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2. Phase I dose-escalation single centre clinical trial to evaluate the safety of infusion of memory T cells as adoptive therapy in COVID-19 (RELEASE)

Author

Pérez-Martínez, A., Mora-Rillo, M., Ferreras, C., Guerra-García, P., Pascual-Miguel, B., Mestre-Durán, C., Borobia, A.M., Carcas, A.J., Queiruga-Parada, J., García, I., Sánchez-Zapardiel, E., Gasior, M., De Paz, R., Marcos, A., Vicario, J.L., Balas, A., Moreno, M.A., Eguizabal, C., Solano, C., Arribas, J.R., Buckley, R.de Miguel, Montejano, R., and Soria, B.

Published
2021
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3. Coherent response of zoo‐ and phytoplankton assemblages to global warming since the Last Glacial Maximum.

Author

Strack, T., Jonkers, L., C. Rillo, M., Baumann, K.‐H., Hillebrand, H., and Kucera, M.

Subjects
LAST Glacial Maximum, GLOBAL warming, MARINE plankton, SPECIES diversity, GLACIAL melting, FORAMINIFERA, PHYTOPLANKTON
Abstract

Aim: We are using the fossil record of different marine plankton groups to determine how their biodiversity has changed during past climate warming comparable to projected future warming. Location: North Atlantic Ocean and adjacent seas. Time series cover a latitudinal range from 75° N to 6° S. Time period: Past 24,000 years, from the Last Glacial Maximum (LGM) to the current warm period covering the last deglaciation. Major taxa studied: Planktonic foraminifera, dinoflagellates and coccolithophores. Methods: We analyse time series of fossil plankton communities using principal component analysis and generalized additive models to estimate the overall trend of temporal compositional change in each plankton group and to identify periods of significant change. We further analyse local biodiversity change by analysing species richness, species gains and losses, and the effective number of species in each sample, and compare alpha diversity to the LGM mean. Results: All plankton groups show remarkably similar trends in the rates and spatio‐temporal dynamics of local biodiversity change and a pronounced non‐linearity with climate change in the current warm period. Assemblages of planktonic foraminifera and dinoflagellates started to change significantly with the onset of global warming around 15,500 to 17,000 years ago and continued to change at the same rate during the current warm period until at least 5000 years ago, while coccolithophore assemblages changed at a constant rate throughout the past 24,000 years, seemingly irrespective of the prevailing temperature change. Main conclusions: Climate change during the transition from the LGM to the current warm period led to a long‐lasting reshuffling of zoo‐ and phytoplankton assemblages, likely associated with the emergence of new ecological interactions and possibly a shift in the dominant drivers of plankton assemblage change from more abiotic‐dominated causes during the last deglaciation to more biotic‐dominated causes with the onset of the Holocene. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Epidemiology and natural history of cutaneous squamous cell carcinoma in recessive dystrophic epidermolysis bullosa patients: 20 years’ experience of a reference centre in Spain

Author

Castelo, B., Viñal, D., Maseda, R., Ostios, L., Sánchez, D., García-Salvatierra, B., Escámez, M. J., Martínez-Santamaría, L., Del Río, M., Mora-Rillo, M., Vilches, Y., Beato, M. J., López Gutiérrez, J. C., Romero, N., Santos, C., Miranda, J., and de Lucas, R.

Published
2019
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5. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study

Author

del Toro, M D, Gálvez, J, Falcone, M, Russo, A, Giamarellou, H, Trecarichi, E M, Losito, A R, García-Vázquez, E, Hernández, A, Gómez, J, Bou, G, Iosifidis, E, Prim, N, Navarro, F, Mirelis, B, Skiada, A, Origüen, J, Juan, R San, Fernández-Ruiz, M, Larrosa, N, Puig-Asensio, M, Cisneros, J M, Molina, J, González, V, Rucci, V, de Gopegui, E Ruiz, Marinescu, C I, Martínez-Martínez, L, Fariñas, M C, Cano, M E, Gozalo, M, Mora-Rillo, M, Francisco, C Navarro-San, Peña, C, Gómez-Zorrilla, S, Tubau, F, Tsakris, A, Zarkotou, O, Antoniadou, A, Poulakou, G, Pitout, J, Virmani, D, Torre-Cisneros, J, Guzmán-Puche, J, Helvaci, Ö, Sahin, A O, Pintado, V, Ruiz, P, Bartoletti, M, Giannella, M, Tacconelli, E, Riemenschneider, F, Calbo, E, Badia, C, Xercavins, M, Gasch, O, 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, Cantón, Rafael, Doi, Yohei, Tuon, Felipe Francisco, Karaiskos, Ilias, Pérez-Nadales, Elena, 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
2017
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6. Immunotherapy: EVALUATION OF MEMORY T CELLS AS ADOPTIVE THERAPY IN CORONAVIRUS PNEUMONIA AND/OR LYMPHOPENIA: A PHASE II CLINICAL TRIAL (RELEASE NCT04578210)

Author

Ferreras, C., primary, Hernández, C., additional, Martín-Quirós, A., additional, Al-Akioui-Sanz, K., additional, Mora-Rillo, M., additional, Ibáñez, F., additional, Goterris, R., additional, de Paz, R., additional, Guerra-García, P., additional, Queiruga-Parada, J., additional, Molina, P., additional, Briones, M., additional, Planelles, D., additional, Borobia, A.M., additional, Carcas, A., additional, Vicario, J.L., additional, Moreno, M., additional, Balas, A., additional, Eguizabal, C., additional, Soria, B., additional, Solano, C., additional, and Perez-Martinez, A., additional

Published
2023
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7. Compassionate use of remdesivir for patients with severe Covid-19

Author

Grein, J, Ohmagari, N, Shin, D, Diaz, G, Asperges, E, Castagna, A, Feldt, T, Green, G, Green, M, Lescure, F, Nicastri, E, Oda, R, Yo, K, Quiros-Roldan, E, Studemeister, A, Redinski, J, Ahmed, S, Bernett, J, Chelliah, D, Chen, D, Chihara, S, Cohen, S, Cunningham, J, D'Arminio Monforte, A, Ismail, S, Kato, H, Lapadula, G, L'Her, E, Maeno, T, Majumder, S, Massari, M, Mora-Rillo, M, Mutoh, Y, Nguyen, D, Verweij, E, Zoufaly, A, Osinusi, A, Dezure, A, Zhao, Y, Zhong, L, Chokkalingam, A, Elboudwarej, E, Telep, L, Timbs, L, Henne, I, Sellers, S, Cao, H, Tan, S, Winterbourne, L, Desai, P, Mera, R, Gaggar, A, Myers, R, Brainard, D, Childs, R, Flanigan, T, Grein J., Ohmagari N., Shin D., Diaz G., Asperges E., Castagna A., Feldt T., Green G., Green M. L., Lescure F. -X., Nicastri E., Oda R., Yo K., Quiros-Roldan E., Studemeister A., Redinski J., Ahmed S., Bernett J., Chelliah D., Chen D., Chihara S., Cohen S. H., Cunningham J., D'Arminio Monforte A., Ismail S., Kato H., Lapadula G., L'Her E., Maeno T., Majumder S., Massari M., Mora-Rillo M., Mutoh Y., Nguyen D., Verweij E., Zoufaly A., Osinusi A. O., DeZure A., Zhao Y., Zhong L., Chokkalingam A., Elboudwarej E., Telep L., Timbs L., Henne I., Sellers S., Cao H., Tan S. K., Winterbourne L., Desai P., Mera R., Gaggar A., Myers R. P., Brainard D. M., Childs R., Flanigan T., Grein, J, Ohmagari, N, Shin, D, Diaz, G, Asperges, E, Castagna, A, Feldt, T, Green, G, Green, M, Lescure, F, Nicastri, E, Oda, R, Yo, K, Quiros-Roldan, E, Studemeister, A, Redinski, J, Ahmed, S, Bernett, J, Chelliah, D, Chen, D, Chihara, S, Cohen, S, Cunningham, J, D'Arminio Monforte, A, Ismail, S, Kato, H, Lapadula, G, L'Her, E, Maeno, T, Majumder, S, Massari, M, Mora-Rillo, M, Mutoh, Y, Nguyen, D, Verweij, E, Zoufaly, A, Osinusi, A, Dezure, A, Zhao, Y, Zhong, L, Chokkalingam, A, Elboudwarej, E, Telep, L, Timbs, L, Henne, I, Sellers, S, Cao, H, Tan, S, Winterbourne, L, Desai, P, Mera, R, Gaggar, A, Myers, R, Brainard, D, Childs, R, Flanigan, T, Grein J., Ohmagari N., Shin D., Diaz G., Asperges E., Castagna A., Feldt T., Green G., Green M. L., Lescure F. -X., Nicastri E., Oda R., Yo K., Quiros-Roldan E., Studemeister A., Redinski J., Ahmed S., Bernett J., Chelliah D., Chen D., Chihara S., Cohen S. H., Cunningham J., D'Arminio Monforte A., Ismail S., Kato H., Lapadula G., L'Her E., Maeno T., Majumder S., Massari M., Mora-Rillo M., Mutoh Y., Nguyen D., Verweij E., Zoufaly A., Osinusi A. O., DeZure A., Zhao Y., Zhong L., Chokkalingam A., Elboudwarej E., Telep L., Timbs L., Henne I., Sellers S., Cao H., Tan S. K., Winterbourne L., Desai P., Mera R., Gaggar A., Myers R. P., Brainard D. M., Childs R., and Flanigan T.

Abstract

BACKGROUND Remdesivir, a nucleotide analogue prodrug that inhibits viral RNA polymerases, has shown in vitro activity against SARS-CoV-2. METHODS We provided remdesivir on a compassionate-use basis to patients hospitalized with Covid-19, the illness caused by infection with SARS-CoV-2. Patients were those with confirmed SARS-CoV-2 infection who had an oxygen saturation of 94% or less while they were breathing ambient air or who were receiving oxygen support. Patients received a 10-day course of remdesivir, consisting of 200 mg administered intravenously on day 1, followed by 100 mg daily for the remaining 9 days of treatment. This report is based on data from patients who received remdesivir during the period from January 25, 2020, through March 7, 2020, and have clinical data for at least 1 subsequent day. RESULTS Of the 61 patients who received at least one dose of remdesivir, data from 8 could not be analyzed (including 7 patients with no post-treatment data and 1 with a dosing error). Of the 53 patients whose data were analyzed, 22 were in the United States, 22 in Europe or Canada, and 9 in Japan. At baseline, 30 patients (57%) were receiving mechanical ventilation and 4 (8%) were receiving extracorporeal membrane oxygenation. During a median follow-up of 18 days, 36 patients (68%) had an improvement in oxygen-support class, including 17 of 30 patients (57%) receiving mechanical ventilation who were extubated. A total of 25 patients (47%) were discharged, and 7 patients (13%) died; mortality was 18% (6 of 34) among patients receiving invasive ventilation and 5% (1 of 19) among those not receiving invasive ventilation. CONCLUSIONS In this cohort of patients hospitalized for severe Covid-19 who were treated with compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients (68%). Measurement of efficacy will require ongoing randomized, placebo-controlled trials of remdesivir therapy.

Published
2020

9. Five waves of COVID-19 pandemic in Italy: results of a national survey evaluating the impact on activities related to arrhythmias, pacing, and electrophysiology promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Author

Boriani, G., Guerra, F., De Ponti, R., D'Onofrio, A., Accogli, M., Bertini, M., Bisignani, G., Forleo, G. B., Landolina, M., Lavalle, C., Notarstefano, P., Ricci, R. P., Zanotto, G., Palmisano, P., Luise, R., De Bonis, S., Pangallo, A., Talarico, A., Maglia, G., Aspromonte, V., Nigro, G., Bianchi, V., Rapacciuolo, A., Ammendola, E., Solimene, F., Stabile, G., Biffi, M., Ziacchi, M., Malpighi, P. S. O., Saporito, D., Casali, E., Turco, V., Malavasi, V. L., Vitolo, M., Imberti, J. F., Anna, A. S., Zardini, M., Placci, A., Quartieri, F., Bottoni, N., Carinci, V., Barbato, G., De Maria, E., Borghi, A., Ramazzini, O. B., Bronzetti, G., Tomasi, C., Boggian, G., Virzi, S., Sassone, B., Corzani, A., Sabbatani, P., Pastori, P., Ciccaglioni, A., Adamo, F., Scaccia, A., Spampinato, A., Patruno, N., Biscione, F., Cinti, C., Pignalberi, C., Calo, L., Tancredi, M., Di Belardino, N., Ricciardi, D., Cauti, F., Rossi, P., Cardinale, M., Ansalone, G., Narducci, M. L., Pelargonio, G., Silvetti, M., Drago, F., Santini, L., Pentimalli, F., Pepi, P., Caravati, F., Taravelli, E., Belotti, G., Rordorf, R., Mazzone, P., Bella, P. D., Rossi, S., Canevese, L. F., Cilloni, S., Doni, L. A., Vergara, P., Baroni, M., Perna, E., Gardini, A., Negro, R., Perego, G. B., Curnis, A., Arabia, G., Russo, A. D., Marchese, P., Dell'Era, G., Occhetta, E., Pizzetti, F., Amellone, C., Giammaria, M., Devecchi, C., Coppolino, A., Tommasi, S., Anselmino, M., Coluccia, G., Guido, A., Rillo, M., Palama, Z., Luzzi, G., Pellegrino, P. L., Grimaldi, M., Grandinetti, G., Vilei, E., Potenza, D., Scicchitano, P., Favale, S., Santobuono, V. E., Sai, R., Melissano, D., Candida, T. R., Bonfantino, V. M., Di Canda, D., Gianfrancesco, D., Carretta, D., Pisano, E. C. L., Medico, A., Giaccari, R., Aste, R., Murgia, C., Nissardi, V., Sanna, G. D., Firetto, G., Crea, P., Ciotta, E., Sgarito, G., Caramanno, G., Ciaramitaro, G., Faraci, A., Fasheri, A., Di Gregorio, L., Campsi, G., Muscio, G., Giannola, G., Padeletti, M., Del Rosso, A., Nesti, M., Miracapillo, G., Giovannini, T., Pieragnoli, P., Rauhe, W., Marini, M., Guarracini, F., Ridarelli, M., Fedeli, F., Mazza, A., Zingarini, G., Andreoli, C., Carreras, G., Zorzi, A., Rossillo, A., Ignatuk, B., Zerbo, F., Molon, G., Fantinel, M., Zanon, F., Marcantoni, L., Zadro, M., and Bevilacqua, M.

Subjects
Cardiac resynchronization therapy, Remote monitoring, Emergency Medicine, Internal Medicine, Ablation, Arrhythmia, Atrial fibrillation, COVID-19, Implantable cardioverter defibrillators, Pacemakers
Abstract

The subsequent waves of the COVID-19 pandemic in Italy had a major impact on cardiac care.A survey to evaluate the dynamic changes in arrhythmia care during the first five waves of COVID-19 in Italy (first: March-May 2020; second: October 2020-January 2021; third: February-May 2021; fourth: June-October 2021; fifth: November 2021-February 2022) was launched.A total of 127 physicians from arrhythmia centers (34% of Italian centers) took part in the survey. As compared to 2019, a reduction in 40% of elective pacemaker (PM), defibrillators (ICD), and cardiac resynchronization devices (CRT) implantations, with a 70% reduction for ablations, was reported during the first wave, with a progressive and gradual return to pre-pandemic volumes, generally during the third-fourth waves, slower for ablations. For emergency procedures (PM, ICD, CRT, and ablations), recovery from the initial 10% decline occurred in most cases during the second wave, with some variability. However, acute care for atrial fibrillation, electrical cardioversions, and evaluations for syncope showed a prolonged reduction of activity. The number of patients with devices which started remote monitoring increased by 40% during the first wave, but then the adoption of remote monitoring declined.The dramatic and profound derangement in arrhythmia management that characterized the first wave of the COVID-19 pandemic was followed by a progressive return to the volume of activities of the pre-pandemic periods, even if with different temporal dynamics and some heterogeneity. Remote monitoring was largely implemented during the first wave, but full implementation is needed.

Published
2022

13. Comparison of geographic workflow preferences with real-time dynamic regional mapping data during catheter ablation

Author

Zedda, AM, primary, Rillo, M, additional, Sultan, A, additional, Ramanna, H, additional, Deisenhofer, I, additional, Richter, S, additional, Mccready, J, additional, Muller, D, additional, Senatore, G, additional, Venkataraman, R, additional, Lo, M, additional, Day, JD, additional, Chung, FP, additional, Tao, C, additional, and Di Cori, A, additional

Published
2021
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14. A phase I/II dose-escalation single center study to evaluate the safety of infusion of memory t cells as adoptive therapy in coronavirus pneumonia and /or lymphopenia (release)

Author

Perez-Martinez, A., primary, Ferreras, C., additional, Mora-Rillo, M., additional, Guerra, P., additional, Pascual-Miguel, B., additional, Mestre-Durán, C., additional, Borobia, A.M., additional, Carcas, A., additional, Quiroga, J., additional, García, I., additional, Sánchez-Zapardiel, E., additional, Gasior, M., additional, de Paz, R., additional, Marcos, A., additional, Vicario, J.L., additional, Balas, A., additional, Eguizabal, C., additional, Solano, C., additional, Arribas, J.R., additional, de Miguel, R., additional, Montejano, R., additional, and Soria, B., additional

Published
2021
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17. Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Author

Boriani, G., Palmisano, P., Guerra, F., Bertini, M., Zanotto, G., Lavalle, C., Notarstefano, P., Accogli, M., Bisignani, G., Forleo, G. B., Landolina, M., D'Onofrio, A., Ricci, R., De Ponti, R., Luise, R., Grieco, P., Pangallo, A., Quirino, G., Talarico, A., De Bonis, S., Carbone, A., De Simone, A., Nappi, F., Rotondi, F., Stabile, G., Uran, C., Balla, C., Boggian, G., Carinci, V., Barbato, G., Corzani, A., Sabbatani, P., Erminio, M., Imberti, J. F., Malavasi, N., Pastori, P., Quartieri, F., Bottoni, N., Saporito, D., Virzi, S., Sassone, B., Zardini, M., Placci, A., Ziacchi, M., Massaro, G., Adamo, F., Scaccia, A., Spampinato, A., Biscione, F., Castro, A., Cauti, F., Rossi, P., Cinti, C., Gatto, M., Kol, A., Narducci, M. L., Pelargonio, G., Patruno, N., Pignalberi, C., Ricci, R. P., Ricciardi, D., Santini, L., Tancredi, M., Di Belardino, N., Pentimalli, F., Zoni-Berisso, M., Belotti, G., Chieffo, E., Cilloni, S., Doni, L. A., Gardini, A., Malaspina, D., Mazzone, P., Della Bella, P., Negro, R., Perego, G. B., Rordorf, R., Cipolletta, L., Russo, A. D., Luzi, M., Amellone, C., Ebrille, E., Favro, E., Lucciola, M. T., Devecchi, C., Rametta, F., Devecchi, F., Matta, M., Sant'Andrea, A. O., Santagostino, M., Dell'Era, G., Candida, T. R., Bonfantino, V. M., Gianfrancesco, D., Guido, A., Pellegrino, P. L., Pisano, E. C. L., Rillo, M., Palama, Z., Sai, R., Santobuono, V. E., Favale, S., Scicchitano, P., Nissardi, V., Campisi, G., Sgarito, G., Arena, G., Casorelli, E., Fumagalli, S., Giaccardi, M., Nesti, M., Padeletti, M., Rossi, A., Piacenti, M., Del Greco, M., Catanzariti, D., Manfrin, M., Werner, R., Marini, M., Andreoli, C., Fedeli, F., Mazza, A., Pagnotta, F., Ridarelli, M., Molon, G., and Rossillo, A.

Subjects
Male, Cardiac pacing, 030204 cardiovascular system & hematology, Ablation, Cardiac Resynchronization Therapy, 0302 clinical medicine, Surveys and Questionnaires, Health care, Pandemic, Registries, 030212 general & internal medicine, Acute management, Secondary prevention, Atrial fibrillation, Arrhythmia, COVID-19, Emergency, Implantable cardioverter defibrillators, Pacemakers, Remote monitoring, Middle Aged, Electrophysiology, Italy, Emergency Medicine, Female, Coronavirus Infections, Adult, medicine.medical_specialty, Atrial fbrillation, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Implantable cardioverter defbrillators, NO, 03 medical and health sciences, Physicians, medicine, Internal Medicine, Humans, Pandemics, Ablation, Arrhythmia, Atrial fbrillation, Emergency, Implantable cardioverter defbrillators, Pacemakers, Remote monitoring, COVID-19, Aged, business.industry, Outbreak, Arrhythmias, Cardiac, medicine.disease, Im - Original, Emergency medicine, business
Abstract

COVID-19 outbreak had a major impact on the organization of care in Italy, and a survey to evaluate provision of for arrhythmia during COVID-19 outbreak (March–April 2020) was launched. A total of 104 physicians from 84 Italian arrhythmia centres took part in the survey. The vast majority of participating centres (95.2%) reported a significant reduction in the number of elective pacemaker implantations during the outbreak period compared to the corresponding two months of year 2019 (50.0% of centres reported a reduction of > 50%). Similarly, 92.9% of participating centres reported a significant reduction in the number of implantable cardioverter-defibrillator (ICD) implantations for primary prevention, and 72.6% a significant reduction of ICD implantations for secondary prevention (> 50% in 65.5 and 44.0% of the centres, respectively). The majority of participating centres (77.4%) reported a significant reduction in the number of elective ablations (> 50% in 65.5% of the centres). Also the interventional procedures performed in an emergency setting, as well as acute management of atrial fibrillation had a marked reduction, thus leading to the conclusion that the impact of COVID-19 was disrupting the entire organization of health care, with a massive impact on the activities and procedures related to arrhythmia management in Italy. Electronic supplementary material The online version of this article (10.1007/s11739-020-02487-w) contains supplementary material, which is available to authorized users.

Published
2020

18. SARS-CoV-2-Specific Memory T Lymphocytes From COVID-19 Convalescent Donors: Identification, Biobanking, and Large-Scale Production for Adoptive Cell Therapy

Author

Ferreras, C., primary, Pascual-Miguel, B., additional, Mestre-Durán, C., additional, Navarro-Zapata, A., additional, Clares-Villa, L., additional, Martín-Cortázar, C., additional, De Paz, R., additional, Marcos, A., additional, Vicario, J. L., additional, Balas, A., additional, García-Sánchez, F., additional, Eguizabal, C., additional, Solano, C., additional, Mora-Rillo, M., additional, Soria, B., additional, and Pérez-Martínez, A., additional

Published
2021
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19. Impact of ablation index settings on pulmonary vein reconnection

Author

Lepillier, A., primary, Strisciuglio, T., additional, De Ruvo, E., additional, Scaglione, M., additional, Anselmino, M., additional, Sebag, F. A., additional, Pecora, D., additional, Gallagher, M. M., additional, Rillo, M., additional, Viola, G., additional, Pisanò, E., additional, Abbey, S., additional, Lamberti, F., additional, Pani, A., additional, Zucchelli, G., additional, Sgarito, G., additional, De Simone, A., additional, Bertaglia, E., additional, Solimene, F., additional, and Stabile, Giuseppe, additional

Published
2021
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22. SARS-CoV-2 specific memory T lymphocytes from COVID-19 convalescent donors: identification, biobanking and large-scale production for Adoptive Cell Therapy

Author

Ferreras, C, primary, Pascual-Miguel, B, additional, Mestre-Durán, C, additional, Navarro-Zapata, A, additional, Clares-Villa, L, additional, Martín-Cortázar, C, additional, De Paz, R, additional, Marcos, A, additional, Vicario, JL, additional, Balas, A, additional, García-Sánchez, F, additional, Eguizabal, C, additional, Solano, C, additional, Mora-Rillo, M, additional, Soria, B, additional, and Pérez-Martínez, A, additional

Published
2020
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24. Glomerular filtration rate: A prognostic marker in atrial fibrillation—A subanalysis of the AntiThrombotic Agents Atrial Fibrillation

Author

Proietti, Riccardo, Gonzini, Lucio, Pizzimenti, Giovanni, Ledda, Antonietta, Sanna, Pietro, Alturki, Ahmed, Russo, Vincenzo, Lencioni, Mauro, Siciliano, R., Boffa, M., Bazzanini, F., Di Nucci, G., Fonti, S., De Franceschi, T., Davio, P., Alagna, G., Cipollini, F., Arma, P., Gunnellini, M. G., Dottori, M., Paulillo, D., Giudice, M., Sicuro, M., Lenti, S., Iannelli, G., Notarstefano, P., Galiotto, M., Apolloni, Enzo, Molini, G., Massarelli, L., Di Iorio, P., Scandurra, F., Candelmo, F., Iodice, P., Laureano, R., Perlangeli, S., Praticò, A., Lucchesi, Q., Conese, V., Scalera, G., Palma, F., De Antoni, M. E., Beltramello, G., Carbonella, M., Capone, A., Bianchi, V., Zerella, F., Masina, M., Boggian, G., Pancaldi, L. G., Brucato, A. L., Scialfa, S., Ferrari, P., Gavazzi, A., Santoro, E., Bertinieri, G., Caragnano, V., Zaccaroni, S., Marchetti, G., Urbinati, S., Belmonte, G., Giannoni, C., Panuccio, D., Pedone, V., Colletta, M., Di Pasquale, G., Cemin, R., Paffoni, P. R. C., Pezzotti, Chiara, Capretti, M., Lamari, A. L., Maugeri, S., Moretti, R., Ganga, R., Mascia, P., Caddori, A., Cusumano, S., Alletto, M., DE VINCENZO, Ciro, Musacchio, E., Stendardo, A., Cantarella, SALVATORE ALFREDO, Ferrari, V., Bassano, F., PERRONE CAPANO, Carla, Piccinni, G. C., Catanzaro, M., Vinciguerra, A., Lusiani, L., De Caro, G., Scarcia, M., Scarcia, Aurora, Losi, E., Gaddi, O., Lo Sciuto, A., Cascio Ingurgio, N., Vignai, E., Romano, M., Borzì, V., Bellanuova, I. A., Felis, S., Gulizia, M. M., Francese, G. M., Artale, S., Mazzuca, S., Perticone, F., Tirotta, D., Talini, E., Ventrella, F., Iosa, G., Cuccurullo, O., Bertello, P. D., Benemio, G., Garognoli, O., Arcelli, G., Prosciutti, L., De Matthaeis, G., Quattrini, C., Calcagno, S., Canestrini, S., Franco, A., Pastorelli, R., Acquati, F., Botto, G. L., Sitta, N., Migliacci, R., Cosmi, F., Tarquini, B., Chiappetta, P., Sprovieri, M. F., Macrì, G., Bertolazzi, S., Spotti, Alessia, Pirelli, S., Marasco, M. F., Elia, Martina, Gambino, G. M., Fenoglio, L., Gelmini, G. P., Ziacchi, V., Rigon, N., Petix, N. R., Zipoli, A., Caiolo, A., Marino, E., Scattolin, G., Gerini, S., Parisi, G., Tavernese, G., Conti, Alessandro, Ferrante, Federico, Morettini, A., Alterini, B., Rocchi, Federico, Nozzoli, C., Goedecke, L., Seravalle, C., Cuomo, A., Panettieri, I., Pellegrino, P., Di Biase, M., Savarese, G., Patriarchi, F., Bondì, Giuseppina, Rossini, Elena, Nello, S., Ranieri, A. T., Gelonesi, F. N., Costantini, M., Dugnani, M., Ria, L., Mussardo, V., Zanini, G., Morgante, O., Fazio, G., Lo, G., Castello, C., Moroni, L. A., Costa, S., Domenicucci, S., Venzano, C., Loiacono, L., Ortuso, R., Esposito, L., Cuzzucrea, D. G., Fiammengo, F., Selva, E., Gestra, R., Alessandri, M., Nuzzi, G., Porrino, L., Parise, P., Capponi, E. A., Mandorla, S., Politi, Caterina, Olivieri, Claudia, Gurioli, L., Agostinelli, P., Striuli, R., Petrarca, Massimo, Corsini, Francesca, Orlandini, F., Badolati, S., Colarusso, D., Vertullo, V., Pelaggi, P., Campagna, G., Haupt, E., Parente, F., Milanese, G., Magliari, F., Morando, G., Guarise, P., Mazzone, A., Palumbo, G., Lambelet, P., Camaiti, A., Pasquinelli, P., Frediani, L., Vituliano, A., Brunelleschi, G., Lisi, C., La Torre, P. P. A., Villella, A., Rimoldi, A., Russo, V., Di Summa, F., Reggiani, A., Raimondo, F. C., Disalvo, D., Borrello, V. M., Magnante, A., Stellitano, E., Procopio, L., Franculli, F., Serafini, Filippo, Tondo, C., Fiorentini, C., Manfredini, R., Robbiolo, L., Pizzimenti, G., VASQUEZ LOPEZ, LUIDER FERNEY, Piangiamore, A., Tosi, P., Donà, G., Bacchiega, E., Malavasi, V., Modena, M. G., Divella, C., Marengo, C., Montanari, P., Manicardi, V., Abate, L., Cuccuini, A., Magni, S., Vincenti, A., Spinelli, M., Mortara, A., Specchia, G., Silvestri, N., Silvestri, Oriana, Piscopo, G., Muscherà, R., Gallucci, F., Cannavale, A., Bresciani, A., Perrone Filardi, P., Fontanella, Andrea, Iannuzzo, D., Lucà, S., Zuccoli, A., Rinaldi, P., Ferri, G., Barbieri, E., Grasselli, S., Rossi, A., Agosti, S., Sanna, GIAN PAOLO, Casu, G., Orecchioni, G., Da Silva Carvalho, P. C., POZZI MUCELLI, Roberto, Salvati, Fabio, Bendini, M. G., Giordano, G., Pellegrini, F., Pighini, G., Tremolada, F., Zanin, L., Ledda, A., Floresta, A. M., Enia, F., Nicolosi, G., Ingrillì, F., D'Angelo, A., Musacchio, D., Savastano, Silvia, Magnani, Leonardo, Capitelli, M., Cioni, Giovanni, Aloisi, B., De Finis, A., Vacri, A., Costantini, V., Guercini, F., Zingarini, G., Nardoni, M. C., Teghini, L., Panigada, G., Di Marco, S., Vergoni, W., Paonessa, K., Artom, A., Bigliardi, M., Riccardi, R., Riva, L., Marandino, A., Barsotti, L., Ginocchio, G., Marchese, Dario, Tintori, G., Annese, M., Breschi, R., Manini, M., Scopelliti, Giulia, Pastore, A., Spirito, G., Amato, A., Del Bianco, F., Ongari, M., Fiorencis, R., Querci, F., Martone, V. D., Molero, U., Fiusti, R., Giovannini, T., D'Arienzo, E., Cellamare, G., Placci, A., Gulli, G., Ruggeri, A., Pulitanò, G., Iori, I., Ingianni, N., Saporito, D., Marconi, GIAN MARIA, Grossi, Alice, Grosseto, D., Ciamei, M., Mete, F., Russo, F., Bianchi, C., Costantino, S., Manfellotto, D., Risa, M. P., Azzolini, P., Conversano, L., Santini, M., Macchiusi, A., Francia, P., Pietrantonio, F., Biscione, F., Magliano, G., Fedele, Francesca, Salituri, S., Salituri, F., Zamboni, S., Rossetti, C., Roncon, Leonora, Delucchi, M., De Benedictis, M., Vitolo, A., Anselmi, Michela, Celino, T., Moretti, V., Cuccurullo, M., Castelli, G., Martino, G., Pierandrei, G., Carella, A. M., Tonizzo, M., Nassi, R., Tarducci, R., Fronticelli Baldelli, M., Commisso, B., Lazzarini, D., Matarazzo, M. M., Novati, P., Petacchi, R., Maninchedda, P., Melandri, F., Bellesi, P., Sacchetti, C., Grandi, M., Cattana, A., Tassara, R., Menardo, G., Aykut, V., Chesi, G., Reverzani, A., Galgano, Angela, Bartone, B., Stornello, M., Muscio, G., Gemmiti, M. P., Alfonsi, F., Fontana, D., Astarita, C., Gaspardo, G., La Brocca, A., Rillo, M., Pascente, T., Pirozzi, M. R., Addis, L., De Siati, P., Beato, E., Iannaccone, V., Barabani, M., Castronuovo, M., Battaia, L., Biscottini, B., Boccali, A., Marengo, S., Dallerba, R., Diana, A., Coser, Alessandra, Pauletto, P., Calzolari, V., Olivari, Z., De Masi De Luca, G., Accogli, M., Gerloni, R., Cattin, Laura, Vitali Serdoz, L., Sinagra, G., Bulfoni, A., DE BIASIO, Melissa, Proclemer, A., Miserocchi, F., Marazzi, R., SALERNO URIARTE, JORGE ANTONIO, Levantesi, G., Olivetti, P., Capuano, A., Bertoncelli, M. C., Molinaro, N., Anastasio, L., Teti, G., Vescovo, G. A., Muriago, M., Incao, F., Lettica, G. V., Nieswandt, V., Osti, R., Tafi, A., Proietti, Riccardo, Gonzini, Lucio, Pizzimenti, Giovanni, Ledda, Antonietta, Sanna, Pietro, Alturki, Ahmed, Russo, Vincenzo, Lencioni, Mauro, Siciliano, R., Boffa, M., Bazzanini, F., Di Nucci, G., Fonti, S., De Franceschi, T., Davio, P., Alagna, G., Cipollini, F., Arma, P., Gunnellini, M. G., Dottori, M., Paulillo, D., Giudice, M., Sicuro, M., Lenti, S., Iannelli, G., Notarstefano, P., Galiotto, M., Apolloni, E., Molini, G., Massarelli, L., Di Iorio, P., Scandurra, F., Candelmo, F., Iodice, P., Laureano, R., Perlangeli, S., Praticò, A., Lucchesi, Q., Conese, V., Scalera, G., Palma, F., De Antoni, M. E., Beltramello, G., Carbonella, M., Capone, A., Bianchi, V., Zerella, F., Masina, M., Boggian, G., Pancaldi, L. G., Brucato, A. L., Scialfa, S., Ferrari, P., Gavazzi, A., Santoro, E., Bertinieri, G., Caragnano, V., Zaccaroni, S., Marchetti, G., Urbinati, S., Belmonte, G., Giannoni, C., Panuccio, D., Pedone, V., Colletta, M., Di Pasquale, G., Cemin, R., Paffoni, P. R. C., Pezzotti, C., Capretti, M., Lamari, A. L., Maugeri, S., Moretti, R., Ganga, R., Mascia, P., Caddori, A., Cusumano, S., Alletto, M., De Vincenzo, C., Musacchio, E., Stendardo, A., Cantarella, S. A., Ferrari, V., Bassano, F., Perrone, C., Piccinni, G. C., Catanzaro, M., Vinciguerra, A., Lusiani, L., De Caro, G., Scarcia, M., Scarcia, A., Losi, E., Gaddi, O., Lo Sciuto, A., Cascio Ingurgio, N., Vignai, E., Romano, M., Borzì, V., Bellanuova, I. A., Felis, S., Gulizia, M. M., Francese, G. M., Artale, S., Mazzuca, S., Perticone, F., Tirotta, D., Talini, E., Ventrella, F., Iosa, G., Cuccurullo, O., Bertello, P. D., Benemio, G., Garognoli, O., Arcelli, G., Prosciutti, L., De Matthaeis, G., Quattrini, C., Calcagno, S., Canestrini, S., Franco, A., Pastorelli, R., Acquati, F., Botto, G. L., Sitta, N., Migliacci, R., Cosmi, F., Tarquini, B., Chiappetta, P., Sprovieri, M. F., Macrì, G., Bertolazzi, S., Spotti, A., Pirelli, S., Marasco, M. F., Elia, M., Gambino, G. M., Fenoglio, L., Gelmini, G. P., Ziacchi, V., Rigon, N., Petix, N. R., Zipoli, A., Caiolo, A., Marino, E., Scattolin, G., Gerini, S., Parisi, G., Tavernese, G., Conti, A., Ferrante, F., Morettini, A., Alterini, B., Rocchi, F., Nozzoli, C., Goedecke, L., Seravalle, C., Cuomo, A., Panettieri, I., Pellegrino, P., Di Biase, M., Savarese, G., Patriarchi, F., Bondi, G., Rossini, E., Nello, S., Ranieri, A. T., Gelonesi, F. N., Costantini, M., Dugnani, M., Ria, L., Mussardo, V., Zanini, G., Morgante, O., Fazio, G., Lo, G., Castello, C., Moroni, L. A., Costa, S., Domenicucci, S., Venzano, C., Loiacono, L., Ortuso, R., Esposito, L., Cuzzucrea, D. G., Fiammengo, F., Selva, E., Gestra, R., Alessandri, M., Nuzzi, G., Porrino, L., Parise, P., Capponi, E. A., Mandorla, S., Politi, C., Olivieri, C., Gurioli, L., Agostinelli, P., Striuli, R., Petrarca, M., Corsini, F., Orlandini, F., Badolati, S., Colarusso, D., Vertullo, V., Pelaggi, P., Campagna, G., Haupt, E., Parente, F., Milanese, G., Magliari, F., Morando, G., Guarise, P., Mazzone, A., Palumbo, G., Lambelet, P., Camaiti, A., Pasquinelli, P., Frediani, L., Vituliano, A., Brunelleschi, G., Lisi, C., La Torre, P. P. A., Villella, A., Rimoldi, A., Russo, V., Di Summa, F., Reggiani, A., Raimondo, F. C., Disalvo, D., Borrello, V. M., Magnante, A., Stellitano, E., Procopio, L., Franculli, F., Serafini, F., Tondo, C., Fiorentini, C., Manfredini, R., Robbiolo, L., Pizzimenti, G., Vasquez, L., Piangiamore, A., Tosi, P., Donà, G., Bacchiega, E., Malavasi, V., Modena, M. G., Divella, C., Marengo, C., Montanari, P., Manicardi, V., Abate, L., Cuccuini, A., Magni, S., Vincenti, A., Spinelli, M., Mortara, A., Specchia, G., Silvestri, N., Silvestri, O., Piscopo, G., Muscherà, R., Gallucci, F., Cannavale, A., Bresciani, A., Perrone Filardi, P., Fontanella, A., Iannuzzo, D., Lucà, S., Zuccoli, A., Rinaldi, P., Ferri, G., Barbieri, E., Grasselli, S., Rossi, A., Agosti, S., Sanna, P., Casu, G., Orecchioni, G., Da Silva Carvalho, P. C., Pozzi, R., Salvati, F., Bendini, M. G., Giordano, G., Pellegrini, F., Pighini, G., Tremolada, F., Zanin, L., Ledda, A., Floresta, A. M., Enia, F., Nicolosi, G., Ingrillì, F., D'Angelo, A., Musacchio, D., Savastano, S., Magnani, L., Capitelli, M., Cioni, G., Aloisi, B., De Finis, A., Vacri, A., Costantini, V., Guercini, F., Zingarini, G., Nardoni, M. C., Teghini, L., Panigada, G., Di Marco, S., Vergoni, W., Paonessa, K., Artom, A., Bigliardi, M., Riccardi, R., Riva, L., Marandino, A., Barsotti, L., Ginocchio, G., Marchese, D., Tintori, G., Annese, M., Breschi, R., Manini, M., Scopelliti, G., Pastore, A., Spirito, G., Amato, A., Del Bianco, F., Ongari, M., Fiorencis, R., Querci, F., Martone, V. D., Molero, U., Fiusti, R., Giovannini, T., D'Arienzo, E., Cellamare, G., Placci, A., Gulli, G., Ruggeri, A., Pulitanò, G., Iori, I., Ingianni, N., Saporito, D., Marconi, M., Grossi, A., Grosseto, D., Ciamei, M., Mete, F., Russo, F., Bianchi, C., Costantino, S., Manfellotto, D., Risa, M. P., Azzolini, P., Conversano, L., Santini, M., Macchiusi, A., Francia, P., Pietrantonio, F., Biscione, F., Magliano, G., Fedele, F., Salituri, S., Salituri, F., Zamboni, S., Rossetti, C., Roncon, L., Delucchi, M., De Benedictis, M., Vitolo, A., Anselmi, M., Celino, T., Moretti, V., Cuccurullo, M., Castelli, G., Martino, G., Pierandrei, G., Carella, A. M., Tonizzo, M., Nassi, R., Tarducci, R., Fronticelli Baldelli, M., Commisso, B., Lazzarini, D., Matarazzo, M. M., Novati, P., Petacchi, R., Maninchedda, P., Melandri, F., Bellesi, P., Sacchetti, C., Grandi, M., Cattana, A., Tassara, R., Menardo, G., Aykut, V., Chesi, G., Reverzani, A., Galgano, A., Bartone, B., Stornello, M., Muscio, G., Gemmiti, M. P., Alfonsi, F., Fontana, D., Astarita, C., Gaspardo, G., La Brocca, A., Rillo, M., Pascente, T., Pirozzi, M. R., Addis, L., De Siati, P., Beato, E., Iannaccone, V., Barabani, M., Castronuovo, M., Battaia, L., Biscottini, B., Boccali, A., Marengo, S., Dallerba, R., Diana, A., Coser, A., Pauletto, P., Calzolari, V., Olivari, Z., De Masi De Luca, G., Accogli, M., Gerloni, R., Cattin, L., Vitali Serdoz, L., Sinagra, G., Bulfoni, A., De Biasio, M., Proclemer, A., Miserocchi, F., Marazzi, R., Salerno Uriarte, J. A., Levantesi, G., Olivetti, P., Capuano, A., Bertoncelli, M. C., Molinaro, N., Anastasio, L., Teti, G., Vescovo, G. A., Muriago, M., Incao, F., Lettica, G. V., Nieswandt, V., Osti, R., and Tafi, A.

Subjects
Male, medicine.medical_specialty, Time Factors, Clinical Investigations, Renal function, 030204 cardiovascular system & hematology, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Fibrinolytic Agents, Risk Factors, atrial fibrillation, glomerular filtration rate, mortality, Cardiology and Cardiovascular Medicine, Internal medicine, Antithrombotic, medicine, Humans, In patient, 030212 general & internal medicine, Renal Insufficiency, Cardiovascular mortality, Aged, Retrospective Studies, business.industry, Incidence, Atrial fibrillation, General Medicine, medicine.disease, Prognosis, Survival Rate, Italy, Hospital admission, Atrial Fibrillation, Female, Follow-Up Studies, Glomerular Filtration Rate, Morbidity, Cardiology, business
Abstract

OBJECTIVE: An increased cardiovascular mortality and morbidity has been widely reported in patients with atrial fibrillation (AF). In this study, a subanalysis of the AntiThrombotic Agents Atrial Fibrillation (ATA‐AF) is performed with the aim to evaluate estimated glomerular filtration rate (eGFR) as an independent prognostic marker of cardiovascular mortality and morbidity in patients with AF. METHODS AND RESULTS: The ATA‐AF study enrolled 7148 patients with AF, in 360 Italian centers. The eGFR was calculated from data reported in patient notes or hospital database. This post‐hoc analysis included 1097 AF patients with eGFR data available and 1‐year clinical follow‐up. The endpoint was assessed as cardiovascular mortality and/or hospital admission for cardiovascular causes at follow‐up. Patients were also divided in two groups according to the eGFR (

Published
2018

25. External validation of the INCREMENT-CPE mortality score in a carbapenem-resistant Klebsiella pneumoniae bacteraemia cohort: the prognostic significance of colistin resistance

Author

Machuca, I, Gutierrez-Gutierrez, B, Rivera-Espinar, F, Cano, A, Gracia-Ahufinger, I, Guzman-Puche, J, Marfil-Perez, E, Perez-Nadales, E, Caston, JJ, Bonomo, RA, Carmeli, Y, Paterson, D, Pascual, A, Martinez-Martinez, L, Rodriguez-Bano, J, Torre-Cisneros, J, Salamanca, E, de Cueto, M, Hsueh, PR, Viale, P, Bartoletti, M, Giannella, M, Pano-Pardo, JR, Mora-Rillo, M, Navarro-San Francisco, C, Venditti, M, Falcone, M, Russo, A, Tumbarello, M, Trecarichi, EM, Losito, AR, Daikos, G, Skiada, A, Canton, R, Pintado, V, Ruiz, P, Doi, Y, Tuon, FF, Karaiskos, I, Giamarellou, H, Schwaber, MJ, Azap, OK, Souli, M, Antoniadou, A, Poulakou, G, Roilides, E, Iosifidis, E, Pournaras, S, Tsakris, A, Zarkotou, O, Akova, M, Helvaci, O, Sahin, AO, Perez, F, Bermejo, J, Rucci, V, Oliver, A, de Gopegui, ER, Marinescu, CI, de la Calle, C, Martinez, JA, Morata, L, Soriano, A, Lowman, W, Almirante, B, Larrosa, N, Puig-Asensio, M, Garcia-Vazquez, E, Hernandez, A, Gomez, J, Bou, G, Prim, N, Navarro, F, Mirelis, B, Origuen, J, San Juan, R, Fernandez-Ruiz, M, Cisneros, JM, Molina, J, Gonzalez, V, Farinas, MC, Cano, ME, Gozalo, M, Pena, C, Gomez-Zorrilla, S, Tubau, F, Pitout, J, Virmani, D, Natera, C, Marfil, E, Tacconelli, E, Riemenschneider, F, Calbo, E, Badia, C, Xercavins, M, Gasch, O, Fontanals, D, and Jove, E

Subjects
KPC, Klebsiella pneumoniae, Carbapenem resistance, INCREMENT risk score, Colistin resistance
Abstract

External validation of the INCREMENT-CPE risk score (ICS) for 30-day all-cause mortality is needed. There is also scarce information about whether colistin resistance influences the prognosis of carbapenem-resistant Klebsiella pneumoniae (CRKp) bacteraemia. In this study, the ability of ICS to predict all-cause mortality in the KAPECOR cohort was calculated using the area under the receiver operating characteristic (AUROC) curve. The association of colistin resistance with mortality was studied. The ICS showed an AUROC curve of 0.77 (95% CI 0.68-0.86). A cut-off of 8 points showed 96.8% sensitivity and 50.7% specificity. Mortality of low-risk patients was not different in those treated with monotherapy versus combination therapy. However, mortality of high-risk patients treated with combination therapy (37.8%) was significantly lower than in those treated with monotherapy (68.4%) (P = 0.008). To study the prognostic significance of colistin resistance, 83 selected cases of bacteraemia due to colistin-susceptible CRKp were obtained from the INCREMENT cohort for comparison. Colistin resistance could not be shown to be associated with higher mortality in either the high-risk ICS group [adjusted odds ratio (aOR) = 1.56, 95% CI 0.69-3.33; P = 0.29] or in 37 ICS-matched pairs (aOR = 1.38, 95% CI 0.55-3.42; P = 0.49), or in a sensitivity analysis including only KPC isolates (aOR = 1.81, 95% CI 0.73-4.57; P = 0.20), but the precision of estimates was low. These results validate ICS for all-cause mortality and to optimise targeted therapy for CRKp bacteraemia. Colistin resistance was not clearly associated with increased mortality. (C) 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Published
2019

26. Predictors of outcome in patients with severe sepsis or septic shock due to extended-spectrum beta-lactamase-producing Enterobacteriaceae

Author

Russo, A, Falcone, M, Gutierrez-Gutierrez, B, Calbo, E, Almirante, B, Viale, PL, Oliver, A, Ruiz-Garbajosa, R, Gasch, O, Gozalo, M, Pitout, J, Akova, M, Pena, C, Cisneros, JM, Hernandez-Torres, A, Farcomeni, A, Prim, N, Origun, J, Bou, G, Tacconelli, E, Tumbarello, M, Hamprecht, A, Karaiskos, I, de la Calle, C, Perez, F, Schwaber, MJ, Bermejo, J, Lowman, W, Hsueh, RR, Mora-Rillo, M, Rodriguez-Gomez, J, Souli, M, Bonomo, RA, Paterson, DL, Carmeli, Y, Pascual, A, Rodriguez-Bano, J, and Venditti, M

Subjects
sepsis, septic shock, beta-lactam/beta-lactamase inhibitors, carbapenems, extended-spectrum beta-lactamases, bacterial infections and mycoses
Abstract

Purpose: There are few data in the literature regarding sepsis or septic shock due to extended-spectrum fi-lactamases (ESBL)-producing Enterobacteriaceae (E). The aim of this study was to assess predictors of outcome in septic patients with bloodstream infection (BSI) caused by ESBL-E. Methods: Patients with severe sepsis or septic shock and BSI due to ESBL-E were selected from the INCREMENT database. The primary endpoint of the study was the evaluation of predictors of outcome after 30 days from development of severe sepsis or septic shock due to ESBL-E infection. Three cohorts were created for analysis: global, empirical-therapy and targeted-therapy cohorts. Results: 367 septic patients were analysed. Overall mortality was 43.9% at 30 days. Escherichia coli (62.4%) and Klebsiella pneumoniae (27.2%) were the most frequent isolates. fi-lactam/fi-lactamase inhibitor (BLBLI) combinations were the most empirically used drug (43.6%), followed by carbapenems (29.4%). Empirical therapy was active in vitro in 249 (67.8%) patients, and escalation of antibiotic therapy was reported in 287 (78.2%) patients. Cox regression analysis showed that age, Charlson Comorbidity Index, McCabe classification, Pitt bacteremia score, abdominal source of infection and escalation of antibiotic therapy were independently associated with 30-day mortality. No differences in survival were reported in patients treated with BLBLI combinations or carbapenems in empirical or definitive therapy. Conclusions: BSI due to ESBL-E in patients who developed severe sepsis or septic shock was associated with high 30-day mortality. Comorbidities, severity scores, source of infection and antibiotic therapy escalation were important determinants of unfavorable outcome. (C) 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Published
2018

28. Predictors of outcome in patients with severe sepsis or septic shock due to extended-spectrum beta-lactamase-producing Enterobacteriaceae

Author

Russo, A., Falcone, M., Gutierrez-Gutierrez, B., Calbo, E., Almirante, B., Viale, P. L., Oliver, A., Ruiz-Garbajosa, R., Gasch, O., Gozalo, M., Pitout, J., Akova, M., Pena, C., Cisneros, J. M., Hernandez-Torres, A., Farcomeni, A., Prim, N., Origun, J., Bou, G., Tacconelli, E., Tumbarello, M., Hamprecht, A., Karaiskos, I, de la Calle, C., Perez, F., Schwaber, M. J., Bermejo, J., Lowman, W., Hsueh, R-R, Mora-Rillo, M., Rodriguez-Gomez, J., Souli, M., Bonomo, R. A., Paterson, D. L., Carmeli, Y., Pascual, A., Rodriguez-Bano, J., Venditti, M., Russo, A., Falcone, M., Gutierrez-Gutierrez, B., Calbo, E., Almirante, B., Viale, P. L., Oliver, A., Ruiz-Garbajosa, R., Gasch, O., Gozalo, M., Pitout, J., Akova, M., Pena, C., Cisneros, J. M., Hernandez-Torres, A., Farcomeni, A., Prim, N., Origun, J., Bou, G., Tacconelli, E., Tumbarello, M., Hamprecht, A., Karaiskos, I, de la Calle, C., Perez, F., Schwaber, M. J., Bermejo, J., Lowman, W., Hsueh, R-R, Mora-Rillo, M., Rodriguez-Gomez, J., Souli, M., Bonomo, R. A., Paterson, D. L., Carmeli, Y., Pascual, A., Rodriguez-Bano, J., and Venditti, M.

Abstract

Purpose: There are few data in the literature regarding sepsis or septic shock due to extended-spectrum fi-lactamases (ESBL)-producing Enterobacteriaceae (E). The aim of this study was to assess predictors of outcome in septic patients with bloodstream infection (BSI) caused by ESBL-E. Methods: Patients with severe sepsis or septic shock and BSI due to ESBL-E were selected from the INCREMENT database. The primary endpoint of the study was the evaluation of predictors of outcome after 30 days from development of severe sepsis or septic shock due to ESBL-E infection. Three cohorts were created for analysis: global, empirical-therapy and targeted-therapy cohorts. Results: 367 septic patients were analysed. Overall mortality was 43.9% at 30 days. Escherichia coli (62.4%) and Klebsiella pneumoniae (27.2%) were the most frequent isolates. fi-lactam/fi-lactamase inhibitor (BLBLI) combinations were the most empirically used drug (43.6%), followed by carbapenems (29.4%). Empirical therapy was active in vitro in 249 (67.8%) patients, and escalation of antibiotic therapy was reported in 287 (78.2%) patients. Cox regression analysis showed that age, Charlson Comorbidity Index, McCabe classification, Pitt bacteremia score, abdominal source of infection and escalation of antibiotic therapy were independently associated with 30-day mortality. No differences in survival were reported in patients treated with BLBLI combinations or carbapenems in empirical or definitive therapy. Conclusions: BSI due to ESBL-E in patients who developed severe sepsis or septic shock was associated with high 30-day mortality. Comorbidities, severity scores, source of infection and antibiotic therapy escalation were important determinants of unfavorable outcome. (C) 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Published
2018

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

Author

Harris, P.N.A. Pezzani, M.D. Gutiérrez-Gutiérrez, B. Viale, P. Hsueh, P.-R. Ruiz-Garbajosa, P. Venditti, M. Tumbarello, M. Navarro-Francisco, C. Calbo, E. Akova, M. Giamarellou, H. Oliver, A. Almirante, B. Gasch, O. Martínez-Martínez, L. Schwaber, M.J. Daikos, G. Pitout, J. Peña, C. Hernández-Torres, A. Doi, Y. Pérez, F. Tuon, F.F. Tacconelli, E. Carmeli, Y. Bonomo, R.A. Pascual, Á. Paterson, D.L. Rodríguez-Baño, J. del Toro, M.D. Gálvez, J. Falcone, M. Russo, 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.S. 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.R. Marinescu, C.I. Fariñas, M.C. Cano, M.E. Gozalo, M. Paño-Pardo, J.R. Mora-Rillo, M. Gómez-Zorrilla, S. Tubau, F. Tsakris, A. Zarkotou, O. Antoniadou, A. Poulakou, G. Souli, M. Lowman, W. Virmani, D. Torre-Cisneros, J. Machuca, I. Gracia-Ahufinger, I. 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. ESGBIS/REIPI/INCREMENT Group

Abstract

We describe regional differences in therapy for bloodstream infection (BSI) caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE). Patients (n = 1482) in 12 countries from an observational study of BSI caused by ESBL-E or CPE were included. Multivariate logistic regression was used to calculate adjusted odds ratios (aORs) for the influence of country of recruitment on empirical use of β-lactam/β-lactamase inhibitors (BLBLIs) or carbapenems, targeted use of BLBLIs for ESBL-E and use of targeted combination therapy for CPE. Compared with Spain, BLBLI use for empirical therapy was least likely in sites from Israel (aOR 0.34, 95% CI 0.14–0.81), Greece (aOR 0.49, 95% CI 0.26–0.94) and Canada (aOR 0.31, 95% CI 0.11–0.88) but more likely in Italy (aOR 1.58, 95% CI 1.11–2.25) and Turkey (aOR 2.09, 95% CI 1.14–3.81). Empirical carbapenem use was more likely in sites from Taiwan (aOR 1.73, 95% CI 1.03–2.92) and USA (aOR 1.89, 95% CI 1.05–3.39) and less likely in Italy (aOR 0.44, 95% CI 0.28–0.69) and Canada (aOR 0.10, 95% CI 0.01–0.74). Targeted BLBLIs for ESBL-E was more likely in Italian sites. Treatment at sites within Israel, Taiwan, Turkey and Brazil was associated with less combination therapy for CPE. Although this study does not provide precise data on the relative prevalence of ESBL-E or CPE, significant variation in therapy exists across countries even after adjustment for patient factors. Better understanding of what influences therapeutic choices for these infections will aid antimicrobial stewardship efforts. © 2017 Elsevier B.V. and International Society of Chemotherapy

Published
2017

30. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study

Author

Gutiérrez-Gutiérrez, B. Salamanca, E. de Cueto, M. Hsueh, P.-R. Viale, P. Paño-Pardo, J.R. Venditti, M. Tumbarello, M. Daikos, G. Cantón, R. Doi, Y. Tuon, F.F. Karaiskos, I. Pérez-Nadales, E. Schwaber, M.J. Azap, Ö.K. Souli, M. Roilides, E. Pournaras, S. Akova, M. Pérez, F. Bermejo, J. Oliver, A. Almela, M. Lowman, W. Almirante, B. Bonomo, R.A. Carmeli, Y. Paterson, D.L. Pascual, A. Rodríguez-Baño, J. del Toro, M.D. Gálvez, J. Falcone, M. Russo, A. Giamarellou, H. Trecarichi, E.M. Losito, A.R. García-Vázquez, E. Hernández, A. Gómez, J. Bou, G. Iosifidis, E. Prim, N. Navarro, F. Mirelis, B. Skiada, A. Origüen, J. Juan, R.S. Fernández-Ruiz, M. Larrosa, N. Puig-Asensio, M. Cisneros, J.M. Molina, J. González, V. Rucci, V. de Gopegui, E.R. Marinescu, C.I. Martínez-Martínez, L. Fariñas, M.C. Cano, M.E. Gozalo, M. Mora-Rillo, M. Francisco, C.N.-S. Peña, C. Gómez-Zorrilla, S. Tubau, F. Tsakris, A. Zarkotou, O. Antoniadou, A. Poulakou, G. Pitout, J. Virmani, D. Torre-Cisneros, J. Guzmán-Puche, J. Helvaci, Ö. Sahin, A.O. Pintado, V. Ruiz, P. Bartoletti, M. Giannella, M. Tacconelli, E. Riemenschneider, F. Calbo, E. Badia, C. Xercavins, M. Gasch, O. Fontanals, D. Jové, E. REIPI/ESGBIS/INCREMENT Investigators REIPI/ESGBIS/INCREMENT Investigators

Abstract

Background The best available treatment against carbapenemase-producing Enterobacteriaceae (CPE) is unknown. The objective of this study was to investigate the effect of appropriate therapy and of appropriate combination therapy on mortality of patients with bloodstream infections (BSIs) due to CPE. Methods In this retrospective cohort study, we included patients with clinically significant monomicrobial BSIs due to CPE from the INCREMENT cohort, recruited from 26 tertiary hospitals in ten countries. Exclusion criteria were missing key data, death sooner than 24 h after the index date, therapy with an active antibiotic for at least 2 days when blood cultures were taken, and subsequent episodes in the same patient. We compared 30 day all-cause mortality between patients receiving appropriate (including an active drug against the blood isolate and started in the first 5 days after infection) or inappropriate therapy, and for patients receiving appropriate therapy, between those receiving active monotherapy (only one active drug) or combination therapy (more than one). We used a propensity score for receiving combination therapy and a validated mortality score (INCREMENT-CPE mortality score) to control for confounders in Cox regression analyses. We stratified analyses of combination therapy according to INCREMENT-CPE mortality score (0–7 [low mortality score] vs 8–15 [high mortality score]). INCREMENT is registered with ClinicalTrials.gov, number NCT01764490. Findings Between Jan 1, 2004, and Dec 31, 2013, 480 patients with BSIs due to CPE were enrolled in the INCREMENT cohort, of whom we included 437 (91%) in this study. 343 (78%) patients received appropriate therapy compared with 94 (22%) who received inappropriate therapy. The most frequent organism was Klebsiella pneumoniae (375 [86%] of 437; 291 [85%] of 343 patients receiving appropriate therapy vs 84 [89%] of 94 receiving inappropriate therapy) and the most frequent carbapenemase was K pneumoniae carbapenemase (329 [75%]; 253 [74%] vs 76 [81%]). Appropriate therapy was associated with lower mortality than was inappropriate therapy (132 [38·5%] of 343 patients died vs 57 [60·6%] of 94; absolute difference 22·1% [95% CI 11·0–33·3]; adjusted hazard ratio [HR] 0·45 [95% CI 0·33–0·62]; p

Published
2017

31. Empiric Therapy with Carbapenem-Sparing Regimens for Bloodstream Infections due to Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: Results from the INCREMENT Cohort

Author

Palacios-Baena, Z.R. Gutiérrez-Gutiérrez, B. Calbo, E. Almirante, B. Viale, P. Oliver, A. Pintado, V. Gasch, O. Martínez-Martínez, L. Pitout, J. Akova, M. Peña, C. Molina Gil-Bermejo, J. Hernández, A. Venditti, M. Prim, N. Bou, G. Tacconelli, E. Tumbarello, M. Hamprecht, A. Giamarellou, H. Almela, M. Pérez, F. Schwaber, M.J. Bermejo, J. Lowman, W. Hsueh, P.-R. Paño-Pardo, J.R. Torre-Cisneros, J. Souli, M. Bonomo, R.A. Carmeli, Y. Paterson, D.L. Pascual, Á. Rodríguez-Baño, J. Gálvez, J. Falcone, M. Russo, A. Daikos, G. Trecarichi, E.M. Losito, A.R. Gómez, J. Iosifidis, E. Roilides, E. Karaiskos, I. Doi, Y. Tuon, F.F. Navarro, F. Mirelis, B. Martínez, J.A. De La Calle, C. Morata, L. San Juan, R. Fernández-Ruiz, M. Larrosa, N. Puig, M. Molina, J. González, V. Rucci, V. Ruiz De Gopegui, E. Marinescu, C.I. Fariñas, M.C. Cano, M.E. Gozalo, M. Mora-Rillo, M. Gómez-Zorrilla, S. Tubau, F. Pournaras, S. Tsakris, A. Zarkotou, O. Azap, Ö.K. Antoniadou, A. Poulakou, G. Virmani, D. Cano, Á. Machuca, I. Helvaci, Ö. Sahin, A.O. Ruiz-Garbajosa, P. Bartoletti, M. Giannella, M. Peter, S. Badia, C. Xercavins, M. Fontanals, D. Jové, E.

Subjects
bacterial infections and mycoses
Abstract

Background. There is little information about the efficacy of active alternative drugs to carbapenems except ?-lactam/?-lactamase inhibitors for the treatment of bloodstream infections (BSIs) due to extended-spectrum ?-lactamase-producing Enterobacteriaceae (ESBL-E). The objective of this study was to assess the outcomes of patients with BSI due to ESBL-E who received empiric therapy with such drugs (other active drugs [OADs]) or carbapenems. Methods. A multinational retrospective cohort study of patients with BSI due to ESBL-E who received empiric treatment with OADs or carbapenems was performed. Cox regression including a propensity score for receiving OADs was performed to analyze 30-day all-cause mortality as main outcome. Clinical failure and length of stay were also analyzed. Results. Overall, 335 patients were included; 249 received empiric carbapenems and 86 OADs. The most frequent OADs were aminoglycosides (43 patients) and fluoroquinolones (20 patients). Empiric therapy with OADs was not associated with mortality (hazard ratio [HR], 0.75; 95% confidence interval [CI], .38-1.48) in the Cox regression analysis. Propensity score-matched pairs, subgroups, and sensitivity analyses did not show different trends; specifically, the adjusted HR for aminoglycosides was 1.05 (95% CI, .51-2.16). OADs were neither associated with 14-day clinical failure (adjusted odds ratio, 0.62; 95% CI, .29-1.36) nor length of hospital stay. Conclusions. We were unable to show that empiric treatment with OAD was associated with a worse outcome compared with carbapenems. This information allows more options to be considered for empiric therapy, at least for some patients, depending on local susceptibility patterns of ESBL-E. © The Author 2017.

Published
2017

33. Predictors of outcome in patients with severe sepsis or septic shock due to extended-spectrum β-lactamase-producing Enterobacteriaceae

Author

Russo, A., primary, Falcone, M., additional, Gutiérrez-Gutiérrez, B., additional, Calbo, E., additional, Almirante, B., additional, Viale, P.L., additional, Oliver, A., additional, Ruiz-Garbajosa, P., additional, Gasch, O., additional, Gozalo, M., additional, Pitout, J., additional, Akova, M., additional, Peña, C., additional, Cisneros, J.M., additional, Hernández-Torres, A., additional, Farcomeni, A., additional, Prim, N., additional, Origüen, J., additional, Bou, G., additional, Tacconelli, E., additional, Tumbarello, M., additional, Hamprecht, A., additional, Karaiskos, I., additional, de la Calle, C., additional, Pérez, F., additional, Schwaber, M.J., additional, Bermejo, J., additional, Lowman, W., additional, Hsueh, P.-R., additional, Mora-Rillo, M., additional, Rodriguez-Gomez, J., additional, Souli, M., additional, Bonomo, R.A., additional, Paterson, D.L., additional, Carmeli, Y., additional, Pascual, A., additional, Rodríguez-Baño, J., additional, and Venditti, M., additional

Published
2018
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34. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study

Author

Gutierrez-Gutierrez, B., Salamanca, E., de Cueto, M., Hsueh, P. -R., Viale, P., Pano-Pardo, J. R., Venditti, M., Tumbarello, M., Daikos, G., Canton, R., Doi, Y., Tuon, F. F., Karaiskos, I., Perez-Nadales, E., Schwaber, M. J., Azap, O. K., Souli, M., Roilides, E., Pournaras, S., Akova, M., Perez, F., Bermejo, J., Oliver, A., Almela, M., Lowman, W., Almirante, B., Bonomo, R. A., Carmeli, Y., Paterson, D. L., Pascual, A., Rodriguez-Bano, J., del Toro, M. D., Galvez, J., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, E. M., Losito, A. R., Garcia-Vazquez, E., Hernandez, A., Gomez, J., Bou, G., Iosifidis, E., Prim, N., Navarro, F., Mirelis, B., Skiada, A., Origuen, J., Juan, R. S., Fernandez-Ruiz, M., Larrosa, N., Puig-Asensio, M., Cisneros, J. M., Molina, J., Gonzalez, V., Rucci, V., de Gopegui, E. R., Marinescu, C. I., Martinez-Martinez, L., Farinas, M. C., Cano, M. E., Gozalo, M., Mora-Rillo, M., Francisco, C. N. -S., Pena, C., Gomez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Antoniadou, A., Poulakou, G., Pitout, J., Virmani, D., Torre-Cisneros, J., Guzman-Puche, J., Helvaci, O., Sahin, A. O., Pintado, V., Ruiz, P., Bartoletti, M., Giannella, M., Tacconelli, E., Riemenschneider, F., Calbo, E., Badia, C., Xercavins, M., Gasch, O., Fontanals, D., Jove, E., Venditti M., Tumbarello M. (ORCID:0000-0002-9519-8552), Trecarichi E. M., Losito A. R., Tacconelli E. (ORCID:0000-0001-8722-5824), Gutierrez-Gutierrez, B., Salamanca, E., de Cueto, M., Hsueh, P. -R., Viale, P., Pano-Pardo, J. R., Venditti, M., Tumbarello, M., Daikos, G., Canton, R., Doi, Y., Tuon, F. F., Karaiskos, I., Perez-Nadales, E., Schwaber, M. J., Azap, O. K., Souli, M., Roilides, E., Pournaras, S., Akova, M., Perez, F., Bermejo, J., Oliver, A., Almela, M., Lowman, W., Almirante, B., Bonomo, R. A., Carmeli, Y., Paterson, D. L., Pascual, A., Rodriguez-Bano, J., del Toro, M. D., Galvez, J., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, E. M., Losito, A. R., Garcia-Vazquez, E., Hernandez, A., Gomez, J., Bou, G., Iosifidis, E., Prim, N., Navarro, F., Mirelis, B., Skiada, A., Origuen, J., Juan, R. S., Fernandez-Ruiz, M., Larrosa, N., Puig-Asensio, M., Cisneros, J. M., Molina, J., Gonzalez, V., Rucci, V., de Gopegui, E. R., Marinescu, C. I., Martinez-Martinez, L., Farinas, M. C., Cano, M. E., Gozalo, M., Mora-Rillo, M., Francisco, C. N. -S., Pena, C., Gomez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Antoniadou, A., Poulakou, G., Pitout, J., Virmani, D., Torre-Cisneros, J., Guzman-Puche, J., Helvaci, O., Sahin, A. O., Pintado, V., Ruiz, P., Bartoletti, M., Giannella, M., Tacconelli, E., Riemenschneider, F., Calbo, E., Badia, C., Xercavins, M., Gasch, O., Fontanals, D., Jove, E., Venditti M., Tumbarello M. (ORCID:0000-0002-9519-8552), Trecarichi E. M., Losito A. R., and Tacconelli E. (ORCID:0000-0001-8722-5824)

Abstract

Background The best available treatment against carbapenemase-producing Enterobacteriaceae (CPE) is unknown. The objective of this study was to investigate the effect of appropriate therapy and of appropriate combination therapy on mortality of patients with bloodstream infections (BSIs) due to CPE. Methods In this retrospective cohort study, we included patients with clinically significant monomicrobial BSIs due to CPE from the INCREMENT cohort, recruited from 26 tertiary hospitals in ten countries. Exclusion criteria were missing key data, death sooner than 24 h after the index date, therapy with an active antibiotic for at least 2 days when blood cultures were taken, and subsequent episodes in the same patient. We compared 30 day all-cause mortality between patients receiving appropriate (including an active drug against the blood isolate and started in the first 5 days after infection) or inappropriate therapy, and for patients receiving appropriate therapy, between those receiving active monotherapy (only one active drug) or combination therapy (more than one). We used a propensity score for receiving combination therapy and a validated mortality score (INCREMENT-CPE mortality score) to control for confounders in Cox regression analyses. We stratified analyses of combination therapy according to INCREMENT-CPE mortality score (0–7 [low mortality score] vs 8–15 [high mortality score]). INCREMENT is registered with ClinicalTrials.gov, number NCT01764490. Findings Between Jan 1, 2004, and Dec 31, 2013, 480 patients with BSIs due to CPE were enrolled in the INCREMENT cohort, of whom we included 437 (91%) in this study. 343 (78%) patients received appropriate therapy compared with 94 (22%) who received inappropriate therapy. The most frequent organism was Klebsiella pneumoniae (375 [86%] of 437; 291 [85%] of 343 patients receiving appropriate therapy vs 84 [89%] of 94 receiving inappropriate therapy) and the most frequent carbapenemase was K pneumoniae carbapenemase

Published
2017

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

Author

Gutiérrez Gutiérrez, Belén, Salamanca, Elena, de Cueto, Marina, Pascual, Alvaro, Rodríguez Baño, Jesús, 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, Bonomo, Robert A., Bermejo, Joaquín, Oliver, Antonio, Almela, Manel, Lowman, Warren, Almirante, Benito, Carmeli, Yehuda, Paterson, David L., Falcone, M., Russo, A., Giamarellou, H., Trecarichi, Enrico Maria, Losito, Angela Raffaella, 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., and Jové, E.

Subjects
0301 basic medicine, Male, medicine.medical_specialty, carbapenems, klebsiella pneumoniae, pneumoniae carbapenemase, 030106 microbiology, Bacteremia, Comorbidity, Logistic regression, Settore MED/17 - MALATTIE INFETTIVE, Sensitivity and Specificity, beta-Lactamases, Decision Support Techniques, 03 medical and health sciences, 0302 clinical medicine, Bacterial Proteins, Enterobacteriaceae, Predictive Value of Tests, Internal medicine, medicine, Humans, In patient, 030212 general & internal medicine, Aged, Anti-Bacterial Agents, Enterobacteriaceae Infections, Female, Logistic Models, Middle Aged, Retrospective Studies, Receiver operating characteristic, business.industry, Medicine (all), Retrospective cohort study, General Medicine, medicine.disease, Surgery, Predictive value of tests, Observational study, business
Abstract

Objective To develop a score to predict mortality in patients with bloodstream infections (BSIs) due to carbapenemase-producing Enterobacteriaceae (CPE). Patients and Methods A multinational retrospective cohort study (INCREMENT project) was performed from January 1, 2004, through December 31, 2013. Patients with clinically relevant monomicrobial BSIs due to CPE were included and randomly assigned to either a derivation cohort (DC) or a validation cohort (VC). The variables were assessed on the day the susceptibility results were available, and the predictive score was developed using hierarchical logistic regression. The main outcome variable was 14-day all-cause mortality. The predictive ability of the model and scores were measured by calculating the area under the receiver operating characteristic curve. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for different cutoffs of the score. Results The DC and VC included 314 and 154 patients, respectively. The final logistic regression model of the DC included the following variables: severe sepsis or shock at presentation (5 points); Pitt score of 6 or more (4 points); Charlson comorbidity index of 2 or more (3 points); source of BSI other than urinary or biliary tract (3 points); inappropriate empirical therapy and inappropriate early targeted therapy (2 points). The score exhibited an area under the receiver operating characteristic curve of 0.80 (95% CI, 0.74-0.85) in the DC and 0.80 (95% CI, 0.73-0.88) in the VC. The results for 30-day all-cause mortality were similar. Conclusion A validated score predictive of early mortality in patients with BSIs due to CPE was developed. Trial Registration clinicaltrials.gov Identifier: NCT01 764490.

Published
2016

36. Ertapenem for the treatment of bloodstream infections due to ESBL-producing Enterobacteriaceae: A multinational pre-registered cohort study

Author

Gutiérrez-Gutiérrez, B. Bonomo, R.A. Carmeli, Y. Paterson, D.L. Almirante, B. Martínez-Martínez, L. Oliver, A. Calbo, E. Peña, C. Akova, M. Pitout, J. Origüen, J. Pintado, V. García-Vázquez, E. Gasch, O. Hamprecht, A. Prim, N. Tumbarello, M. Bou, G. Viale, P. Tacconelli, E. Almela, M. Pérez, F. Giamarellou, H. Cisneros, J.M. Schwaber, M.J. Venditti, M. Lowman, W. Bermejo, J. Hsueh, P.-R. Mora-Rillo, M. Gracia-Ahulfinger, I. Pascual, A. Rodríguez-Baño, J. Karaiskos, I. Trecarichi, E.M. Losito, A.R. Hernández, A. Gómez, J. Navarro, F. Mirelis, B. Larrosa, N. Puig, M. Rucci, V. Bartoletti, M. Giannella, M. Riemenschneider, F. Badia, C. Xercavins, M. Gálvez, J. de Cueto, M. Salamanca, E. Falcone, M. Russo, A. Daikos, G. Roilides, E. Iosifidis, E. Doi, Y. Tuon, F.F. San Juan, R. Fernández-Ruiz, M. Molina, J. González, V. Ruiz de Gopegui, E. Marinescu, C.I. Fariñas, M.C. Cano, M.E. Gozalo, M. Paño-Pardo, J.R. Navarro-San Francisco, C. Gómez-Zorrilla, S. Tubau, F. Pournaras, S. Tsakris, A. Zarkotou, O. Azap, Ö.K. Souli, M. Antoniadou, A. Poulakou, G. Virmani, D. Machuca, I. Pérez-Nadales, E. Torre-Cisneros, J. Helvaci, Ö. Sahin, A.O. Cantón, R. Ruiz, P. Fontanals, D. Jové, E. REIPI/ESGBIS/INCREMENT Group

Subjects
polycyclic compounds, bacterial infections and mycoses
Abstract

Objectives: Data about the efficacy of ertapenem for the treatment of bloodstream infections (BSI) due to ESBL-producing Enterobacteriaceae (ESBL-E) are limited. We compared the clinical efficacy of ertapenem and other carbapenems in monomicrobial BSI due to ESBL-E. Methods: A multinational retrospective cohort study (INCREMENT project) was performed (ClinicalTrials.gov identifier: NCT01764490). Patients given monotherapy with ertapenem or other carbapenems were compared. Empirical and targeted therapies were analysed. Propensity scores were used to control for confounding; sensitivity analyses were performed in subgroups. The outcome variables were cure/improvement rate at day 14 and all-cause 30 day mortality. Results: The empirical therapy cohort (ETC) and the targeted therapy cohort (TTC) included 195 and 509 patients, respectively. Cure/improvement rateswere 90.6% with ertapenem and 75.5% with other carbapenems (P=0.06) in the ETC and 89.8% and 82.6% (P=0.02) in the TTC, respectively; 30 day mortality rates were 3.1% and 23.3% (P=0.01) in the ETC and 9.3% and 17.1% (P=0.01) in the TTC, respectively. Adjusted ORs (95% CI) for cure/improvement with empirical and targeted ertapenem were 1.87 (0.24-20.08; P=0.58) and 1.04 (0.44- 2.50; P=0.92), respectively. For the propensity-matched cohorts it was 1.18 (0.43-3.29; P=0.74). Regarding 30 day mortality, the adjusted HR (95% CI) for targeted ertapenem was 0.93 (0.43-2.03; P=0.86) and for the propensity-matched cohorts it was 1.05 (0.46-2.44; P=0.90). Sensitivity analyses were consistent except for patients with severe sepsis/septic shock, which showed a non-significant trend favouring other carbapenems. Conclusions: Ertapenem appears as effective as other carbapenems for empirical and targeted therapy of BSI due to ESBL-E, but further studies are needed for patients with severe sepsis/septic shock. © The Author 2016.

Published
2016

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

Author

Gutiérrez-Gutiérrez, B. Salamanca, E. de Cueto, M. Pascual, A. Rodríguez-Baño, J. Hsueh, P.-R. Viale, P. Paño-Pardo, J.R. Venditti, M. Tumbarello, M. Daikos, G. Pintado, V. Doi, Y. Tuon, F.F. Karaiskos, I. Machuca, I. Schwaber, M.J. Azap, Ö.K. Souli, M. Roilides, E. Pournaras, S. Akova, M. Pérez, F. Bonomo, R.A. Bermejo, J. Oliver, A. Almela, M. Lowman, W. Almirante, B. Carmeli, Y. Paterson, D.L. 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. 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.

Abstract

Objective To develop a score to predict mortality in patients with bloodstream infections (BSIs) due to carbapenemase-producing Enterobacteriaceae (CPE). Patients and Methods A multinational retrospective cohort study (INCREMENT project) was performed from January 1, 2004, through December 31, 2013. Patients with clinically relevant monomicrobial BSIs due to CPE were included and randomly assigned to either a derivation cohort (DC) or a validation cohort (VC). The variables were assessed on the day the susceptibility results were available, and the predictive score was developed using hierarchical logistic regression. The main outcome variable was 14-day all-cause mortality. The predictive ability of the model and scores were measured by calculating the area under the receiver operating characteristic curve. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for different cutoffs of the score. Results The DC and VC included 314 and 154 patients, respectively. The final logistic regression model of the DC included the following variables: severe sepsis or shock at presentation (5 points); Pitt score of 6 or more (4 points); Charlson comorbidity index of 2 or more (3 points); source of BSI other than urinary or biliary tract (3 points); inappropriate empirical therapy and inappropriate early targeted therapy (2 points). The score exhibited an area under the receiver operating characteristic curve of 0.80 (95% CI, 0.74-0.85) in the DC and 0.80 (95% CI, 0.73-0.88) in the VC. The results for 30-day all-cause mortality were similar. Conclusion A validated score predictive of early mortality in patients with BSIs due to CPE was developed. Trial Registration clinicaltrials.gov Identifier: NCT01 764490. © 2016 Mayo Foundation for Medical Education and Research

Published
2016

38. Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain

Author

Palacios-Baena, ZR, Oteo, J, Conejo, C, Larrosa, MN, Bou, G, Fernandez-Martinez, M, Gonzalez-Lopez, JJ, Pintado, V, Martinez-Martinez, L, Merino, M, Pomar, V, Mora-Rillo, M, Rivera, MA, Oliver, A, Ruiz-Carrascoso, G, Ruiz-Garbajosa, P, Zamorano, L, Bautista, V, Ortega, A, Morales, I, Pascual, A, Campos, J, and Rodriguez-Bano, J

Subjects
Risk factors, Carbapenem resistant Enterobacteriaceae, Clinical features, Geographic distribution
Abstract

Background: Most available information on carbapenemase-producing Enterobacteriaceae (CPE) is usually associated with specific types of infection or patient or with descriptions of outbreaks. The aim of this study was to comprehensively analyse the clinical epidemiology, clinical features and outcomes of colonisation and infections due to CPE in Spain. Methods: A multicentre prospective cohort study was carried out in 34 Spanish hospitals from February to May 2013. All new patients testing positive for CPE in clinical samples were included. Logistic regression was used to identify predictors of mortality. Results: Overall, 245 cases were included. The most frequent organism was Klebsiella pneumoniae (74%) and the carbapenemases belonged to the OXA-48 (74%), metallo-beta-lactamase (MBL) (24%) and KPC (2%) groups. Acquisition was nosocomial in 145 cases (60%) and healthcare- associated (HCA) in 91 (37%); 42% of the latter were nursing home residents, in whom OXA-48-producing K. pneumoniae ST405 predominated. MBLs and OXA-48 predominated in ICU and medical patients, respectively. Overall, 67% of patients had infections. The most frequent infections identified in this study were urinary tract (43%) and skin structure (21%) infections, and 10% of infections were bacteraemic. Crude mortality was 20%. Inappropriate antibiotic therapy was independently associated with an increased risk of death (OR = 3.30; 95% CI: 1.34-8.11). Conclusions: We found some differences in the epidemiology of CPE depending on the type of carbapenemase produced. Although a low proportion of CPE infections were bacteraemic, active antibiotic therapy was a protective factor for reducing mortality. (C) 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Published
2016

39. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study

Author

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

Published
2017
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42. Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata

Author

Amor, Antonio J., primary, Serra‐Mir, Mercè, additional, Martínez‐González, Miguel A., additional, Corella, Dolores, additional, Salas‐Salvadó, Jordi, additional, Fitó, Montserrat, additional, Estruch, Ramón, additional, Serra‐Majem, Lluis, additional, Arós, Fernando, additional, Babio, Nancy, additional, Ros, Emilio, additional, Ortega, Emilio, additional, Pérez‐Heras, A., additional, Viñas, C., additional, Casas, R., additional, de Santamaría, L., additional, Romero, S., additional, Sacanella, E., additional, Chiva, G., additional, Valderas, P., additional, Arranz, S., additional, Baena, J. M., additional, García, M., additional, Oller, M., additional, Amat, J., additional, Duaso, I., additional, García, Y., additional, Iglesias, C., additional, Simón, C., additional, Quinzavos, Ll., additional, Parra, Ll., additional, Liroz, M., additional, Benavent, J., additional, Clos, J., additional, Pla, I., additional, Amorós, M., additional, Bonet, M. T., additional, Martin, M. T., additional, Sánchez, M. S., additional, Altirriba, J., additional, Manzano, E., additional, Altés, A., additional, Sala‐Vila, A., additional, Cofán, M., additional, Valls‐Pedret, C., additional, Freitas‐Simoes, T. M., additional, Doménech, M., additional, Gilabert, R., additional, Bargalló, N., additional, Bulló, M., additional, Basora, J., additional, González, R., additional, Díaz‐López, A., additional, Molina, C., additional, Mena, G., additional, Márquez, F., additional, Martínez, P., additional, Ibarrola, N., additional, Sorli, M., additional, García Roselló, J., additional, Martín, F., additional, Tort, N., additional, Isach, A., additional, Salas‐Huetos, A., additional, Becerra‐Tomás, N., additional, Rosique Esteban, N., additional, Cabré, J. J., additional, Mestres, G., additional, Paris, F., additional, Llaurado, M., additional, Pedret, R., additional, Basells, J., additional, Vizcaino, J., additional, Segarra, R., additional, Hernandez‐Alonso, P., additional, Giardina, S., additional, Ferreira‐Pego, C., additional, Papandreou, C., additional, Camacho, L., additional, Toledo, E., additional, Buil‐Cosiales, P., additional, Ruiz‐Canela, M., additional, Martínez, J. A., additional, Sanjulian, B., additional, Sánchez‐Tainta, A., additional, Diez‐Espino, J., additional, Razquin, C., additional, Garcia‐Arellano, A., additional, Goni, E., additional, Vazquez, Z., additional, Berrade, N., additional, Extremera‐Urabayen, V., additional, Eguaras, S., additional, Marti, A., additional, Arroyo‐Azpa, C., additional, García‐Pérez, L., additional, Villanueva Telleria, J., additional, Cortés Ugalde, F., additional, Sagredo Arce, T., additional, de la Noceda Montoy, M. D. García, additional, Vigata López, M. D., additional, Arceiz Campo, M. T., additional, Urtasun Samper, A., additional, Gueto Rubio, M. V., additional, Sola, A., additional, Goñi, N., additional, Lecea, O., additional, Tello, S., additional, Vila, J., additional, de la Torre, R., additional, Muñoz‐Aguayo, D., additional, Elosua, R., additional, Marrugat, J., additional, Schröder, H., additional, Molina, N., additional, Maestre, E., additional, Castañer, O., additional, Rovira, A., additional, Farre, M., additional, Sorli, J. V., additional, Zanon‐Moreno, V., additional, Carrasco, P., additional, Ortega‐Azorín, C., additional, Asensio, E. M., additional, Osma, R., additional, Barragán, R., additional, Francés, F., additional, Guillén, M., additional, González, J. I., additional, Saiz, C., additional, Portolés, O., additional, Giménez, F. J., additional, Coltell, O., additional, Guillem‐Saiz, P., additional, Quiles, L., additional, Pascual, V., additional, Riera, C., additional, Pages, M. A., additional, Godoy, D., additional, Carratala‐Calvo, A., additional, Martín‐Rillo, M. J., additional, Llopis‐Osorio, E., additional, Ruiz‐Baixauli, J., additional, Bertolín‐Muñoz, A., additional, Salaverría, I., additional, del Hierro, T., additional, Algorta, J., additional, Francisco, S., additional, Alonso‐Gómez, A., additional, Sanz, E., additional, Rekondo, J., additional, Bello, M. C., additional, Loma‐Osorio, A., additional, Gómez‐Gracia, E., additional, Warnberg, J., additional, Benítez Pont, R., additional, Bianchi Alba, M., additional, Gómez‐Huelgas, R., additional, Martínez‐González, J., additional, Velasco García, V., additional, de Diego Salas, J., additional, Baca Osorio, A., additional, Gil Zarzosa, J., additional, Sánchez Luque, J. J., additional, Vargas López, E., additional, Ruiz‐Gutiérrez, V., additional, Sánchez Perona, J., additional, Montero Romero, E., additional, García‐García, M., additional, Jurado‐Ruiz, E., additional, Fiol, M., additional, García‐Valdueza, M., additional, Moñino, M., additional, Proenza, A., additional, Prieto, R., additional, Frontera, G., additional, Ginard, M., additional, Fiol, F., additional, Jover, A., additional, Romaguera, D., additional, García, J., additional, Lapetra, J., additional, Santos‐Lozano, J. M., additional, Ortega‐Calvo, M., additional, Mellado, L., additional, Leal, M., additional, Martínez, E., additional, José García, F., additional, Román, P., additional, Iglesias, P., additional, Corchado, Y., additional, Miró, L., additional, Domínguez, C., additional, Lozano, J. M., additional, Mayoral, E., additional, Lamuela‐Raventós, R. M., additional, López‐Sabater, M. C., additional, Castellote‐Bargallo, A. I., additional, Tresserra‐Rimbau, A., additional, Álvarez‐Pérez, J., additional, Díaz‐Benítez, E. M., additional, Bautista Castaño, I., additional, Sánchez‐Villegas, A., additional, Fernández‐Rodríguez, M. J., additional, Casanas Quintana, T., additional, Pérez‐Cabrera, J., additional, Nissensohn, M., additional, Díaz‐González, V., additional, Ruano‐Rodríguez, C., additional, Ortiz‐Andrelluchi, A. P., additional, Macías Gutiérrez, B., additional, Santana‐Santana, A. J., additional, Pintó, X., additional, de la Cruz, E., additional, Galera, A., additional, Soler, Y., additional, Trias, F., additional, Sarasa, I., additional, Padres, E., additional, Corbella, E., additional, Cabezas, C., additional, Vinyoles, E., additional, Rovira, M. A., additional, García, L., additional, Flores, G., additional, Verdú, J. M., additional, Baby, P., additional, Ramos, A., additional, Mengual, L., additional, Roura, P., additional, Yuste, M. C., additional, Guarner, A., additional, Santamaría, M. I., additional, Mata, M., additional, de Juan, C., additional, Brau, A., additional, Tur, J. A., additional, Portillo, M. P., additional, Sáez, G., additional, Aldamiz, M., additional, Alonso, A., additional, Berjón, J., additional, Forga, L., additional, Gallego, J., additional, Larrauri, A., additional, Portu, J., additional, Timiraos, J., additional, and Serrano‐Martínez, M., additional

Published
2017
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43. How to assist clinicians in improving antimicrobial prescribing: tools and interventions provided by stewardship programs

Author

López-Medrano F, Moreno-Ramos F, de Cueto M, Mora-Rillo M, and Salavert M

Subjects
Antibiotic, Antifungal, Antifúngicos, Antimicrobial, Antimicrobianos, PROA, Programas de optimización, Stewardship programs
Abstract

In the last decade, there has been an exponential increase in the microorganisms resistant to antimicrobials and a significant increase in the cost of these types of drugs. This phenomenon has increased interest in the development of interventions for counseling on and control of the use of antimicrobials, referred to as stewardship programs. In this article we review, from various points of view, the tools that have been developed with this purpose. First, we highlight the value of locally adapted guidelines and clinical pathways as an essential part of the operational process. Then we emphasize the importance of the relationship between microbiologists and clinicians for the accurate transmission of the information provided by blood cultures to make the most appropriate choice of antimicrobial for the patient's treatment. We also review the computerized tools that have facilitated the correct use of antimicrobials according to the controls established by the departments of pharmacy. Based on the previous tools, some programs based on "bedside recommendations" provided by multidisciplinary teams have been developed for optimizing the rational use of antimicrobials (PROA programs). Finally, we comment on the peculiarities of the programs targeting antifungals that have been developed in recent years.

Published
2013

44. Response to HAART according to sex and origin (immigrant vs autochthonous) in a cohort of patients who initiate antiretroviral treatment

Author

Perez?Molina, Ja, Mora?Rillo, M, Suarez?Lozano, I, Casado, Jl, Teira, R, Rivas, P, Pedrol, E, Hernando, A, Domingo, P, Barquilla, E, Esteban, H, and Gonzalez?Garcia, J

Subjects
Highly active antiretroviral therapy -- Dosage and administration -- Access control, Women immigrants -- Health aspects, HIV patients -- Demographic aspects -- Drug therapy, Health
Abstract

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK, Purpose Although poorly studied, gender differences can affect the efficacy of HAART. Immigrant women (IW) may also be at risk of treatment failure due to greater marginalization, cultural differences, or [...]

Published
2010
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45. Malattie dellIpofisi

Author

Gargiulo, Patrizia, Iuorio, R., and Rillo, M.

Subjects
Ipofisi adenomi ipofisari deficit ipofisari
Published
2011

47. Catheter ablation of atrial fibrilation using a nonfluoroscopic system

Author

Pappone C, Lamberti F, Rillo M, Vicedomini G, Conversano A, Loricchio ML, Mazzone P, Ben-Haim S, Bianchi S, Chierchia S, Pappone, C, Lamberti, F, Rillo, M, Vicedomini, G, Conversano, A, Loricchio, Ml, Mazzone, P, Ben-Haim, S, Bianchi, S, and Chierchia, S

Published
1998

48. Palpitations: what is the mechanism, and when should we treat them?

Author

Rosano GM, Rillo M, Leonardo F, Pappone C, Chierchia SL, Rosano, Gm, Rillo, M, Leonardo, F, Pappone, C, and Chierchia, Sl

Subjects
Heart Diseases, Pregnancy, Humans, Women's Health, Arrhythmias, Cardiac, Female, Heart, Menopause, Gonadal Steroid Hormones, Menstrual Cycle
Abstract

Palpitation is an unpleasant awareness of an abnormal beating of the heart. This symptom may be brought on by a variety of cardiac disorders, such as cardiomyopathy, valvular heart disease, and coronary artery disease, but the most common cause is primary cardiac arrhythmias. Several noncardiac disorders may also cause palpitations, and in this case are an effect of the disease upon cardiac rhythm. Palpitations occur frequently in women at all ages, especially during the luteal phase of the menstrual cycle, during pregnancy, and during the perimenopausal period. Palpitations occurring at young age and associated with fast heart rate are frequently due to Wolff-Parkinson-White syndrome or other forms of re-entrant tachycardia, and may require catheter ablation. A correlation between ovarian hormones and occurrence of paroxysmal supraventricular tachycardia has recently been reported in female patients with normal menstrual cycles; palpitations are frequently reported in cases of mitral valve prolapse, whereas episodes of paroxysmal supraventricular tachycardia reported during pregnancy may be due to mechanical stimuli or to a suggested arrhythmogenic effect of pregnancy. Palpitations during the perimenopausal period are usually benign and seem to be related to the increased sympathetic activity caused by the menopause. Although the vast majority of palpitations are benign and need not be treated, an electrophysiological study is indicated for those patients who have a documented episode of palpitation associated with syncope or with a pulse that is inappropriately rapid during symptoms. The treatment of palpitations due to cardiac arrhythmias is dependent upon the kind of arrhythmia detected during either invasive or noninvasive electrophysiological studies.

Published
1997

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