Publications by authors named "Alida Fe Talento"

Objectives: To determine the percentage of patients across Ireland who are discharged from the Emergency Department (ED) with an antimicrobial prescription, the indication, classification of infections, and guideline compliance. To identify potential areas for antimicrobial stewardship (AMS) interventions in the ED.

Patients And Methods: A multicentre, prospective cohort analysis study in EDs across eight hospitals in Ireland.

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Article Synopsis
  • CAPA, or COVID-19-associated pulmonary aspergillosis, occurs in patients with severe SARS-CoV-2 infections and has a high mortality rate of about 50%, complicated by azole resistance.
  • A genomic analysis of 21 CAPA isolates from four European countries revealed a 14.3% prevalence of azole resistance, all linked to known genetic mutations.
  • The findings suggest that monitoring for resistant strains and potentially updating antifungal treatment guidelines could improve patient outcomes among those suspected of having CAPA.
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Background: To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx).

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Article Synopsis
  • The study aimed to evaluate the distribution of Candida species and their antifungal resistance in cases of candidaemia across Europe, analyzing data collected from 41 centers in 17 countries between 2018 and 2022.
  • The most common isolates identified were C. albicans, C. glabrata, and C. parapsilosis, with notable geographical variations in their prevalence and antifungal resistance patterns.
  • Resistance to fluconazole was observed in certain species, particularly C. glabrata and C. parapsilosis, with rare cases of echinocandin resistance found, including specific genetic mutations in resistant isolates.
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Background: Feedback on optimal antimicrobial prescribing to clinicians is an important strategy to ensure antimicrobial stewardship (AMS) in the hospital setting.

Objective: To explore the perceptions of antimicrobial prescribing feedback among clinicians in acute care.

Study Design: Prospective qualitative design.

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Article Synopsis
  • Infections from the fungal pathogen Aspergillus fumigatus are showing increasing resistance to standard azole antifungal treatments, yet there's limited knowledge on how patients acquire these drug-resistant strains from the environment.
  • A study analyzing 218 fungal isolates from the UK and Ireland revealed two main genetic groups (clades A and B), with most environmental resistance found in clade A and strong evidence of patients getting infections from environmental sources.
  • The research also identified genetic regions under positive selection that relate to azole resistance, highlighting the need for more understanding of how these fungi develop drug resistance, particularly in patients who are already vulnerable due to respiratory infections.
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Invasive fungal disease (IFD) is a growing health burden. High mortality rates, increasing numbers of at-risk hosts, and a limited availability of rapid diagnostics and therapeutic options mean that patients are increasingly exposed to unnecessary antifungals. High rates of prescriptions promote patient exposure to undue toxicity and drive the emergence of resistance.

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Background: Antimicrobial stewardship (AMS) describes interventions designed to optimize antimicrobial therapy, minimize adverse treatment consequences and reduce the spread of antimicrobial resistance (AMR). Previous research has investigated the patient's role in healthcare infection prevention but the patient's role in AMS has not been extensively explored.

Objectives: To investigate the willingness of hospital inpatients to question staff about prudent antimicrobial use in an Irish hospital and evaluate the impact of patient and public involvement in research (PPI) on this study.

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Within the last 12 months, coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spread globally to pandemic proportions [...

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Unlabelled: Chronic obstructive pulmonary disease (COPD) patients have been recognized to be at increased risk of Aspergillus spp. colonization, which may progress to invasive pulmonary aspergillosis (IPA). The objective of this study was to determine the frequency of Aspergillus colonization, or disease, in a cohort of COPD patients.

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Objective: Pregnancy induces unique physiological changes to the urinary tract, leaving pregnant women more susceptible to pyelonephritis. Urinary tract infections are generally diagnosed using urine sampling and testing with reagent sticks (dipstick) or laboratory culture. This study aimed to establish the prevalence of positive urine reagent strip and urine culture in asymptomatic pregnant women.

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We report a case of severe COVID-19 pneumonia complicated by fatal co-infection with a multi-triazole resistant and highlight the importance of recognising the significance of sp. isolation from respiratory samples. Early diagnosis and detection of triazole resistance are essential for appropriate antifungal therapy to improve outcome in patients with coronavirus associated invasive aspergillosis.

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co-infection in patients with severe coronavirus disease 2019 (COVID-19) pneumonia, leading to acute respiratory distress syndrome, has recently been reported. To date, 38 cases have been reported, with other cases most likely undiagnosed mainly due to a lack of clinical awareness and diagnostic screening. Importantly, there is currently no agreed case definition of COVID-19 associated invasive pulmonary aspergillosis (CAPA) that could aid in the early detection of this co-infection.

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Background: Recent outbreaks of Candida auris further exemplify that invasive Candida infections are a substantial threat to patients and healthcare systems. Even short treatment delays are associated with higher mortality rates. Epidemiological shifts towards more resistant Candida spp.

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Influenza virus infection is now recognised as a risk factor for invasive pulmonary aspergillosis (IPA). Delays in diagnosis contribute to delayed commencement of antifungal therapy. In addition, the emergence of resistance to first-line triazole antifungal agents puts emphasis on early detection to prevent adverse outcomes.

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Purpose: The diagnosis of invasive fungal diseases (IFD) in critical care patients (CrCP) is difficult. The study investigated the performance of a set of biomarkers for diagnosis of IFD in a mixed specialty critical care unit (CrCU).

Methods: A prospective observational study in patients receiving critical care for ≥7days was performed.

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A wide array of PCR tests has been developed to aid the diagnosis of invasive aspergillosis (IA), providing technical diversity but limiting standardisation and acceptance. Methodological recommendations for testing blood samples using PCR exist, based on achieving optimal assay sensitivity to help exclude IA. Conversely, when testing more invasive samples (BAL, biopsy, CSF) emphasis is placed on confirming disease, so analytical specificity is paramount.

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Background: The clinical course of Staphylococcus aureus bloodstream infection is unpredictable and bacterial virulence, host immune response and patient characteristics are among the factors that contribute to the clinical course of infection. To investigate the relationship between cytokine response and clinical outcome, circulating cytokine levels were investigated in response to S. aureus bloodstream infection in patients with different clinical courses of infection.

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Coryneform bacteria are usually considered as non-pathogenic when isolated from clinical specimens. We present a case of Brevibacterium otitidis neurosurgical infection in an immunocompetent patient, and highlight the difficulty with identification and interpretation of antimicrobial susceptibility results for this unusual pathogen.

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