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1. Transitions of blood immune endotypes and improved outcome by anakinra in COVID-19 pneumonia: an analysis of the SAVE-MORE randomized controlled trial

Author

Kyriazopoulou, Evdoxia, Hasin-Brumshtein, Yehudit, Midic, Uros, Poulakou, Garyfallia, Milionis, Haralampos, Metallidis, Simeon, Astriti, Myrto, Fragkou, Archontoula, Rapti, Aggeliki, Taddei, Eleonora, Kalomenidis, Ioannis, Chrysos, Georgios, Angheben, Andrea, Kainis, Ilias, Alexiou, Zoi, Castelli, Francesco, Serino, Francesco Saverio, Bakakos, Petros, Nicastri, Emanuele, Tzavara, Vasiliki, Ioannou, Sofia, Dagna, Lorenzo, Dimakou, Katerina, Tzatzagou, Glykeria, Chini, Maria, Bassetti, Matteo, Kotsis, Vasileios, Tsoukalas, Dionysios G., Selmi, Carlo, Konstantinou, Alexandra, Samarkos, Michael, Doumas, Michael, Masgala, Aikaterini, Pagkratis, Konstantinos, Argyraki, Aikaterini, Akinosoglou, Karolina, Symbardi, Styliani, Netea, Mihai G., Panagopoulos, Periklis, Dalekos, George N., Liesenfeld, Oliver, Sweeney, Timothy E., Khatri, Purvesh, and Giamarellos-Bourboulis, Evangelos J.

Published
2024
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2. HEPARIN-BINDING PROTEIN LEVELS PREDICT UNFAVORABLE OUTCOME IN COVID-19 PNEUMONIA: A POST HOC ANALYSIS OF THE SAVE TRIAL

Author

Kyriazopoulou, Evdoxia, Dalekos, George N., Metallidis, Symeon, Poulakou, Garyphalia, Papanikolaou, Ilias C., Tzavara, Vasiliki, Argyraki, Katerina, Alexiou, Zoi, Panagopoulos, Periklis, Samarkos, Michael, Chrysos, George, Tseliou, Aikaterini, Milionis, Haralampos, Sympardi, Styliani, Vasishta, Anil, and Giamarellos-Bourboulis, Evangelos J.

Published
2024
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3. Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study

Author

Tumbarello, Mario, Talento, Alida Fe, Ruiz, Alba C, Racil, Zdenek, Stoma, Igor, Calbacho, Maria, Van Wijngaerden, Eric, Henriques, Júlia, Jordan, Harriett, Ferroni, Valentina, Ozyurt, Ozlem Koyuncu, Milacek, Christopher, Krause, Robert, Zurl, Christoph, Backx, Matthijs, Li, Ang, Seufert, Raphael, Tomazin, Rok, Blankenheim, Yael, Dávila-Valls, Julio, García-Clemente, Paloma, Freiberger, Tomas, Buil, Jochem, Meis, Jacques F, Akyol, Deniz, Guegan, Hélène, Logan, Clare, Hoenigl, Martin, Salmanton-García, Jon, Egger, Matthias, Gangneux, Jean-Pierre, Bicanic, Tihana, Arikan-Akdagli, Sevtap, Alastruey-Izquierdo, Ana, Klimko, Nikolai, Barac, Aleksandra, Özenci, Volkan, Meijer, Eelco F J, Khanna, Nina, Bassetti, Matteo, Rautemaa-Richardson, Riina, Lagrou, Katrien, Adam, Kai-Manuel, Akalin, Emin Halis, Akova, Murat, Arsic Arsenijevic, Valentina, Aujayeb, Avinash, Blennow, Ola, Bretagne, Stéphane, Danion, François, Denis, Blandine, de Jonge, Nick Alexander, Desoubeaux, Guillaume, Drgona, Lubos, Erben, Nurettin, Gori, Andrea, García Rodríguez, Julio, Garcia-Vidal, Carolina, Giacobbe, Daniele Roberto, Goodman, Anna L, Hamal, Petr, Hammarström, Helena, Toscano, Cristina, Lanternier, Fanny, Lass-Flörl, Cornelia, Lockhart, Deborah E A, Longval, Thomas, Loughlin, Laura, Matos, Tadeja, Mikulska, Malgorzata, Narayanan, Manjusha, Martín-Pérez, Sonia, Prattes, Juergen, Rogers, Benedict, Rahimli, Laman, Ruiz, Maite, Roilides, Emmanuel, Samarkos, Michael, Scharmann, Ulrike, Sili, Uluhan, Sipahi, Oguz Resat, Sivakova, Alena, Steinmann, Joerg, Trauth, Janina, Turhan, Ozge, Van Praet, Jens, Vena, Antonio, White, P Lewis, Willinger, Birgit, Tortorano, Anna Maria, Arendrup, Maiken C, Koehler, Philipp, and Cornely, Oliver A

Published
2023
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4. Efficacy and safety of early soluble urokinase plasminogen receptor plasma-guided anakinra treatment of COVID-19 pneumonia: a subgroup analysis of the SAVE-MORE randomised trial

Author

Akinosoglou, Karolina, Kotsaki, Antigone, Gounaridi, Ioanna-Maria, Christaki, Eirini, Metallidis, Simeon, Adamis, Georgios, Fragkou, Archontoula, Fantoni, Massimo, Rapti, Aggeliki, Kalomenidis, Ioannis, Chrysos, Georgios, Boni, Gloria, Kainis, Ilias, Alexiou, Zoi, Castelli, Francesco, Serino, Francesco Saverio, Bakakos, Petros, Nicastri, Emanuele, Tzavara, Vassiliki, Safarika, Asimina, Ioannou, Sofia, Dagna, Lorenzo, Dimakou, Katerina, Tzatzagou, Glykeria, Chini, Maria, Bassetti, Matteo, Kotsis, Vasileios, Angheben, Andrea, Tsoukalas, George, Selmi, Carlo, Spiropoulou, Olga-Maria, Samarkos, Michael, Doumas, Michael, Damoraki, Georgia, Masgala, Aikaterini, Papanikolaou, Ilias, Argyraki, Aikaterini, Negri, Marcantonio, Leventogiannis, Konstantinos, Sympardi, Styliani, Gatselis, Nikolaos K., Petrakis, Vasileios, Netea, Mihai G., Panagopoulos, Periklis, Sakka, Vissaria, Milionis, Haralampos, Dalekos, George N., and Giamarellos-Bourboulis, Evangelos J.

Published
2023
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5. Interferon gamma-induced protein 10 (IP-10) for the early prognosis of the risk for severe respiratory failure and death in COVID-19 pneumonia

Author

Samaras, Charilaos, Kyriazopoulou, Evdoxia, Poulakou, Garyfallia, Reiner, Eran, Kosmidou, Maria, Karanika, Ioanna, Petrakis, Vasileios, Adamis, George, Gatselis, Nikolaos K., Fragkou, Archontoula, Rapti, Aggeliki, Taddei, Eleonora, Kalomenidis, Ioannis, Chrysos, George, Bertoli, Giulia, Kainis, Ilias, Alexiou, Zoi, Castelli, Francesco, Saverio Serino, Francesco, Bakakos, Petros, Nicastri, Emanuele, Tzavara, Vassiliki, Kostis, Evangelos, Dagna, Lorenzo, Koukidou, Sofia, Tzatzagou, Glykeria, Chini, Maria, Bassetti, Matteo, Trakatelli, Christina, Tsoukalas, George, Selmi, Carlo, Samarkos, Michael, Pyrpasopoulou, Athina, Masgala, Aikaterini, Antonakis, Emmanouil, Argyraki, Aikaterini, Akinosoglou, Karolina, Sympardi, Styliani, Panagopoulos, Periklis, Milionis, Haralampos, Metallidis, Simeon, Syrigos, Konstantinos N., Angel, Alon, Dalekos, George N., Netea, Mihai G., and Giamarellos-Bourboulis, Evangelos J.

Published
2023
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6. The Effect of a Care Bundle on the Rate of Blood Culture Contamination in a General Intensive Care Unit.

Author

Veini, Fani, Samarkos, Michael, Voutsinas, Pantazis-Michael, and Kotanidou, Anastasia

Subjects
BLOOD collection, INAPPROPRIATE prescribing (Medicine), INTENSIVE care patients, TIME series analysis, INTENSIVE care units
Abstract

Background/objectives: Blood culture (BC) contamination is a frequent problem which leads to increased laboratory workload, inappropriate use of antibiotics and the associated adverse events, and increased healthcare costs. This study prospectively examined the effect of a care bundle on BC contamination rates in a high workload ICU. Results: During the study, in total, 4236 BC vials were collected. After the intervention, the BC contamination rate decreased significantly from 6.2% to 1.3%. The incidence rate of contaminated BC sets was significantly lower following the intervention: 0.461 vs. 0.154 BC sets per 100 ICU bed-days. Overall compliance with the BC care bundle increased dramatically from 3.4% to 96.9%. Methods: We performed a before–after study in a general ICU from January 2018 to May 2019, with the intervention starting on November 2018. Blood culture sets were classified as positive, contaminated, indeterminate, and negative. We used bivariate and interrupted time series analysis to assess the effect of the intervention on BC contamination rates and other BC quality indicators. Conclusions: The BC care bundle was effective in reducing BC contamination rates and improving several quality indicators in our setting. The indeterminate BC rate is an important but understudied problem, and we suggest that it should be included in BC quality indicators as well. A significant limitation of the study was that the long-term effect of the intervention was not assessed. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Effect of anakinra on mortality in patients with COVID-19: a systematic review and patient-level meta-analysis

Author

Kyriazopoulou, Evdoxia, Huet, Thomas, Cavalli, Giulio, Gori, Andrea, Kyprianou, Miltiades, Pickkers, Peter, Eugen-Olsen, Jesper, Clerici, Mario, Veas, Francisco, Chatellier, Gilles, Kaplanski, Gilles, Netea, Mihai G., Pontali, Emanuele, Gattorno, Marco, Cauchois, Raphael, Kooistra, Emma, Kox, Matthijs, Bandera, Alessandra, Beaussier, Hélène, Mangioni, Davide, Dagna, Lorenzo, van der Meer, Jos W.M., Giamarellos-Bourboulis, Evangelos J., Hayem, Gilles, Volpi, Stefano, Sormani, Maria Pia, Signori, Alessio, Bozzi, Giorgio, Minoia, Francesca, Aliberti, Stefano, Grasselli, Giacomo, Alagna, Laura, Lombardi, Andrea, Ungaro, Riccardo, Agostoni, Carlo, Blasi, Francesco, Costantino, Giorgio, Fracanzani, Anna Ludovica, Montano, Nicola, Peyvandi, Flora, Sottocorno, Marcello, Muscatello, Antonio, Filocamo, Giovanni, Papadopoulos, Antonios, Mouktaroudi, Maria, Karakike, Eleni, Saridaki, Maria, Gkavogianni, Theologia, Katrini, Konstantina, Vechlidis, Nikolaos, Avgoustou, Christina, Chalvatzis, Stamatios, Marantos, Theodoros, Damoulari, Christina, Damoraki, Georgia, Ktena, Sofia, Tsilika, Maria, Koufargyris, Panagiotis, Karageorgos, Athanasios, Droggiti, Dionysia-Irene, Koliakou, Aikaterini, Poulakou, Garyfallia, Tsiakos, Konstantinos, Myrodia, Dimitra-Melia, Gravvani, Areti, Trontzas, Ioannis P., Syrigos, Konstantinos, Kalomenidis, Ioannis, Kranidioti, Eleftheria, Panagopoulos, Periklis, Petrakis, Vasileios, Metallidis, Simeon, Loli, Georgia, Tsachouridou, Olga, Dalekos, George N., Gatselis, Nikolaos, Stefos, Aggelos, Georgiadou, Sarah, Lygoura, Vassiliki, Milionis, Haralampos, Kosmidou, Maria, Papanikolaou, Ilias C., Akinosoglou, Karolina, Giannitsioti, Efthymia, Chrysos, Georgios, Mavroudis, Panagiotis, Sidiropoulou, Chrysanthi, Adamis, Georgios, Fragkou, Archontoula, Rapti, Aggeliki, Alexiou, Zoi, Symbardi, Styliani, Masgala, Aikaterini, Kostaki, Konstantina, Kostis, Evangelos, Samarkos, Michael, Bakakos, Petros, Tzavara, Vassiliki, Dimakou, Katerina, Tzatzagou, Glykeria, Chini, Maria, Kotsis, Vasileios, Tsoukalas, George, Bliziotis, Ioannis, Doumas, Michael, Argyraki, Aikaterini, Kainis, Ilias, Fantoni, Massimo, Cingolani, Antonella, Angheben, Andrea, Cardellino, Chiara Simona, Castelli, Francesco, Serino, Francesco Saverio, Nicastri, Emanuele, Ippolito, Giuseppe, Bassetti, Matteo, Selmi, Carlo, Netea, Mihai G, van der Meer, Jos W M, and Giamarellos-Bourboulis, Evangelos J

Published
2021
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8. Early treatment of COVID-19 with anakinra guided by soluble urokinase plasminogen receptor plasma levels: a double-blind, randomized controlled phase 3 trial

Author

Kyriazopoulou, Evdoxia, Poulakou, Garyfallia, Milionis, Haralampos, Metallidis, Simeon, Adamis, Georgios, Tsiakos, Konstantinos, Fragkou, Archontoula, Rapti, Aggeliki, Damoulari, Christina, Fantoni, Massimo, Kalomenidis, Ioannis, Chrysos, Georgios, Angheben, Andrea, Kainis, Ilias, Alexiou, Zoi, Castelli, Francesco, Serino, Francesco Saverio, Tsilika, Maria, Bakakos, Petros, Nicastri, Emanuele, Tzavara, Vassiliki, Kostis, Evangelos, Dagna, Lorenzo, Koufargyris, Panagiotis, Dimakou, Katerina, Savvanis, Spyridon, Tzatzagou, Glykeria, Chini, Maria, Cavalli, Giulio, Bassetti, Matteo, Katrini, Konstantina, Kotsis, Vasileios, Tsoukalas, George, Selmi, Carlo, Bliziotis, Ioannis, Samarkos, Michael, Doumas, Michael, Ktena, Sofia, Masgala, Aikaterini, Papanikolaou, Ilias, Kosmidou, Maria, Myrodia, Dimitra-Melia, Argyraki, Aikaterini, Cardellino, Chiara Simona, Koliakou, Katerina, Katsigianni, Eleni-Ioanna, Rapti, Vassiliki, Giannitsioti, Efthymia, Cingolani, Antonella, Micha, Styliani, Akinosoglou, Karolina, Liatsis-Douvitsas, Orestis, Symbardi, Styliani, Gatselis, Nikolaos, Mouktaroudi, Maria, Ippolito, Giuseppe, Florou, Eleni, Kotsaki, Antigone, Netea, Mihai G., Eugen-Olsen, Jesper, Kyprianou, Miltiades, Panagopoulos, Periklis, Dalekos, George N., and Giamarellos-Bourboulis, Evangelos J.

Published
2021
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12. Assessment of De-Escalation of Empirical Antimicrobial Therapy in Medical Wards with Recognized Prevalence of Multi-Drug-Resistant Pathogens: A Multicenter Prospective Cohort Study in Non-ICU Patients with Microbiologically Documented Infection.

Author

Rapti, Vasiliki, Poulakou, Garyfallia, Mousouli, Anastasia, Kakasis, Athanasios, Pagoni, Stamata, Pechlivanidou, Evmorfia, Masgala, Aikaterini, Sympardi, Styliani, Apostolopoulos, Vasileios, Giannopoulos, Charalampos, Alexiou, Nikolaos, Arvaniti, Kostoula, Trakatelli, Christina, Prionas, Apostolos, Samarkos, Michael, Daikos, George L., and Giamarellou, Helen

Subjects
ESCHERICHIA coli, ANTIMICROBIAL stewardship, URINALYSIS, URINARY organs, DRUG resistance in microorganisms, URINARY tract infections
Abstract

Antimicrobial resistance poses a major threat to human health worldwide and the implementation of antimicrobial stewardship programs (ASPs), including antimicrobial de-escalation (ADE), is a multifaceted tool for minimizing unnecessary or inappropriate antibiotic exposure. This was a prospective observational study of 142 non-Intensive Care Unit (ICU) patients with microbiologically documented infection who were initially administered empirical antimicrobial therapy and admitted to the medical wards of 6 tertiary-care hospitals in Greece from January 2017 to December 2018. Patients were divided into two groups, the ADE and non-ADE group, based on whether ADE was applied or not, respectively. Exploratory end-points were ADE feasibility, safety and efficacy. ADE was applied in 76 patients at a median time of 4 days (IQR: 3, 5). An increased likelihood of ADE was observed in patients with urinary tract (OR: 10.04, 95% CI: 2.91, 34.57; p < 0.001), skin and soft tissue (OR: 16.28, 95% CI: 1.68, 158.08; p = 0.016) and bloodstream infections (OR: 2.52, 95% CI: 1, 6.36; p = 0.05). Factors significantly associated with higher rates of ADE were clarithromycin administration, diagnosis of urinary tract infection (UTI), isolation of E. coli, age and symptoms type on admission. Mortality was lower in the ADE group (18.4% vs. 30.3% p < 0.1) and ADE was not significantly associated with the probability of death (p = 0.432). ADE was associated with favorable clinical outcomes and can be performed even in settings with high prevalence of multi-drug resistant (MDR) pathogens without compromising safety. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Antibiotic Stewardship in Surgical Departments.

Author

Kourbeti, Irene, Kamiliou, Aikaterini, and Samarkos, Michael

Subjects
ANTIMICROBIAL stewardship, SURGICAL intensive care, DRUG resistance in microorganisms, INTENSIVE care units, ARTIFICIAL intelligence
Abstract

Antimicrobial resistance (AMR) has emerged as one of the leading public health threats of the 21st century. New evidence underscores its significance in patients' morbidity and mortality, length of stay, as well as healthcare costs. Globally, the factors that contribute to antimicrobial resistance include social and economic determinants, healthcare governance, and environmental interactions with impact on humans, plants, and animals. Antimicrobial stewardship (AS) programs have historically overlooked surgical teams as they considered them more difficult to engage. This review aims to summarize the evolution and significance of AS in surgical wards, including the surgical intensive care unit (SICU) and the role of diagnostic stewardship (DS). The contribution of AS team members is presented. The new diagnostic modalities and the new technologies including artificial intelligence (AI) are also reviewed. [ABSTRACT FROM AUTHOR]

Published
2024
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23. COVID-19 in Patients with Melanoma: A Single-Institution Study.

Author

Anastasopoulou, Amalia, Diamantopoulos, Panagiotis T., Kouzis, Panagiotis, Saridaki, Maria, Sideris, Konstantinos, Samarkos, Michael, and Gogas, Helen

Subjects
EVALUATION of medical care, LENGTH of stay in hospitals, COVID-19, MELANOMA, COVID-19 vaccines, RETROSPECTIVE studies, CANCER patients, SEVERITY of illness index, HOSPITAL care, COMORBIDITY, LONGITUDINAL method, IMMUNOTHERAPY
Abstract

Simple Summary: The complexity of possible interactions of baseline patient characteristics and cancer-related factors with the course of COVID-19 is illustrated by the controversial results of studies that assess the severity and outcome of COVID-19 in cancer patients. The present research is a single-institution analysis of 121 melanoma patients with COVID-19. The purpose of our study is to characterize the spectrum of severity and outcome of COVID-19 in melanoma patients. The 30-day mortality rate after COVID-19 infection was low (4.2%). Melanoma stage, treatment receipt and treatment type had no impact on COVID-19 severity and hospitalization risk. Vaccinated patients experienced milder disease compared to the unvaccinated ones. Heart failure and the time period of the infection were independent predictors of severity. The results of the study expand the evidence on the safety of melanoma treatments in light of COVID-19 and will be useful to clinicians treating melanoma patients with COVID-19. We conducted a single-center, non-interventional retrospective study of melanoma patients with COVID-19 (1 March 2020 until 17 March 2023). The cohort was further divided into three groups according to the periods of SARS-CoV-2 variant dominance in Greece. We recorded demographics, comorbidities, vaccination data, cancer diagnosis/stage, types of systemic melanoma treatments, date of COVID-19 diagnosis and survival. We identified 121 patients. The vast majority (87.6%) had advanced disease (stages III or IV). A total of 80.1% of the patients were receiving immune checkpoint inhibitor-based therapies, 92.5% had asymptomatic/mild COVID-19 and 7.4% had moderate/severe/critical disease, while 83.5% contracted COVID-19 during the third period of the pandemic. Sixteen patients (13.2%) were hospitalized for COVID-19 with a median length of stay of 12 days (range: 1–55 days). Advanced age, heart failure, number of comorbidities (≤1 vs. >1), vaccination status and the time period of the infection correlated with more severe COVID-19, whereas only heart failure and time period were independently correlated with severity. The 30-day mortality rate after COVID-19 was 4.2%. With a median follow-up of 340 days post-COVID-19, 17.4% of patients were deceased. In this cohort of melanoma patients with COVID-19, the 30-day mortality rate was low. There was no association between melanoma stage, treatment receipt and type of treatment with COVID-19 severity. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Author Correction: Early treatment of COVID-19 with anakinra guided by soluble urokinase plasminogen receptor plasma levels: a double-blind, randomized controlled phase 3 trial

Author

Kyriazopoulou, Evdoxia, Poulakou, Garyfallia, Milionis, Haralampos, Metallidis, Simeon, Adamis, Georgios, Tsiakos, Konstantinos, Fragkou, Archontoula, Rapti, Aggeliki, Damoulari, Christina, Fantoni, Massimo, Kalomenidis, Ioannis, Chrysos, Georgios, Angheben, Andrea, Kainis, Ilias, Alexiou, Zoi, Castelli, Francesco, Serino, Francesco Saverio, Tsilika, Maria, Bakakos, Petros, Nicastri, Emanuele, Tzavara, Vassiliki, Kostis, Evangelos, Dagna, Lorenzo, Koufargyris, Panagiotis, Dimakou, Katerina, Savvanis, Spyridon, Tzatzagou, Glykeria, Chini, Maria, Cavalli, Giulio, Bassetti, Matteo, Katrini, Konstantina, Kotsis, Vasileios, Tsoukalas, George, Selmi, Carlo, Bliziotis, Ioannis, Samarkos, Michael, Doumas, Michael, Ktena, Sofia, Masgala, Aikaterini, Papanikolaou, Ilias, Kosmidou, Maria, Myrodia, Dimitra-Melia, Argyraki, Aikaterini, Cardellino, Chiara Simona, Koliakou, Katerina, Katsigianni, Eleni-Ioanna, Rapti, Vassiliki, Giannitsioti, Efthymia, Cingolani, Antonella, Micha, Styliani, Akinosoglou, Karolina, Liatsis-Douvitsas, Orestis, Symbardi, Styliani, Gatselis, Nikolaos, Mouktaroudi, Maria, Ippolito, Giuseppe, Florou, Eleni, Kotsaki, Antigone, Netea, Mihai G., Eugen-Olsen, Jesper, Kyprianou, Miltiades, Panagopoulos, Periklis, Dalekos, George N., and Giamarellos-Bourboulis, Evangelos J.

Published
2021
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25. Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study

Author

Hoenigl, Martin, primary, Salmanton-García, Jon, additional, Egger, Matthias, additional, Gangneux, Jean-Pierre, additional, Bicanic, Tihana, additional, Arikan-Akdagli, Sevtap, additional, Alastruey-Izquierdo, Ana, additional, Klimko, Nikolai, additional, Barac, Aleksandra, additional, Özenci, Volkan, additional, Meijer, Eelco F J, additional, Khanna, Nina, additional, Bassetti, Matteo, additional, Rautemaa-Richardson, Riina, additional, Lagrou, Katrien, additional, Adam, Kai-Manuel, additional, Akalin, Emin Halis, additional, Akova, Murat, additional, Arsic Arsenijevic, Valentina, additional, Aujayeb, Avinash, additional, Blennow, Ola, additional, Bretagne, Stéphane, additional, Danion, François, additional, Denis, Blandine, additional, de Jonge, Nick Alexander, additional, Desoubeaux, Guillaume, additional, Drgona, Lubos, additional, Erben, Nurettin, additional, Gori, Andrea, additional, García Rodríguez, Julio, additional, Garcia-Vidal, Carolina, additional, Giacobbe, Daniele Roberto, additional, Goodman, Anna L, additional, Hamal, Petr, additional, Hammarström, Helena, additional, Toscano, Cristina, additional, Lanternier, Fanny, additional, Lass-Flörl, Cornelia, additional, Lockhart, Deborah E A, additional, Longval, Thomas, additional, Loughlin, Laura, additional, Matos, Tadeja, additional, Mikulska, Malgorzata, additional, Narayanan, Manjusha, additional, Martín-Pérez, Sonia, additional, Prattes, Juergen, additional, Rogers, Benedict, additional, Rahimli, Laman, additional, Ruiz, Maite, additional, Roilides, Emmanuel, additional, Samarkos, Michael, additional, Scharmann, Ulrike, additional, Sili, Uluhan, additional, Sipahi, Oguz Resat, additional, Sivakova, Alena, additional, Steinmann, Joerg, additional, Trauth, Janina, additional, Turhan, Ozge, additional, Van Praet, Jens, additional, Vena, Antonio, additional, White, P Lewis, additional, Willinger, Birgit, additional, Tortorano, Anna Maria, additional, Arendrup, Maiken C, additional, Koehler, Philipp, additional, Cornely, Oliver A, additional, Tumbarello, Mario, additional, Talento, Alida Fe, additional, Ruiz, Alba C, additional, Racil, Zdenek, additional, Stoma, Igor, additional, Calbacho, Maria, additional, Van Wijngaerden, Eric, additional, Henriques, Júlia, additional, Jordan, Harriett, additional, Ferroni, Valentina, additional, Ozyurt, Ozlem Koyuncu, additional, Milacek, Christopher, additional, Krause, Robert, additional, Zurl, Christoph, additional, Backx, Matthijs, additional, Li, Ang, additional, Seufert, Raphael, additional, Tomazin, Rok, additional, Blankenheim, Yael, additional, Dávila-Valls, Julio, additional, García-Clemente, Paloma, additional, Freiberger, Tomas, additional, Buil, Jochem, additional, Meis, Jacques F, additional, Akyol, Deniz, additional, Guegan, Hélène, additional, and Logan, Clare, additional

Published
2023
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26. Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study

Author

Scynexis, Hoenigl, Martin, Salmanton-García, Jon, Egger, Matthias, Gangneux, Jean-Pierre, Bicanic, Tihana, Arikan-Akdagli, Sevtap, Alastruey-Izquierdo, Ana, Klimko, Nikolai, Barac, Aleksandra, Özenci, Volkan, Meijer, Eelco F. J., Khanna, Nina, Bassetti, Matteo, Rautemaa-Richardson, Riina, Lagrou, Katrien, Adam, Kai-Manuel, Akalin, Emin Halis, Akova, Murat, Arsic-Arsenijevic, Valentina, Aujayeb, Avinash, Blennow, Ola, Bretagne, Stéphane, Danion, François, Denis, Blandine, Jonge, Nick de, Desoubeaux, Guillaume, Drgona, Lubos, Erben, Nurettin, Gori, Andrea, García-Rodríguez, Julio, García-Vidal, Carolina, Giacobbe, Daniele Roberto, Goodman, Anna L., Hamal, Petr, Hammarström, Helena, Toscano, Cristina, Lanternier, Fanny, Lass-Flörl, Cornelia, Lockhart, Deborah E. A., Longval, Thomas, Loughlin, Laura, Matos, Tadeja, Mikulska, Malgorzata, Narayanan, Manjusha, Martín-Pérez, Sonia, Prattes, Juergen, Rogers, Benedict, Rahimli, Laman, Ruiz, Maite, Roilides, Emmanuel, Samarkos, Michael, Scharmann, Ulrike, Sili, Uluhan, Sipahi, Oguz Resat, Sivakova, Alena, Steinmann, Joerg, Trauth, Janina, Turhan, Ozge, Praet, Jens van, Vena, Antonio, White, P. Lewis, Willinger, Birgit, Tortorano, Anna Maria, Arendrup, Maiken C., Koehler, Philipp, Cornely, Oliver A., ECMM Candida III Study Group, Scynexis, Hoenigl, Martin, Salmanton-García, Jon, Egger, Matthias, Gangneux, Jean-Pierre, Bicanic, Tihana, Arikan-Akdagli, Sevtap, Alastruey-Izquierdo, Ana, Klimko, Nikolai, Barac, Aleksandra, Özenci, Volkan, Meijer, Eelco F. J., Khanna, Nina, Bassetti, Matteo, Rautemaa-Richardson, Riina, Lagrou, Katrien, Adam, Kai-Manuel, Akalin, Emin Halis, Akova, Murat, Arsic-Arsenijevic, Valentina, Aujayeb, Avinash, Blennow, Ola, Bretagne, Stéphane, Danion, François, Denis, Blandine, Jonge, Nick de, Desoubeaux, Guillaume, Drgona, Lubos, Erben, Nurettin, Gori, Andrea, García-Rodríguez, Julio, García-Vidal, Carolina, Giacobbe, Daniele Roberto, Goodman, Anna L., Hamal, Petr, Hammarström, Helena, Toscano, Cristina, Lanternier, Fanny, Lass-Flörl, Cornelia, Lockhart, Deborah E. A., Longval, Thomas, Loughlin, Laura, Matos, Tadeja, Mikulska, Malgorzata, Narayanan, Manjusha, Martín-Pérez, Sonia, Prattes, Juergen, Rogers, Benedict, Rahimli, Laman, Ruiz, Maite, Roilides, Emmanuel, Samarkos, Michael, Scharmann, Ulrike, Sili, Uluhan, Sipahi, Oguz Resat, Sivakova, Alena, Steinmann, Joerg, Trauth, Janina, Turhan, Ozge, Praet, Jens van, Vena, Antonio, White, P. Lewis, Willinger, Birgit, Tortorano, Anna Maria, Arendrup, Maiken C., Koehler, Philipp, Cornely, Oliver A., and ECMM Candida III Study Group

Abstract

[Background] The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of patients with culture-proven candidaemia across Europe to assess how adherence to guideline recommendations is associated with outcomes., [Methods] In this observational cohort study, 64 participating hospitals located in 20 European countries, with the number of eligible hospitals per country determined by population size, included the first ten consecutive adults with culture-proven candidaemia after July 1, 2018, and entered data into the ECMM Candida Registry (FungiScope CandiReg). We assessed ECMM Quality of Clinical Candidaemia Management (EQUAL Candida) scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases and the Infectious Diseases Society of America guidelines., [Findings] 632 patients with candidaemia were included from 64 institutions. Overall 90-day mortality was 43% (265/617), and increasing age, intensive care unit admission, point increases in the Charlson comorbidity index score, and Candida tropicalis as causative pathogen were independent baseline predictors of mortality in Cox regression analysis. EQUAL Candida score remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for the baseline predictors, even after restricting the analysis to patients who survived for more than 7 days after diagnosis (adjusted hazard ratio 1·08 [95% CI 1·04–1·11; p<0·0001] in patients with a central venous catheter and 1·09 [1·05–1·13; p<0·0001] in those without one, per one score point decrease). Median duration of hospital stay was 15 days (IQR 4–30) after diagnosis of candidaemia and was extended specifically for completion of parenteral therapy in 100 (16%) of 621 patients. Initial echinocandin treatment was associated with lower overall mortality and longer duration of hospital stay among survivors than treatment with other antifungals., [Interpretation] Although overall mortality in patients with candidaemia was high, our study indicates that adherence to clinical guideline recommendations, reflected by higher EQUAL Candida scores, might increase survival. New antifungals, with similar activity as current echinocandins but with longer half-lives or oral bioavailability, are needed to reduce duration of hospital stay.

Published
2023

27. Guideline adherence and survival of patients with candidaemia in Europe:results from the ECMM Candida III multinational European observational cohort study

Author

Hoenigl, Martin, Salmanton-García, Jon, Egger, Matthias, Gangneux, Jean-Pierre, Bicanic, Tihana, Arikan-Akdagli, Sevtap, Alastruey-Izquierdo, Ana, Klimko, Nikolai, Barac, Aleksandra, Özenci, Volkan, Meijer, Eelco F. J., Khanna, Nina, Bassetti, Matteo, Rautemaa-Richardson, Riina, Lagrou, Katrien, Adam, Kai Manuel, Akalin, Emin Halis, Akova, Murat, Arsenijevic, Valentina Arsic, Aujayeb, Avinash, Blennow, Ola, Bretagne, Stéphane, Danion, François, Denis, Blandine, de Jonge, Nick Alexander, Desoubeaux, Guillaume, Drgona, Lubos, Erben, Nurettin, Gori, Andrea, García Rodríguez, Julio, Garcia-Vidal, Carolina, Giacobbe, Daniele Roberto, Goodman, Anna L., Hamal, Petr, Hammarström, Helena, Toscano, Cristina, Lanternier, Fanny, Lass-Flörl, Cornelia, Lockhart, Deborah E. A., Longval, Thomas, Loughlin, Laura, Matos, Tadeja, Mikulska, Malgorzata, Narayanan, Manjusha, Martín-Pérez, Sonia, Prattes, Juergen, Rogers, Benedict, Rahimli, Laman, Ruiz, Maite, Roilides, Emmanuel, Samarkos, Michael, Scharmann, Ulrike, Sili, Uluhan, Sipahi, Oguz Resat, Sivakova, Alena, Steinmann, Joerg, Trauth, Janina, Turhan, Ozge, Van Praet, Jens, Vena, Antonio, White, P. Lewis, Willinger, Birgit, Tortorano, Anna Maria, Arendrup, Maiken C., Koehler, Philipp, Cornely, Oliver A., Hoenigl, Martin, Salmanton-García, Jon, Egger, Matthias, Gangneux, Jean-Pierre, Bicanic, Tihana, Arikan-Akdagli, Sevtap, Alastruey-Izquierdo, Ana, Klimko, Nikolai, Barac, Aleksandra, Özenci, Volkan, Meijer, Eelco F. J., Khanna, Nina, Bassetti, Matteo, Rautemaa-Richardson, Riina, Lagrou, Katrien, Adam, Kai Manuel, Akalin, Emin Halis, Akova, Murat, Arsenijevic, Valentina Arsic, Aujayeb, Avinash, Blennow, Ola, Bretagne, Stéphane, Danion, François, Denis, Blandine, de Jonge, Nick Alexander, Desoubeaux, Guillaume, Drgona, Lubos, Erben, Nurettin, Gori, Andrea, García Rodríguez, Julio, Garcia-Vidal, Carolina, Giacobbe, Daniele Roberto, Goodman, Anna L., Hamal, Petr, Hammarström, Helena, Toscano, Cristina, Lanternier, Fanny, Lass-Flörl, Cornelia, Lockhart, Deborah E. A., Longval, Thomas, Loughlin, Laura, Matos, Tadeja, Mikulska, Malgorzata, Narayanan, Manjusha, Martín-Pérez, Sonia, Prattes, Juergen, Rogers, Benedict, Rahimli, Laman, Ruiz, Maite, Roilides, Emmanuel, Samarkos, Michael, Scharmann, Ulrike, Sili, Uluhan, Sipahi, Oguz Resat, Sivakova, Alena, Steinmann, Joerg, Trauth, Janina, Turhan, Ozge, Van Praet, Jens, Vena, Antonio, White, P. Lewis, Willinger, Birgit, Tortorano, Anna Maria, Arendrup, Maiken C., Koehler, Philipp, and Cornely, Oliver A.

Abstract

Background: The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of patients with culture-proven candidaemia across Europe to assess how adherence to guideline recommendations is associated with outcomes. Methods: In this observational cohort study, 64 participating hospitals located in 20 European countries, with the number of eligible hospitals per country determined by population size, included the first ten consecutive adults with culture-proven candidaemia after July 1, 2018, and entered data into the ECMM Candida Registry (FungiScope CandiReg). We assessed ECMM Quality of Clinical Candidaemia Management (EQUAL Candida) scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases and the Infectious Diseases Society of America guidelines. Findings: 632 patients with candidaemia were included from 64 institutions. Overall 90-day mortality was 43% (265/617), and increasing age, intensive care unit admission, point increases in the Charlson comorbidity index score, and Candida tropicalis as causative pathogen were independent baseline predictors of mortality in Cox regression analysis. EQUAL Candida score remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for the baseline predictors, even after restricting the analysis to patients who survived for more than 7 days after diagnosis (adjusted hazard ratio 1·08 [95% CI 1·04–1·11; p<0·0001] in patients with a central venous catheter and 1·09 [1·05–1·13; p<0·0001] in those without one, per one score point decrease). Median duration of hospital stay was 15 days (IQR 4–30) after diagnosis of candidaemia and was extended specifically for completion of parenteral therapy in 100 (16%) of 621 patients. Initial echinocandin treatment was associated with lower overall mortality and longer duration of hospital stay among survivors than t

Published
2023

30. Colistin Monotherapy versus Combination Therapy for Carbapenem-Resistant Organisms

Author

Kaye, Keith S., primary, Marchaim, Dror, additional, Thamlikitkul, Visanu, additional, Carmeli, Yehuda, additional, Chiu, Cheng-Hsun, additional, Daikos, George, additional, Dhar, Sorabh, additional, Durante-Mangoni, Emanuele, additional, Gikas, Achilles, additional, Kotanidou, Anastasia, additional, Paul, Mical, additional, Roilides, Emmanuelle, additional, Rybak, Michael, additional, Samarkos, Michael, additional, Sims, Matthew, additional, Tancheva, Dora, additional, Tsiodras, Sotirios, additional, Kett, Daniel, additional, Patel, Gopi, additional, Calfee, David, additional, Leibovici, Leonard, additional, Power, Laura, additional, Munoz-Price, Sylvia, additional, Stevenson, Kurt, additional, Susick, Laura, additional, Latack, Katie, additional, Daniel, Jolene, additional, Chiou, Christine, additional, Divine, George W., additional, Ghazyaran, Varduhi, additional, and Pogue, Jason M., additional

Published
2023
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33. Predictive score for patients with carbapenemase-producing enterobacterales colonization upon admission in a tertiary care hospital in an endemic area

Author

Papafotiou, Chrysanthe, primary, Roussos, Sotirios, additional, Sypsa, Vana, additional, Bampali, Sofia, additional, Spyridopoulou, Kalliopi, additional, Karapanou, Amalia, additional, Moussouli, Anastasia, additional, Samarkos, Michael, additional, Daikos, George L, additional, and Psichogiou, Mina, additional

Published
2022
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34. Acute hepatitis and liver injury in hospitalized patients with COVID‑19 infection

Author

Georgakopoulou, Vasiliki, primary, Bali, Triada, additional, Adamantou, Magdalini, additional, Asimakopoulou, Stavroula, additional, Makrodimitri, Sotiria, additional, Samara, Stamatia, additional, Triantafyllou, Maria, additional, Voutsinas, Pantazis, additional, Eliadi, Irene, additional, Karamanakos, Georgios, additional, Basoulis, Dimitrios, additional, Chatzipanagiotou, Odysseas, additional, Adamopoulou, Eleni, additional, Alevizou, Antonia, additional, Athanasiadis, Menelaos, additional, Spandidos, Demetrios, additional, Papalexis, Petros, additional, Tarantinos, Kyriakos, additional, Sipsas, Nikolaos, additional, Samarkos, Michael, additional, and Cholongitas, Evangelos, additional

Published
2022
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35. Comparison of liver function test- and inflammation-based prognostic scores for coronavirus disease 2019: a single center study

Author

Cholongitas, Evangelos, primary, Bali, Triada, additional, Georgakopoulou, Vasiliki E, additional, Kamiliou, Aikaterini, additional, Vergos, Ioannis, additional, Makrodimitri, Sotiria, additional, Samara, Stamatia, additional, Triantafylou, Maria, additional, Basoulis, Dimitrios, additional, Eliadi, Irene, additional, Karamanakos, Georgios, additional, Sipsas, Nikolaos V., additional, and Samarkos, Michael, additional

Published
2022
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37. The Effect of Different Colistin Dosing Regimens on Nephrotoxicity: A Cohort Study

Author

Samarkos, Michael, primary, Papanikolaou, Konstantinos, additional, Sourdi, Athena, additional, Paisios, Nikolaos, additional, Mainas, Efstratios, additional, Paramythiotou, Elisabeth, additional, Antoniadou, Anastasia, additional, Sambatakou, Helen, additional, Gargalianos-Kakolyris, Panayiotis, additional, Skoutelis, Athanasios, additional, and Daikos, George L., additional

Published
2022
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39. Molecular screening of cat and dog ectoparasites for the presence of Bartonella spp. in Attica, Greece

Author

Liodaki, Maria Spanakos, Gregory Samarkos, Michael Daikos, George L. Christopoulou, Varvara Piperaki, Evangelia-Theophano

Subjects
animal diseases, bacterial infections and mycoses
Abstract

The purpose of this study was the molecular detection of Bartonella spp. in fleas and ticks parasitizing cats and dogs from 39 locations in Attica, Greece. One hundred and forty five ectoparasites (104 fleas and 41 ticks) from 92 cats and 53 dogs were investigated individually using PCRs targeting the 16S-23S ribosomal RNA intergenic spacer (ITS) and the citrate synthase (gltA) genetic loci. Bartonella spp. were detected in 14 out of 104 fleas (13.5%) and in none of the ticks examined. Consequent sequence analysis of the amplicons from the two loci identified 3 strains as Bartonella henselae, and 11 as Bartonella clarridgeiae. Οur study demonstrates the presence of B. henselae and B. clarridgeiae in Ctenocephalides felis fleas from cat and dog in Greece. We also report a novel ITS sequence for B. clarridgeiae. Considering that fleas could pose a risk for human bartonellosis from their infected hosts, further studies on the public health risk of Bartonella presence in animal ectoparasites are warranted.

Published
2022

42. A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients

Author

Georgakopoulou, Vasiliki E., primary, Vlachogiannis, Nikolaos I., additional, Basoulis, Dimitrios, additional, Eliadi, Irene, additional, Georgiopoulos, Georgios, additional, Karamanakos, Georgios, additional, Makrodimitri, Sotiria, additional, Samara, Stamatia, additional, Triantafyllou, Maria, additional, Voutsinas, Pantazis M., additional, Ntziora, Fotinie, additional, Psichogiou, Mina, additional, Samarkos, Michael, additional, Sfikakis, Petros P., additional, and Sipsas, Nikolaos V., additional

Published
2022
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43. Guideline Adherence Predicts Survival of Candidemia in Europe: Results from the ECMM Candida III Multinational European Study

Author

Hoenigl, Martin, primary, Salmanton-Garcia, Jon, additional, Egger, Matthias, additional, Gangneux, Jean-Pierre, additional, Bicanic, Tihana, additional, Arikan-Akdagli, Sevtap, additional, Alastruey-Izquierdo, Ana, additional, Klimko, Nikolai, additional, Barac, Aleksandra, additional, Özenci, Volkan, additional, Meijer, Eelco F. J., additional, Khanna, Nina, additional, Bassetti, Matteo, additional, Rautemaa-Richardson, Riina, additional, Lagrou, Katrien, additional, Adam, Kai-Manuel, additional, Akalın, Emin Halis, additional, Akova, Murat, additional, Arsic-Arsenijevic, Valentina, additional, Aujayeb, Avinash, additional, Blennow, Ola, additional, Bretagne, Stephane, additional, Danion, François, additional, Denis, Blandine, additional, de Jonge, Nick Alexander, additional, Desoubeaux, Guillaume, additional, Drgona, Lubos, additional, Erben, Nurettin, additional, Gori, Andrea, additional, Rodríguez, Julio García, additional, Garcia-Vidal, Carolina, additional, Giacobbe, Daniele Roberto, additional, Goodman, Anna L., additional, Hamal, Petr, additional, Hammarström, Helena, additional, Toscano, Christina, additional, Lanternier, Fanny, additional, Lass-Flörl, Cornelia, additional, Lockhart, Deborah E. A., additional, Longval, Thomas, additional, Loughlin, Laura, additional, Matos, Tadeja, additional, Mikulska, Malgorzata, additional, Narayanan, Manjusha, additional, Martín-Pérez, Sonia, additional, Prattes, Juergen, additional, Rogers, Benedict, additional, Rahimli, Laman, additional, Ruiz, Maite, additional, Roilides, Emmanuel, additional, Samarkos, Michael, additional, Scharmann, Ulrike, additional, Sili, Uluhan, additional, Sipahi, Oguz Resat, additional, Siváková, Alena, additional, Steinmann, Joerg, additional, Trauth, Janina, additional, Turhan, Özge, additional, Van Praet, Jens, additional, Vena, Antonio, additional, White, Lewis, additional, Willinger, Birgit, additional, Tortorano, Anna Maria, additional, Arendrup, Maiken C., additional, Koehler, Philipp, additional, Cornely, Oliver A., additional, and Group, ECMM Candida III Study, additional

Published
2022
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44. Early suPAR-Guided Anakinra Treatment in COVID-19 Pneumonia: Subgroup Analyses and 90-Day Outcomes of the SAVE-MORE Trial

Author

Akinosoglou, Karolina, primary, Kotsaki, Antigone, additional, Gounaridi, Ioanna-Maria, additional, Christaki, Eirini, additional, Metallidis, Simeon, additional, Adamis, Georgios, additional, Fragkou, Archontoula, additional, Fantoni, Massimo, additional, Rapti, Aggeliki, additional, Kalomenidis, Ioannis, additional, Chrysos, Georgios, additional, Boni, Gloria, additional, Kainis, Ilias, additional, Alexiou, Zoi, additional, Castelli, Francesco, additional, Serino, Francesco Saverio, additional, Bakakos, Petros, additional, Nicastri, Emanuele, additional, Tzavara, Vassiliki, additional, Safarika, Asimina, additional, Ioannou, Sofia, additional, Dagna, Lorenzo, additional, Dimakou, Katerina, additional, Tzatzagou, Glykeria, additional, Chini, Maria, additional, Bassetti, Matteo, additional, Kotsis, Vasileios, additional, Angheben, Andrea, additional, Tsoukalas, George, additional, Selmi, Carlo, additional, Spiropoulou, Olga-Maria, additional, Samarkos, Michael, additional, Doumas, Michael, additional, Damoraki, Georgia, additional, Masgala, Aikaterini, additional, Papanikolaou, Ilias, additional, Argyraki, Aikaterini, additional, Negri, Marcantonio, additional, Leventogiannis, Konstantinos, additional, Symbardi, Styliani, additional, Gatselis, Nikolaos K., additional, Petrakis, Vasileios, additional, Netea, Mihai G., additional, Panagopoulos, Periklis, additional, Sakka, Vissaria, additional, Milionis, Haralampos, additional, Dalekos, George, additional, and Giamarellos-Bourboulis, Evangelos, additional

Published
2022
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45. 630. Emergence of Colistin Resistance in the OVERCOME Trial: Impact of Combination Therapy with Meropenem

Author

Pogue, Jason M, primary, Rybak, Michael J, additional, Stamper, Kyle, additional, Marchaim, Dror, additional, Thamlikitkul, Visanu, additional, Carmeli, Yehuda, additional, Chiu, Cheng, additional, Daikos, Georgios L, additional, Dhar, Sorabh, additional, Mangoni, Emanuele Durante, additional, Gikas, Achilleas, additional, Kotanidou, Anastasia, additional, Paul, Mical, additional, Roilides, Emmanuel, additional, Samarkos, Michael, additional, Sims, Matthew, additional, Tancheva, Dora, additional, Tsiodras, Sotirios, additional, Divine, George, additional, Ghazaryan, Varduhi, additional, and Kaye, Keith S, additional

Published
2021
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46. 638. The Impact of in vitro Synergy Between Colistin and Meropenem on Clinical Outcomes in Invasive Carbapenem-resistant Gram-negative Infections: A Report from the OVERCOME Trial

Author

Pogue, Jason M, primary, Rybak, Michael J, additional, Stamper, Kyle, additional, Marchaim, Dror, additional, Thamlikitkul, Visanu, additional, Carmeli, Yehuda, additional, Chiu, Cheng, additional, Daikos, Georgios L, additional, Dhar, Sorabh, additional, Mangoni, Emanuele Durante, additional, Gikas, Achilleas, additional, Kotanidou, Anastasia, additional, Paul, Mical, additional, Roilides, Emmanuel, additional, Samarkos, Michael, additional, Sims, Matthew, additional, Tancheva, Dora, additional, Tsiodras, Sotirios, additional, Divine, George, additional, Ghazaryan, Varduhi, additional, and Kaye, Keith S, additional

Published
2021
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48. Early treatment of COVID-19 with anakinra guided by soluble urokinase plasminogen receptor plasma levels: a double-blind, randomized controlled phase 3 trial

Author

Kyriazopoulou, Evdoxia Poulakou, Garyfallia Milionis, Haralampos and Metallidis, Simeon Adamis, Georgios Tsiakos, Konstantinos and Fragkou, Archontoula Rapti, Aggeliki Damoulari, Christina and Fantoni, Massimo Kalomenidis, Ioannis Chrysos, Georgios and Angheben, Andrea Kainis, Ilias Alexiou, Zoi Castelli, Francesco Serino, Francesco Saverio Tsilika, Maria Bakakos, Petros Nicastri, Emanuele Tzavara, Vassiliki Kostis, Evangelos Dagna, Lorenzo Koufargyris, Panagiotis Dimakou, Katerina Savvanis, Spyridon Tzatzagou, Glykeria Chini, Maria and Cavalli, Giulio Bassetti, Matteo Katrini, Konstantina and Kotsis, Vasileios Tsoukalas, George Selmi, Carlo Bliziotis, Ioannis Samarkos, Michael Doumas, Michael Ktena, Sofia and Masgala, Aikaterini Papanikolaou, Ilias Kosmidou, Maria and Myrodia, Dimitra-Melia Argyraki, Aikaterini Cardellino, Chiara Simona Koliakou, Katerina Katsigianni, Eleni-Ioanna Rapti, Vassiliki Giannitsioti, Efthymia Cingolani, Antonella Micha, Styliani Akinosoglou, Karolina Liatsis-Douvitsas, Orestis and Symbardi, Styliani Gatselis, Nikolaos Mouktaroudi, Maria and Ippolito, Giuseppe Florou, Eleni Kotsaki, Antigone Netea, Mihai G. Eugen-Olsen, Jesper Kyprianou, Miltiades and Panagopoulos, Periklis Dalekos, George N. and Giamarellos-Bourboulis, Evangelos J.

Abstract

Early increase of soluble urokinase plasminogen activator receptor (suPAR) serum levels is indicative of increased risk of progression of coronavirus disease 2019 (COVID-19) to respiratory failure. The SAVE-MORE double-blind, randomized controlled trial evaluated the efficacy and safety of anakinra, an IL-1 alpha/beta inhibitor, in 594 patients with COVID-19 at risk of progressing to respiratory failure as identified by plasma suPAR >= 6 ng ml(-1), 85.9% (n = 510) of whom were receiving dexamethasone. At day 28, the adjusted proportional odds of having a worse clinical status (assessed by the 11-point World Health Organization Clinical Progression Scale (WHO-CPS)) with anakinra, as compared to placebo, was 0.36 (95% confidence interval 0.26-0.50). The median WHO-CPS decrease on day 28 from baseline in the placebo and anakinra groups was 3 and 4 points, respectively (odds ratio (OR) = 0.40, P < 0.0001); the respective median decrease of Sequential Organ Failure Assessment (SOFA) score on day 7 from baseline was 0 and 1 points (OR = 0.63, P = 0.004). Twenty-eight-day mortality decreased (hazard ratio = 0.45, P = 0.045), and hospital stay was shorter. The SAVE-MORE phase 3 study demonstrates the efficacy of anakinra, an IL-1 alpha/beta inhibitor, in patients with COVID-19 and high serum levels of soluble plasminogen activator receptor.

Published
2021

49. The Role of Macrolides for the Management of Community-Acquired Pneumonia and Pneumonia by the Novel Coronavirus SARS-CoV-2 (COVID-19): A Position Paper by Four Medical Societies from Greece

Author

Giamarellos-Bourboulis, Evangelos J. Daikos, George L. and Gargalianos, Panagiotis Gogos, Charalambos Lazanas, Marios and Panagopoulos, Periklis Poulakou, Garyphallia Sambatakou, Helen and Samarkos, Michael

Abstract

In light of the accumulating evidence for survival benefit coming from the use of macrolides for community-acquired pneumonia (CAP), a group of experts from the field of internal medicine and infectious diseases frame a position statement on the use of macrolides for the management of bacterial CAP and for infection by the novel coronavirus (COVID-19). The statement is framed taking into consideration existing publications and own research experience. The main content of this statement is that the combination of one beta-lactam and a macrolide should be the first treatment of choice for patients with severe bacterial CAP. Severity is assessed as scoring 2 or more points on the CURB65 scoring system of severity or as pneumonia severity index III to V or C-reactive protein more than 150 mg/l; the suggested macrolide is either azithromycin or clarithromycin. The experts also suggest that in COVID-19 pneumonia, the combination of one beta-lactam and a macrolide should be reserved only when there is strong suspicion of bacterial co-infection.

Published
2021

50. Restricted antimicrobial prescribing in an area of highly prevalent antimicrobial resistance

Author

Samarkos, Michael Skouloudi, Marina Anastasopoulou, Amalia and Markogiannakis, Antonios

Abstract

Objective: To assess the predictive value for infection with multidrug-resistant organisms (MDROs) of reasons for empirical prescription of restricted antibiotics (rABX), in a setting with high resistance rates. Methods: We prospectively studied all rABX prescriptions in a 550-bed tertiary teaching hospital from April 15 to June 14, 2018 and from September 1 to October 30, 2018. Prescribing physicians had to justify their decision by choosing one or more prespecified reasons. Results: We reviewed 172 empirical prescriptions of rABX, which accounted for 67.2% of all rABX prescriptions. Stated reasons for empirical prescription of rABX were recent hospitalization (72.7%), escalation due to non-response to previous antimicrobials (47.7%), treatment for severe sepsis/septic shock (45.9%), escalation due to recurrence or deterioration (22.1%), prior MDRO infection (12.8%), and prior MDRO colonization (7.6%). Empirical treatment for septic shock or severe sepsis was the only significant predictor of MDRO isolation (OR = 5.26, 95% CI: 1.5-18.4, P= 0.009), while recent hospitalization had a high negative predictive value for MDRO (97.4%). Fourteen per cent of microbiologically documented infections were associated with MDROs resistant to the prescribed rABX. Conclusions: Empirical treatment for severe sepsis or septic shock was the only independent predictor of MDRO isolation. Recent hospitalization had a high negative predictive value for MDRO infection. The isolation of pathogens resistant to the prescribed rABX suggests that in a setting with widespread antimicrobial resistance, it could be difficult to reduce the empirical use of rABX without risking inadequate treatment.

Published
2021

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