Publications by authors named "Armando Perez-Cardona"
Impact of a real-time diagnostic and antimicrobial stewardship workflow on time to appropriate therapy for infections caused by multidrug-resistant Gram-negative organisms.
Int J Antimicrob Agents
June 2023
Article Synopsis
- Multidrug-resistant (MDR) Gram-negative bacteria pose serious health risks, and timely treatment directly influences patient survival, which led to this study on enhancing therapy response times using new antibiotic combinations.* -
- Researchers conducted a study on adult patients with severe infections from carbapenem-resistant Enterobacterales and MDR Pseudomonas, evaluating the effects of a new diagnostic and antimicrobial stewardship workflow implemented in 2019.* -
- Results showed significant reduction in time to appropriate therapy (TAP), dropping from 103 hours to 75 hours, alongside a quicker turnaround in susceptibility testing, indicating the effectiveness of the improved workflow on patient outcomes.*
Article Synopsis
- Pseudomonas aeruginosa is a hard-to-treat pathogen, particularly in patients with Cystic Fibrosis, and this study tracked multidrug-resistant strains over 17 months in a young CF patient who had a double lung transplant.* -
- Researchers analyzed 22 P. aeruginosa isolates using techniques such as whole genome sequencing and phylogenetic analysis, finding that most strains were resistant to numerous antibiotics and that mutations were accumulating over time, particularly in genes related to DNA repair.* -
- The study highlighted significant genetic diversity among the isolates and identified variations in gene expression related to antibiotic resistance, emphasizing the need for new clinical approaches rather than just relying on single pure cultures for analysis.*
Early detection of carbapenem resistance in Gram-negative (CRGN) infections can help tailor therapy sooner and prevent horizontal transmission more efficiently. This involves timely, multidisciplinary communication. To this aim, we describe our experience with implementing reflex testing algorithms for expanded antibiotic susceptibilities and molecular mechanisms of resistance in a large academic hospital.
View Article and Find Full Text PDFEpidemiology of carbapenem-resistant Enterobacteriaceae in hospitals of a large healthcare system in Miami, Florida from 2012 to 2016: Five years of experience with an internal registry.
Am J Infect Control
November 2020
Background: Carbapenem-resistant Enterobacteriaceae (CRE) is an urgent public health threat globally. Limited data are available regarding the epidemiology of CRE in South Florida. We describe the epidemiology of CRE within a large public healthcare system in Miami, FL, the experience with an internal registry, active surveillance testing, and the impact of infection prevention practices.
View Article and Find Full Text PDFBackground: Vancomycin-resistant enterococci are an important cause of healthcare-associated infections and are inherently resistant to many commonly used antibiotics. Linezolid is the only drug currently approved by the US Food and Drug Administration to treat vancomycin-resistant enterococci; however, resistance to this antibiotic appears to be increasing. Although outbreaks of linezolid- and vancomycin-resistant Enterococcus faecium (LR-VRE) in solid organ transplant recipients remain uncommon, they represent a major challenge for infection control and hospital epidemiology.
View Article and Find Full Text PDFInfections with carbapenemase-producing carbapenem-resistant Enterobacteriaceae represent an emergent problem worldwide. Treatment of infections caused by New Delhi metallo-beta-lactamase (NDM)-harboring Enterobacteriaceae is particularly challenging as it frequently involves the use of nephrotoxic agents, which is problematic in kidney transplant recipients and non-renal transplant patients with marginal kidney function. We present two cases of urinary tract infections caused by NDM-harboring Enterobacteriaceae successfully treated with a combination of "double carbapenem" and oral fosfomycin.
View Article and Find Full Text PDFSuccessful Treatment of Carbapenemase-Producing Pandrug-Resistant Klebsiella pneumoniae Bacteremia.
Antimicrob Agents Chemother
October 2015
New antibiotic options are urgently needed for the treatment of carbapenem-resistant Enterobacteriaceae infections. We report a 64-year-old female with prolonged hospitalization following an intestinal transplant who developed refractory bacteremia due to a serine carbapenemase-producing pandrug-resistant isolate of Klebsiella pneumoniae. After failing multiple antimicrobial regimens, the patient was successfully treated.
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