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Morata Ruiz L, Ruggieri A, Falcone M, Pasquau Liaño J, Gentile I, Salavert Lletí M, Moreno Núñez L, Cascio A, Tascini C, Loeches Yagüe M, De Rosa FG, Ori A, Comandini A, Cattaneo A, Grossi PA. Dalbavancin real-life utilization among diabetic patients suffering from infections in Italy and Spain: The DALBADIA retrospective cohort study. J Glob Antimicrob Resist 2024; 36:200-209. [PMID: 38211660 DOI: 10.1016/j.jgar.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/14/2023] [Accepted: 11/29/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES To retrospectively describe the patterns of use of dalbavancin for treating infections in diabetic patients in Italian and Spanish standard clinical practice. METHODS DALBADIA [NCT04959799] was a multicentre, observational, retrospective cohort study, conducted in Italy and Spain. The study enrolled 97 adults with type 1 or 2 diabetes mellitus, treated with dalbavancin as per standard clinical practice for a Gram-positive bacterial infection or the Gram-positive component of a mixed infection. RESULTS Dalbavancin was used to treat cellulitis (18/92 patients, 19.6%), followed by prosthetic joint infection (14 patients, 15.2%), endocarditis (13 patients, 14.1%), and primary bacteraemia (10 patients, 10.9%); 78/92 (84.8%) patients had Gram-positive infections only, and 14 (15.2%) had mixed infections. The most frequently isolated microorganisms were Staphylococcus aureus in 43 (55.8% of the patients with microbial isolation), 25.6% of which methicillin-resistant; Staphylococcus epidermidis in 13 (16.9%), 53.8% of which methicillin-resistant; Enterococcus faecalis in 11 (14.3%). The main reason for the dalbavancin choice was the intent to simplify the antibiotic regimen (81.5% of cases). A multidisciplinary team participated in the treatment choice process for 53 (57.6%) patients. Dalbavancin was given as first-line antibiotic in 34 (37.0%) patients and administered as one infusion in 32 (34.8%), and as two infusions in 39 (42.4%). In total, 57/62 (91.9%) eligible patients with available assessment were judged clinically cured or improved at the end of observation. CONCLUSION In clinical practice, dalbavancin was used in diabetic patients to treat ABSSSIs and other difficult-to-treat infections with a favourable safety profile and a high rate of positive clinical responses.
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Affiliation(s)
- Laura Morata Ruiz
- Hospital Clìnic, Department of Infectious Diseases, University of Barcelona, Barcelona, Spain
| | | | - Marco Falcone
- AOU Pisana PO Cisanello, UO Malattie Infettive, University of Pisa, Pisa, Italy
| | - Juan Pasquau Liaño
- Hospital Universitario Virgen de las Nieve, Unidad de Enfermedades Infecciosas, Granada, Spain
| | - Ivan Gentile
- AOU Federico II, Malattie Infettive, Patologia Clinica e Medicina Interna, Università di Napoli Federico II, Naples, Italy
| | - Miguel Salavert Lletí
- Hospital Universitario y Politécnico La Fe, Unidad de Enfermedades Infecciosas, Valencia, Spain
| | - Leonor Moreno Núñez
- Hospital Universitario Fundación Alcorcón, Enfermedades Infecciosas, Madrid, Spain
| | - Antonio Cascio
- AOU Policlinico Giaccone, UOC Malattie Infettive e Tropicali, Palermo, Italy
| | | | | | - Francesco Giuseppe De Rosa
- Ospedale Cardinal Massaia, SC Malattie Infettive, Asti, Italy, AOU Città della Salute e Scienza, Presidio Molinette, Turin, Italy
| | | | | | | | - Paolo Antonio Grossi
- ASST Sette Laghi, SC Malattie Infettive e Tropicali, University of Insubria, Varese, Italy
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Bermejo Olano MDM, Campelo Gutierrez C, Hervas Gómez R, Alfayate García JM, Sánchez Ríos JP, Moreno Núñez L. [Risk factors associated with osteomyelitis due to Corynebacterium striatum in patients with diabetic foot]. Med Clin (Barc) 2024; 162:15-18. [PMID: 37981483 DOI: 10.1016/j.medcli.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVE Corynebacterium striatum (CS) is an emerging micro-organism in diabetic foot infection for which there are currently few studies. The objective was to analyze the risk factors (RF) related to CS osteomyelitis in patients with diabetic foot. METHODS A case-control study was conducted in the Diabetic Foot Unit between 2015 and 2021. Forty-four patients with osteomyelitis due to CS (cases) and 44 patients with osteomyelitis due a different micro-organism (controls) were included. RESULTS Peripheral artery disease (OR: 2.8, p = 0.037), atrial fibrillation (OR: 3.7, p = 0.034), ischemic diabetic foot (OR: 3.3, p = 0.020) and previous prolonged antibiotic therapy more than 14 days (OR: 3.4, p = 0.012) were identified as RF for osteomyelitis due to CS. When performing the multivariate analysis antibiotic therapy >14 days was independent RF (OR: 3.46; p = 0.017). CONCLUSIONS Previous antibiotic therapy received more than 14 days is an independent and statistically significant RF for CS osteomyelitis in patients with diabetic foot.
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Affiliation(s)
| | | | - Rafael Hervas Gómez
- Unidad de Infecciosas, Hospital Universitario Fundación Alcorcón, Madrid, España
| | | | | | - Leonor Moreno Núñez
- Unidad de Infecciosas, Hospital Universitario Fundación Alcorcón, Madrid, España.
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Hidalgo-Tenorio C, Pitto-Robles I, Arnés García D, de Novales FJM, Morata L, Mendez R, de Pablo OB, López de Medrano VA, Lleti MS, Vizcarra P, Lora-Tamayo J, Arnáiz García A, Núñez LM, Masiá M, Seco MPR, Sadyrbaeva-Dolgova S. Cefto Real-Life Study: Real-World Data on the Use of Ceftobiprole in a Multicenter Spanish Cohort. Antibiotics (Basel) 2023; 12:1218. [PMID: 37508314 PMCID: PMC10376387 DOI: 10.3390/antibiotics12071218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Ceftobiprole is a fifth-generation cephalosporin that has been approved in Europe solely for the treatment of community-acquired and nosocomial pneumonia. The objective was to analyze the use of ceftobiprole medocaril (Cefto-M) in Spanish clinical practice in patients with infections in hospital or outpatient parenteral antimicrobial therapy (OPAT). METHODS This retrospective, observational, multicenter study included patients treated from 1 September 2021 to 31 December 2022. RESULTS A total of 249 individuals were enrolled, aged 66.6 ± 15.4 years, of whom 59.4% were male with a Charlson index of four (IQR 2-6), 13.7% had COVID-19, and 4.8% were in an intensive care unit (ICU). The most frequent type of infection was respiratory (55.8%), followed by skin and soft tissue infection (21.7%). Cefto-M was administered to 67.9% of the patients as an empirical treatment, in which was administered as monotherapy for 7 days (5-10) in 53.8% of cases. The infection-related mortality was 11.2%. The highest mortality rates were identified for ventilator-associated pneumonia (40%) and infections due to methicillin-resistant Staphylococus aureus (20.8%) and Pseudomonas aeruginosa (16.1%). The mortality-related factors were age (OR: 1.1, 95%CI (1.04-1.16)), ICU admission (OR: 42.02, 95%CI (4.49-393.4)), and sepsis/septic shock (OR: 2.94, 95%CI (1.01-8.54)). CONCLUSIONS In real life, Cefto-M is a safe antibiotic, comprising only half of prescriptions for respiratory infections, that is mainly administered as rescue therapy in pluripathological patients with severe infectious diseases.
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Affiliation(s)
- Carmen Hidalgo-Tenorio
- Unit of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18012 Granada, Spain
| | - Inés Pitto-Robles
- Unit of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18012 Granada, Spain
| | - Daniel Arnés García
- Unit of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18012 Granada, Spain
| | | | - Laura Morata
- Infectious Diseases Service, Hospital Clinic, 08036 Barcelona, Spain
| | - Raul Mendez
- Pneumology Deparment, Hospital Universitario La Fe, Valencia (CIBERES), 46026 Valencia, Spain
| | | | | | - Miguel Salavert Lleti
- Infectious Diseases Service, Hospital Universitario La Fe, Valencia (CIBERES), 46026 Valencia, Spain
| | - Pilar Vizcarra
- Infectious Diseases Service, Hospital Ramón y Cajal, 28034 Madrid, Spain
| | - Jaime Lora-Tamayo
- Internal Medicine Service, Hospital Universitario 12 Octubre (CIBERINFEC), 28041 Madrid, Spain
| | - Ana Arnáiz García
- Department of Infectious Diseases, Hospital Sierrallana, 39300 Torrelavega, Spain
| | - Leonor Moreno Núñez
- Internal Medicine Service, Hospital Fundación de Alcorcón, 28922 Alcorcón, Spain
| | - Mar Masiá
- Infectious Diseases Service, Hospital Universitario General of Elche, 03203 Elche, Spain
| | | | - Svetlana Sadyrbaeva-Dolgova
- Pharmacy Service, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18012 Granada, Spain
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González Anglada MI, Garmendia Fernández C, Moreno Núñez L. [Home hospitalisation: Opportunities and needs]. J Healthc Qual Res 2023; 38:195-196. [PMID: 36872155 DOI: 10.1016/j.jhqr.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 03/06/2023]
Affiliation(s)
- María Isabel González Anglada
- Hospitalización a Domicilio, Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alorcón, Madrid, España.
| | - Cristina Garmendia Fernández
- Hospitalización a Domicilio, Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alorcón, Madrid, España
| | - Leonor Moreno Núñez
- Hospitalización a Domicilio, Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alorcón, Madrid, España
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Sevillano D, Núñez LM, Chevalier M, García-Vicente F. Application of discrete cosine transform to assess the effect of tumor motion variations on the definition of ITV in lung and liver SBRT. Phys Med 2021; 84:132-140. [PMID: 33894583 DOI: 10.1016/j.ejmp.2021.03.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To use Discrete Cosine Transform to include tumor motion variations on ITV definition of SBRT patients. METHODS Data from 66 patients was collected. 2D planar fluoroscopy images (FI) were available for 54 patients. Daily CBCT projections (CBCTp) from 29 patients were employed to measure interfraction amplitude variability. Systematic amplitude variations were obtained from 17 patients with data from both FI and CBCTp. Tumor motion curves obtained from FI were characterized with a Cosine model (CM), based on cosine functions to the power of 2, 4 or 6, and DCT. Performance of both models was evaluated by means of R2 coefficient and by comparing their results on Internal Target Volume (ITV) margins against those calculated from original tumor motion curves. Amplitude variations from CBCTp, as well as estimations of baseline shift variations were added to the DCT model to account for their effect on ITV margins. RESULTS DCT replicated tumor motion curves with a mean R2 values for all patients of 0.86, 0.91 and 0.96 for the lateral (LAT), anterior-posterior (AP) and cranio-caudal (CC) directions respectively. CM yielded worst results, with R2 values of 0.64, 0.61 and 0.74 in the three directions. Interfraction amplitude variation increased ITV margins by a 9%, while baseline shift variability implied a 40% and 80-100% increase for normalized values of baseline shift of 0.2 and 0.4 respectively. CONCLUSIONS Probability distribution functions of tumor positions can be successfully characterized with DCT. This permits to include tumor motion variablilities obtained from patient population into patient specific ITVs.
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Affiliation(s)
- D Sevillano
- Department of Medical Physics, Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - L M Núñez
- Biomedical Engineering, ETSIT, Universidad Politécnica de Madrid, Madrid, Spain
| | - M Chevalier
- Medical Physics, Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
| | - F García-Vicente
- Department of Medical Physics, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Portillo AB, García-Cervigón GP, Figueras MP, Jiménez GN, Galán GJ, Arribas MV, Núñez LM, Gómez RH, Segarral OM, Herraiz CG, Berriguete RG, García JEL. [Telemedicine, prison and illness associated with HIV]. Rev Esp Quimioter 2019; 32:539-544. [PMID: 31642638 PMCID: PMC6913080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Communicate the activity of telemedicine, from its opening, between a hospital consultation of infectious diseases and a penitentiary center. METHODS Descriptive study of the tele-consultation of infectious diseases of the Alcorcón Foundation University Hospital with the Navalcarnero penitentiary center from 2013 to 2017, which is carried out by videoconference. The reason and number of consultations, diagnosis of HIV, antiretroviral treatment (ART), immunovirological situation, diagnosis of hepatitis C virus (HCV= and intervention performed by the infectious expert were analyzed. RESULTS A total of 75 patients were evaluated in a total of 168 consultations (in the first year 11 consultations and in the fifth year 62). The index of successive / new consultations was 1.24 and 85% of the patients required less than 1 year of follow-up. 84% of patients did not move to the hospital. 99% of patients accepted this modality. 96% were HIV positive, 94% of them took ART and 85% had undetectable viral load with 532 CD4/mL of medium. 90% had positive serology for HCV. 72% of the consultations were for the assessment of HCV treatment, which was sofosbuvir/ledipasvir by 63%. 40% changed their ART (70% to avoid interactions). CONCLUSIONS Most of the evaluated patients have HIV infection. This type of consultation has a growing demand, is efficient (avoids transfers and is decisive) and has high acceptance. The most frequent reason for consultation was the treatment of HCV and more than a third of patients required ART change.
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Affiliation(s)
- Antonio Blanco Portillo
- Hospital Universitario Fundación Alcorcón. C/Budapest, 1 28922 Alcorcón, Madrid.,Correspondencia: Antonio Blanco Portillo Hospital Universitario Fundación Alcorcón. C/Budapest, 1 28922 Alcorcón, Madrid. Spain E-mail:
| | | | | | | | - Germán Jiménez Galán
- Centro Penitenciario Madrid IV. Carretera N-V, Km 27.7, 28600 Navalcarnero, Madrid
| | | | - Leonor Moreno Núñez
- Hospital Universitario Fundación Alcorcón. C/Budapest, 1 28922 Alcorcón, Madrid
| | - Rafael Hervás Gómez
- Hospital Universitario Fundación Alcorcón. C/Budapest, 1 28922 Alcorcón, Madrid
| | | | | | | | - Juan E Losa García
- Hospital Universitario Fundación Alcorcón. C/Budapest, 1 28922 Alcorcón, Madrid
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