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Ferrer R, Soriano A, Cantón R, Del Pozo JL, García-Vidal C, Garnacho-Montero J, Larrosa N, Rascado P, Salavert M, Pintado V, Giró-Perafita N, Badia X. A systematic literature review and expert consensus on risk factors associated to infection progression in adult patients with respiratory tract or rectal colonisation by carbapenem-resistant Gram-negative bacteria. Rev Esp Quimioter 2022; 35:455-467. [PMID: 35859521 DOI: 10.37201/req/062.2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Risk factors (RFs) associated with infection progression in patients already colonised by carbapenem-resistant Gram-negative bacteria (CRGNB) have been addressed in few and disperse works. The aim of this study is to identify the relevant RFs associated to infection progression in patients with respiratory tract or rectal colonisation. METHODS A systematic literature review was developed to identify RFs associated with infection progression in patients with CRGNB respiratory tract or rectal colonisation. Identified RFs were then evaluated and discussed by the expert panel to identify those that are relevant according to the evidence and expert's experience. RESULTS A total of 8 articles were included for the CRGNB respiratory tract colonisation and 21 for CRGNB rectal colonisation, identifying 19 RFs associated with pneumonia development and 44 RFs associated with infection progression, respectively. After discussion, the experts agreed on 13 RFs to be associated with pneumonia development after respiratory tract CRGNB colonisation and 33 RFs to be associated with infection progression after rectal CRGNB colonisation. Respiratory tract and rectal colonisation, previous stay in the ICU and longer stay in the ICU were classified as relevant RF independently of the pathogen and site of colonisation. Previous exposure to antibiotic therapy or previous carbapenem use were also common relevant RF for patients with CRGNB respiratory tract and rectal colonisation. CONCLUSIONS The results of this study may contribute to the early identification of CRGNB colonized patients at higher risk of infection development, favouring time-to-effective therapy and improving health outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - X Badia
- Xavier Badia, Omakase Consulting S.L., Barcelona, Spain.
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Carrera-Salinas A, González-Díaz A, Vázquez-Sánchez DA, Camoez M, Niubó J, Càmara J, Ardanuy C, Martí S, Domínguez MÁ, Garcia M, Marco F, Chaves F, Cercenado E, Tapiol J, Xercavins M, Fontanals D, Loza E, Rodríguez-López F, Olarte I, Mirelis B, Ruiz de Gopegui E, Lepe J, Larrosa N. Staphylococcus aureus surface protein G (sasG) allelic variants: correlation between biofilm formation and their prevalence in methicillin-resistant S. aureus (MRSA) clones. Res Microbiol 2022; 173:103921. [DOI: 10.1016/j.resmic.2022.103921] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 01/02/2023]
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Ferrer R, Soriano A, Cantón R, Del Pozo JL, García-Vidal C, Garnacho-Montero J, Larrosa N, Rascado P, Salavert M, Pintado V, Pellicer B, Badía X. [A systematic review and expert's analysis of risk factors of infections in adults due to carbapenem-resistant Pseudomonas aeruginosa or Acinetobacter baumannii in Spain]. Rev Esp Quimioter 2021; 34:298-307. [PMID: 33913312 PMCID: PMC8329577 DOI: 10.37201/req/034.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The aim of the study is to identify risk factors associated to infections caused by carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Acinetobacter baumannii (CRAB) in adult patients through a systematic literature review, classify them according to their importance and provide recommendations by experts in the Spanish context. METHODS We developed a systematic literature review to identify risk factors associated to CRPA or CRAB infections and they were evaluated and discussed by a multidisciplinary panel of experts. RESULTS There were included 29 studies for P. aeruginosa and 23 for A. baumannii out of 593 identified through systematic literature review. We identified 38 risk factors for P. aeruginosa and 36 for A. baumannii. After risk factor evaluation by the panel of experts, results for CRPA were: 11 important, 10 slightly important and 15 unimportant risk factors; and for CRAB were: 9 important, 5 slightly important and 19 unimportant risk factors. For both pathogens, previous use of antibiotics and hospitalization were important risk factors. CONCLUSIONS We could identify the main risk factors associated to CRPA and CRAB through literature review. There is a need for developing additional studies with higher levels of evidence to identify sooner and better infected patients through associated risk factors.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - X Badía
- Xavier Badia, Omakase Consulting, Barcelona, Spain.
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González-Díaz A, Càmara J, Ercibengoa M, Cercenado E, Larrosa N, Quesada MD, Fontanals D, Cubero M, Marimón JM, Yuste J, Ardanuy C. Emerging non-13-valent pneumococcal conjugate vaccine (PCV13) serotypes causing adult invasive pneumococcal disease in the late-PCV13 period in Spain. Clin Microbiol Infect 2019; 26:753-759. [PMID: 31756452 DOI: 10.1016/j.cmi.2019.10.034] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 07/23/2019] [Revised: 10/21/2019] [Accepted: 10/29/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVE An early reduction of adult invasive pneumococcal disease (IPD) was observed after the 13-valent pneumococcal conjugate vaccine (PCV13) introduction for children in Spain. We analysed the epidemiology of adult IPD in the late-PCV13 period. METHODS This was a prospective multicentre study of adult IPD involving six hospitals. Strains were serotyped, genotyped and studied for antimicrobial susceptibility. The late-PCV13 period was compared with the pre- and early-PCV13 periods. RESULTS A total of 2197 episodes were collected-949 in 2008-2009, 609 in 2012-2013 and 639 in 2015-2016. The initial decrease of IPD observed (from 12.3/100 000 to 8.1/100 000; 2008-2009 versus 2012-2013) plateaued in 2015-2016 (8.3/100 000). IPD due to PCV13 serotypes decreased (from 7.7 to 3.5 to 2.3/100 000; p < 0.05), whereas IPD caused by non-PCV13 serotypes increased (from 4.5 to 4.6 to 6.0/100 000; p < 0.05). The most frequent serotypes in the late-PCV13 period were: 8 (15.1%), 3 (10.5%), 12F (7.9%) and 9N (5.4%). These serotypes were related to major genotypes: CC53 (59.8%) and CC404 (30.4%) for serotype 8, CC180 (64.1%) and CC260 (28.1%) for serotype 3, CC989 (91.7%) for serotype 12F and CC67 (84.8%) for serotype 9N. Penicillin-non-susceptibility (21.2%) was associated with serotypes 11A (CC156), 14 (CC156) and 19A (CC320), and macrolide-resistance was related to serotypes 24F and 19A. Rates of pneumococcal meningitis remained stable throughout the periods (ranges 0.9, 0.8 and 1.0/100 000). CONCLUSIONS The initial decrease of adult IPD observed after PCV13 introduction for children has been balanced by the rise of non-PCV13 serotypes. The spread of antibiotic-resistant lineages related to non-PCV13 serotypes (11A and 24F) could be a threat for the treatment of serious pneumococcal diseases.
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Affiliation(s)
- A González-Díaz
- Microbiology Department, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain
| | - J Càmara
- Microbiology Department, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain
| | - M Ercibengoa
- Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain; Biodonostia, Infectious Diseases Area, Respiratory Infection and Antimicrobial Resistance Group; Osakidetza Basque Health Service, Donostialdea Integrated Health Organization, Microbiology Department, San Sebastian, Spain
| | - E Cercenado
- Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain; Microbiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - N Larrosa
- Microbiology Department, Hospital Universitari Vall d'Hebró, Barcelona, Spain
| | - M D Quesada
- Microbiology Dept. Clinical Laboratory North Metropolitan Area, Hospital Universitari Germans Trias i Pujol, UAB, Badalona, Spain
| | - D Fontanals
- Microbiology Department, Corporació Sanitària Parc Taulí, IU-UAB, Sabadell, Spain
| | - M Cubero
- Microbiology Department, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain
| | - J M Marimón
- Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain; Biodonostia, Infectious Diseases Area, Respiratory Infection and Antimicrobial Resistance Group; Osakidetza Basque Health Service, Donostialdea Integrated Health Organization, Microbiology Department, San Sebastian, Spain
| | - J Yuste
- Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain; Pneumococcal Reference Laboratory, Centro Nacional de Microbiología, ISCIII, Madrid, Spain
| | - C Ardanuy
- Microbiology Department, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain; Departament of Pathology and Experimental Therapeutics, University of Barcelona, Spain.
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Reartes SR, Estrada V, Bazán R, Larrosa N, Cossavella A, López A, Busso F, Diaz M. Evaluation of ecological effects of anthropogenic nutrient loading scenarios in Los Molinos reservoir through a mathematical model. Ecol Modell 2016. [DOI: 10.1016/j.ecolmodel.2015.10.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Coelho A, Piedra-Carrasco N, Bartolomé R, Quintero-Zarate J, Larrosa N, Cornejo-Sánchez T, Prats G, Garcillán-Barcia M, de la Cruz F, González-Lopéz J. Role of IncHI2 plasmids harbouring blaVIM-1, blaCTX-M-9, aac(6′)-Ib and qnrA genes in the spread of multiresistant Enterobacter cloacae and Klebsiella pneumoniae strains in different units at Hospital Vall d’Hebron, Barcelona, Spain. Int J Antimicrob Agents 2012; 39:514-7. [DOI: 10.1016/j.ijantimicag.2012.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 01/13/2012] [Accepted: 01/22/2012] [Indexed: 10/28/2022]
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Melendo S, Vilca LM, Albero I, Larrosa N, de Arquer M, Campins M. [Isolation precautions in a tertiary paediatric hospital]. An Pediatr (Barc) 2011; 75:21-5. [PMID: 21439920 DOI: 10.1016/j.anpedi.2011.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 01/24/2011] [Accepted: 02/09/2011] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Isolation is one of the measures to prevent the spread of nosocomial infections. However, in children's hospitals, given the type of patients and infections, and the architectural features of hospital wards, isolation precautions are sometimes difficult to implement and enforce. MATERIAL AND METHODS An observational, descriptive study was conducted on the isolation precautions taken at the Children's Hospital Vall d'Hebron in Barcelona, from January to December, 2007. The isolation precautions applied were those of the Centers for Disease Control and Prevention from the USA, and those of the Department of Health of the Generalitat de Cataluña. RESULTS Of the patients admitted during the study period, 5.4% needed isolation. The General Paediatrics ward generated the highest number of isolations (10.7%). The most frequently microorganisms needing isolation precautions were respiratory syncytial virus and rotavirus. Contact precautions was the type of isolation most applied (90% of isolations). The Neonatal Intensive Care Unit and the Paediatric Oncology and Haematology Service were the areas with a greater number of patients isolated due to infection or colonization by multiresistant bacteria (48% and 67% of the isolations, respectively). CONCLUSIONS The implementation of a surveillance and infection control program is essential to reduce the rate of hospital-acquired infections. Knowledge of the frequency of isolated patients at each centre and the availability of resources for the correct application of isolation precautions are fundamental for these goals to be achieved.
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Affiliation(s)
- S Melendo
- Servicio de Pediatría, Hospital Universitario Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
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Pigrau C, Almirante B, Rodriguez D, Larrosa N, Bescos S, Raspall G, Pahissa A. Osteomyelitis of the jaw: resistance to clindamycin in patients with prior antibiotics exposure. Eur J Clin Microbiol Infect Dis 2008; 28:317-23. [DOI: 10.1007/s10096-008-0626-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Accepted: 08/26/2008] [Indexed: 11/28/2022]
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Pigrau C, Rodríguez D, Planes AM, Almirante B, Larrosa N, Ribera E, Gavaldà J, Pahissa A. Management of Catheter-Related Staphylococcus aureus Bacteremia: When May Sonographic Study Be Unnecessary? Eur J Clin Microbiol Infect Dis 2003; 22:713-9. [PMID: 14605943 DOI: 10.1007/s10096-003-1041-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study reviews the outcome of patients with uncomplicated catheter-related Staphylococcus aureus bacteremia diagnosed in our hospital from January 1997 to December 1999 and treated with short-course antibiotic therapy. Our aim was to assess the effectiveness of this regimen for minimizing complications (relapses, endocarditis and metastatic foci). A total of 213 episodes of bacteremia were registered and 167 (78.4%) were nosocomial. Among these, 87 (52.1%) were catheter-related Staphylococcus aureus bacteremia and 20 were primary nosocomial bacteremia. Endocarditis was diagnosed during the acute episode in 7/107 of these patients (2 by persistent fever after catheter removal and 5 by metastatic foci; 3 of them also had cardiac risk factors) and confirmed with transesophageal echocardiography. Among the 84/87 catheter-related Staphylococcus aureus bacteremia and 16/20 primary nosocomial bacteremia patients who did not develop endocarditis, 31 patients died during the acute episode (16 due to sepsis despite initiation of antibiotic treatment and 15 due to the underlying disease) and five had osteoarticular foci. The remaining 64 episodes were considered to be uncomplicated bacteremia (no cardiac risk factors, persistent fever, metastatic foci, or clinical signs of endocarditis) and were treated with 10-14 days of high-dose antistaphylococcal antibiotics. Echocardiography was not mandatory in these patients. Of the 64 uncomplicated episodes, 62 were followed for at least 3 months and none relapsed or developed endocarditis. Even though some of the patients might have had subclinical endocarditis, short-course therapy with high doses of antistaphylococcal antibiotics was effective for treating uncomplicated catheter-related Staphylococcus aureus bacteremia. Transesophageal echocardiography may not be necessary in these cases.
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Affiliation(s)
- C Pigrau
- Infectious Diseases Division, Hospital Universitari Vall d'Hebron, Universitat Autónoma, Paseo Vall D'Hebron 119-129, 08035 Barcelona, Spain.
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