánchez Olmedo, J, Borges, M, Amador Amerigo, J, Guerrero Gomez, F, Montejo González, J, Sirvent, J, Mesalles Sanjuan, E, Barcenilla Gaite, F, Serrano, N, Cerdá, E, Lesmes Serrano, A, Garcia Fuentes, C, Macias Pingarrón, J, Espinosa, E, Sanchez Garcia, M, Felices, F, de la Torre Prados, M, Maria Jesus, H, Luis, V, Jara, R, Briones Lopez, M, Posada, P, Galvan, B, Mariscal, F, Gil, B, Sierra, R, Rico Feijoo, J, Corcobado Márquez, C, Izura, J, González, J, Soto Ibáñez, J, Petersen, P, Johansson, L, Blomqvist, H, Peterzén, B, Wyon, N, Stiernstrom, H, Lindström, I, Paulsson, A, Agvald Ohman, C, Petersson, J, Friberg, H, Einar, V, Hammarskjöld, F, Schindele, M, Arvidsson, S, Sellgren, J, Hulting, J, Häggqvist, J, Rudenstam, J, Lind, D, Kokinsky, E, Owall, A, Jacobson, S, Nydahl, A, Atalan, K, Ates, C, Kahveci, A, Fistikci, H, Kaya, A, Ozgencil, E, Kizilkaya, M, Bosnak, M, Bodur, H, Akan, M, Guven, M, Turkoglu, M, Topeli, A, Togal, T, Uzel, N, Akinci, I, Cakar, N, Tugrul, S, Demirkiran, O, Adanir, T, Dogruer, K, Turkmen, A, Guven, H, Ulger, F, Kocak, S, Kocak, S., and FUMAGALLI, ROBERTO

Abstract

Background: Antimicrobial resistance is an increasing concern in ICUs worldwide. Infection with an antibiotic resistant (ABR) strain of an organism is associated with greater mortality than infection with the non-resistant strain, but there are few data assessing whether being admitted to an intensive care unit (ICU) with high levels of antimicrobial resistance is associated with a worse outcome than being admitted to an ICU with low rates of resistance. The aim of this study was, therefore, to compare the characteristics of infections and antibiotic treatments and patient outcomes in patients admitted to ICUs in countries considered as having high levels of antibiotic resistance and those admitted to ICUs in countries considered as having low levels of antibiotic resistance.Methods: Data from the large, international EPIC II one-day point prevalence study on infections in patients hospitalized in ICUs were used. For the current study, we compared the data obtained from patients from two groups of countries: countries with reported MRSA rates of ≥ 25% (highABR: Greece, Israel, Italy, Malta, Portugal, Spain, and Turkey) and countries with MRSA rates of < 5% (lowABR: Denmark, Finland, Netherlands, Norway, and Sweden).Results: On the study day, 1187/2204 (53.9%) patients in the HighABR ICUs were infected and 255/558 (45.7%) in the LowABR ICUs (P < 0.01). Patients in the HighABR ICUs were more severely ill than those in the LowABR ICUs, as reflected by a higher SAPS II score (35.6 vs 32.7, P < 0.05) and had longer median ICU (12 days vs 5 days) and hospital (24 days vs 16 days) lengths of stay. They also had higher crude ICU (20.0% vs 15.4%) and hospital (27.0% vs 21.5%) mortality rates (both P < 0.05). However, after multivariable adjustment and matched pair analysis there were no differences in ICU or hospital mortality rates between High or LowABR ICU patients overall or among those with infections.Conclusions: Being hospitalized in an ICU in a region with high level

Published
2014

42. Peripherally inserted central catheters in non-hospitalized cancer patients: 5-year results of a prospective study

Author

Cotogni, P, Barbero, C, Garrino, C, Degiorgis, C, Mussa, B, De Francesco, A, Pittiruti, Mauro, Pittiruti, Mauro (ORCID:0000-0003-4541-7566), Cotogni, P, Barbero, C, Garrino, C, Degiorgis, C, Mussa, B, De Francesco, A, Pittiruti, Mauro, and Pittiruti, Mauro (ORCID:0000-0003-4541-7566)

Abstract

Few prospective follow-up studies evaluating the use of peripherally inserted central catheters (PICCs) to deliver chemotherapy and/or home parenteral nutrition (HPN) have focused exclusively on oncology outpatients. The aim of this prospective study was to assess the reliability and the safety of PICCs over a 5-year use in non-hospitalized cancer patients requiring long-term intravenous therapies.

Published
2014

43. Focus on peripherally inserted central catheters in critically ill patients

Author

Cotogni, P, Pittiruti, Mauro, Pittiruti, Mauro (ORCID:0000-0003-4541-7566), Cotogni, P, Pittiruti, Mauro, and Pittiruti, Mauro (ORCID:0000-0003-4541-7566)

Abstract

Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings (emergency, intensive care, surgery) and for different purposes (fluids or drugs infusions, parenteral nutrition, antibiotic therapy, hemodynamic monitoring, procedures of dialysis/apheresis). However, healthcare professionals are commonly worried about the possible consequences that may result using a central venous access device (CVAD) (mainly, bloodstream infections and thrombosis), both peripherally inserted central catheters (PICCs) and centrally inserted central catheters (CICCs). This review aims to discuss indications, insertion techniques, and care of PICCs in critically ill patients. PICCs have many advantages over standard CICCs. First of all, their insertion is easy and safe -due to their placement into peripheral veins of the arm- and the advantage of a central location of catheter tip suitable for all osmolarity and pH solutions. Using the ultrasound-guidance for the PICC insertion, the risk of hemothorax and pneumothorax can be avoided, as well as the possibility of primary malposition is very low. PICC placement is also appropriate to avoid post-procedural hemorrhage in patients with an abnormal coagulative state who need a CVAD. Some limits previously ascribed to PICCs (i.e., low flow rates, difficult central venous pressure monitoring, lack of safety for radio-diagnostic procedures, single-lumen) have delayed their start up in the intensive care units as common practice. Though, the recent development of power-injectable PICCs overcomes these technical limitations and PICCs have started to spread in critical care settings. Two important take-home messages may be drawn from this review. First, the incidence of complications varies depending on venous accesses and healthcare professionals should be aware of the different clinical performance as well as of the different risks associate

Published
2014

44. Catheter-related complications in cancer patients on home parenteral nutrition: a prospective study of over 51,000 catheter days

Author

Cotogni, P, Pittiruti, Mauro, Barbero, C, Monge, T, Palmo, A, Boggio Bertinet, D., Pitocco, Dario, Pittiruti, Mauro (ORCID:0000-0003-4541-7566), Pitocco, Dario (ORCID:0000-0002-6220-686X), Cotogni, P, Pittiruti, Mauro, Barbero, C, Monge, T, Palmo, A, Boggio Bertinet, D., Pitocco, Dario, Pittiruti, Mauro (ORCID:0000-0003-4541-7566), and Pitocco, Dario (ORCID:0000-0002-6220-686X)

Abstract

Although home parenteral nutrition (HPN) is often indicated in cancer patients, many physicians are concerned about the risks potentially associated with the use of central venous access devices (VADs) in these patients. The aim of this prospective study was to investigate the actual incidence of VAD-related complications in cancer patients on HPN.

Published
2013

48. Genome-wide association study of survival from sepsis due to pneumonia: an observational cohort study.

Author

Rautanen, Anna, Mills, Tara C, Gordon, Anthony C, Hutton, Paula, Steffens, Michael, Nuamah, Rosamond, Chiche, Jean-Daniel, Parks, Tom, Chapman, Stephen J, Davenport, Emma E, Elliott, Katherine S, Bion, Julian, Lichtner, Peter, Meitinger, Thomas, Wienker, Thomas F, Caulfield, Mark J, Mein, Charles, Bloos, Frank, Bobek, Ilona, and Cotogni, Paolo

Subjects
SEPSIS, CAUSES of death, MEDICAL care costs, PNEUMONIA, GENOMES, GENETICS
Abstract

Summary Background Sepsis continues to be a major cause of death, disability, and health-care expenditure worldwide. Despite evidence suggesting that host genetics can influence sepsis outcomes, no specific loci have yet been convincingly replicated. The aim of this study was to identify genetic variants that influence sepsis survival. Methods We did a genome-wide association study in three independent cohorts of white adult patients admitted to intensive care units with sepsis, severe sepsis, or septic shock (as defined by the International Consensus Criteria) due to pneumonia or intra-abdominal infection (cohorts 1–3, n=2534 patients). The primary outcome was 28 day survival. Results for the cohort of patients with sepsis due to pneumonia were combined in a meta-analysis of 1553 patients from all three cohorts, of whom 359 died within 28 days of admission to the intensive-care unit. The most significantly associated single nucleotide polymorphisms (SNPs) were genotyped in a further 538 white patients with sepsis due to pneumonia (cohort 4), of whom 106 died. Findings In the genome-wide meta-analysis of three independent pneumonia cohorts (cohorts 1–3), common variants in the FER gene were strongly associated with survival (p=9·7 × 10 −8 ). Further genotyping of the top associated SNP (rs4957796) in the additional cohort (cohort 4) resulted in a combined p value of 5·6 × 10 −8 (odds ratio 0·56, 95% CI 0·45–0·69). In a time-to-event analysis, each allele reduced the mortality over 28 days by 44% (hazard ratio for death 0·56, 95% CI 0·45–0·69; likelihood ratio test p=3·4 × 10 −9 , after adjustment for age and stratification by cohort). Mortality was 9·5% in patients carrying the CC genotype, 15·2% in those carrying the TC genotype, and 25·3% in those carrying the TT genotype. No significant genetic associations were identified when patients with sepsis due to pneumonia and intra-abdominal infection were combined. Interpretation We have identified common variants in the FER gene that associate with a reduced risk of death from sepsis due to pneumonia. The FER gene and associated molecular pathways are potential novel targets for therapy or prevention and candidates for the development of biomarkers for risk stratification. Funding European Commission and the Wellcome Trust. [ABSTRACT FROM AUTHOR]

Published
2015
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