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2,514 results on '"Kollef, Marin H"'

15. PROPHETIC: Prospective Identification of Pneumonia in Hospitalized Patients in the ICU

Author

Bergin, Stephen P., Coles, Adrian, Calvert, Sara B., Farley, John, Powers, John H., Zervos, Marcus J., Sims, Matthew, Kollef, Marin H., Durkin, Michael J., Kabchi, Badih A., Donnelly, Helen K., Bardossy, Ana Cecilia, Greenshields, Claire, Rubin, Daniel, Sun, Jie-Lena, Chiswell, Karen, Santiago, Jonas, Gu, Peidi, Tenaerts, Pamela, Fowler, Vance G., Jr., and Holland, Thomas L.

Published
2020
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18. Bacterial and fungal superinfections in critically ill patients with COVID-19

Author

Bassetti, Matteo, Kollef, Marin H., and Timsit, Jean-Francois

Subjects
Pfizer Inc., Medical colleges, Hospital patients, Pharmaceutical industry, Health care industry
Abstract

Author(s): Matteo Bassetti [sup.1] [sup.2], Marin H. Kollef [sup.3], Jean-Francois Timsit [sup.4] [sup.5] Author Affiliations: (1) Clinica Malattie Infettive, Ospedale Policlinico San Martino-IRCCS, , L.go R. Benzi 10, 16132, Genoa, [...]

Published
2020
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20. Ceftolozane/tazobactam versus meropenem in patients with ventilated hospital-acquired bacterial pneumonia: subset analysis of the ASPECT-NP randomized, controlled phase 3 trial

Author

Timsit, Jean-François, Huntington, Jennifer A., Wunderink, Richard G., Shime, Nobuaki, Kollef, Marin H., Kivistik, Ülo, Nováček, Martin, Réa-Neto, Álvaro, Martin-Loeches, Ignacio, Yu, Brian, Jensen, Erin H., Butterton, Joan R., Wolf, Dominik J., Rhee, Elizabeth G., and Bruno, Christopher J.

Published
2021
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26. Quantitative SARS-CoV-2 RT-PCR and Bronchoalveolar Cytokine Concentrations Redefine the COVID-19 Phenotypes in Critically Ill Patients.

Author

Vazquez Guillamet, M. Cristina, Vazquez Guillamet, Rodrigo, Rjob, Ashraf, Reynolds, Daniel, Parikh, Bijal, Despotovic, Vladimir, Byers, Derek E., Ellebedy, Ali H., Kollef, Marin H., and Mudd, Philip A.

Subjects
COVID-19 pandemic, SARS-CoV-2, SARS disease, BRONCHOSCOPY, DEXAMETHASONE
Abstract

Rationale: Recent studies suggest that both hypo- and hyperinflammatory acute respiratory distress syndrome (ARDS) phenotypes characterize severe COVID-19-related pneumonia. The role of lung Severe Acute Respiratory Syndrome – Coronavirus 2 (SARS-CoV-2) viral load in contributing to these phenotypes remains unknown. Objectives: To redefine COVID-19 ARDS phenotypes when considering quantitative SARS-CoV-2 RT-PCR in the bronchoalveolar lavage of intubated patients. To compare the relevance of deep respiratory samples versus plasma in linking the immune response and the quantitative viral loads. Methods: Eligible subjects were adults diagnosed with COVID-19 ARDS who required mechanical ventilation and underwent bronchoscopy. We recorded the immune response in the bronchoalveolar lavage and plasma and the quantitative SARS-CoV-2 RT-PCR in the bronchoalveolar lavage. Hierarchical clustering on principal components was applied separately on the 2 compartments' datasets. Baseline characteristics were compared between clusters. Measurements and Results: Twenty subjects were enrolled between August 2020 and March 2021. Subjects underwent bronchoscopy on average 3.6 days after intubation. All subjects were treated with dexamethasone prior to bronchoscopy, 11 of 20 (55.6%) received remdesivir and 1 of 20 (5%) received tocilizumab. Adding viral load information to the classic 2-cluster model of ARDS revealed a new cluster characterized by hypoinflammatory responses and high viral load in 23.1% of the cohort. Hyperinflammatory ARDS was noted in 15.4% of subjects. Bronchoalveolar lavage clusters were more stable compared to plasma. Conclusions: We identified a unique group of critically ill subjects with COVID-19 ARDS who exhibit hypoinflammatory responses but high viral loads in the lower airways. These clusters may warrant different treatment approaches to improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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36. Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP)

Author

Tabah, Alexis, Bassetti, Matteo, Kollef, Marin H., Zahar, Jean-Ralph, Paiva, José-Artur, Timsit, Jean-Francois, and Roberts, Jason A.

Subjects
Pfizer Inc. -- Foreign operations, Task forces -- Research, Communicable diseases -- Research, Medical research, Medicine, Experimental, Drug resistance in microorganisms -- Research, Methicillin -- Research, Microbiology -- Research, Evidence-based medicine -- Research, Pharmaceutical industry -- Foreign operations, Health care industry
Abstract

Background Antimicrobial de-escalation (ADE) is a strategy of antimicrobial stewardship, aiming at preventing the emergence of antimicrobial resistance (AMR) by decreasing the exposure to broad-spectrum antimicrobials. There is no high-quality research on ADE and its effects on AMR. Its definition varies and there is little evidence-based guidance for clinicians to use ADE in the intensive care unit (ICU). Methods A task force of 16 international experts was formed in November 2016 to provide with guidelines for clinical practice to develop questions targeted at defining ADE, its effects on the ICU population and to provide clinical guidance. Groups of 2 experts were assigned 1-2 questions each within their field of expertise to provide draft statements and rationale. A Delphi method, with 3 rounds and an agreement threshold of 70% was required to reach consensus. Results We present a comprehensive document with 13 statements, reviewing the evidence on the definition of ADE, its effects in the ICU population and providing guidance for clinicians in subsets of clinical scenarios where ADE may be considered. Conclusion ADE remains a topic of controversy due to the complexity of clinical scenarios where it may be applied and the absence of evidence to the effects it may have on antimicrobial resistance., Author(s): Alexis Tabah [sup.1], Matteo Bassetti [sup.2], Marin H. Kollef [sup.3], Jean-Ralph Zahar [sup.4], José-Artur Paiva [sup.5], Jean-Francois Timsit [sup.6] [sup.7], Jason A. Roberts [sup.8] [sup.9] [sup.10], Jeroen Schouten [sup.11], [...]

Published
2020
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38. Reply to MacFadden et al

Author

Guillamet, M. Cristina Vazquez, Vazquez, Rodrigo, Micek, Scott T., and Kollef, Marin H.

Published
2018

39. Cost and mortality prediction using polymerase chain reaction pathogen detection in sepsis: evidence from three observational trials

Author

Lehmann, Lutz E, Herpichboehm, Bernd, Kost, Gerald J, Kollef, Marin H, and Stüber, Frank

Abstract

Abstract Introduction Delays in adequate antimicrobial treatment contribute to high cost and mortality in sepsis. Polymerase chain reaction (PCR) assays are used alongside conventional cultures to accelerate the identification of microorganisms. We analyze the impact on medical outcomes and healthcare costs if improved adequacy of antimicrobial therapy is achieved by providing immediate coverage after positive PCR reports. Methods A mathematical prediction model describes the impact of PCR-based rapid adjustment of antimicrobial treatment. The model is applied to predict cost and medical outcomes for 221 sepsis episodes of 189 post-surgical and intensive care unit (ICU) sepsis patients with available PCR data from a prospective, observational trial of a multiplex PCR assay in five hospitals. While this trial demonstrated reduction of inadequate treatment days, data on outcomes associated with reduced inadequate initial antimicrobial treatment had to be obtained from two other, bigger, studies which involved 1,147 (thereof 316 inadequately treated) medical or surgical ICU patients. Our results are reported with the (5% to 95%) percentile ranges from Monte Carlo simulation in which the input parameters were randomly and independently varied according to their statistical characterization in the three underlying studies. The model allows predictions also for different patient groups or PCR assays. Results A total of 13.1% of PCR tests enabled earlier adequate treatment. We predict that cost for PCR testing (300 €/test) can be fully recovered for patients above 717 € (605 € to 1,710 €) daily treatment cost. A 2.6% (2.0 to 3.2%) absolute reduction of mortality is expected. Cost per incremental survivor calculates to 11,477 € (9,321 € to 14,977 €) and incremental cost-effectiveness ratio to 3,107 € (2,523 € to 4,055 €) per quality-adjusted life-year. Generally, for ICU patients with >25% incidence of inadequate empiric antimicrobial treatment, and at least 15% with a positive blood culture, PCR represents a cost-neutral adjunct method. Conclusions Rapid PCR identification of microorganisms has the potential to become a cost-effective component for managing sepsis. The prediction model tested with data from three observational trials should be utilized as a framework to deepen insights when integrating more complementary data associated with utilization of molecular assays in the management of sepsis.

Published
2010

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