Publications by authors named "Chumbita Mariana"
Article Synopsis
- The study analyzed the occurrence of multidrug-resistant (MDR) bacteria in solid cancer patients with bloodstream infections (BSIs) over 25 years, revealing a significant rise in MDR strains, especially ESBL-producing bacteria.
- Among 6,117 BSI episodes, Gram-negative bacilli (GNB) were the most prevalent, and 24.8% of patients received inappropriate empiric antibiotic treatment (IEAT), which correlated with higher mortality rates.
- Risk factors for MDR BSIs included prior antibiotic use, infections occurring during treatment, and specific infection sources, highlighting the need for improved risk assessment and careful antibiotic prescribing to enhance patient outcomes.
Article Synopsis
- This study investigates the causes of infections in patients with febrile neutropenia (FN) and evaluates different microbiological testing methods used for diagnosis in a hospital setting.
- Conducted at the Hospital Clinic of Barcelona over two years, it analyzed 4520 tests from 462 FN episodes, revealing a 10% positivity rate and showing that bacterial and viral infections are significant contributors.
- The findings highlight a high rate of documented infections at FN onset, with bacterial infections being common but also emphasize the need for improved management strategies for viral infections, alongside a call for better diagnostic approaches to enhance cost-effectiveness.
Background: This study aimed to describe documented infections associated with postinfusion fever after CAR T-cell therapy and to evaluate daily changes in vital signs, laboratory results, and the National Early Warning Score (NEWS) in patients with and without confirmed bacterial infections following fever onset, with the objective of assisting in antibiotic stewardship.
Methods: This was a retrospective, observational study including all consecutive adult patients who received CAR T-cell therapy. Documented infection in the first fever episode after infusion, and clinical and analytic trend comparison of patients with bacterial documented infections and those without documented infections, are described.
Corrigendum to "Safety and effectiveness of isavuconazole in real-life non-neu tropenic patients" [International Journal of Infectious Diseases 144 (2024) 107070].
Int J Infect Dis
September 2024
Objectives: To describe the management of haematological patients experiencing prolonged SARS-CoV-2 viral shedding, as the optimal management strategy for this condition remains undetermined.
Methods: We conducted a retrospective evaluation of our prospectively followed cohort of haematological patients treated with remdesivir for more than 10 days. Starting January 2023, upon COVID-19 diagnosis, the treatment strategy was based on symptoms and PCR cycle threshold (Ct) as follows: (i) when Ct was 25 or less or if the patient had symptoms, a course of remdesivir for at least 10 days, nirmatrelvir/ritonavir for 5 days (whenever possible) and convalescent plasma was administered; and (ii) when the patient was asymptomatic and had a PCR Ct of more than 25, when possible, a course of 5 days of nirmatrelvir/ritonavir was administered.
Article Synopsis
- Researchers studied the rise of azole-resistant invasive aspergillosis in hematology patients in a Spanish hospital over the last 4 months, identifying 4 cases total, with 3 being azole-resistant.
- The diagnostic methods included fungal culture, antifungal susceptibility testing, and real-time PCR for detecting both Aspergillus species and azole resistance mutations like TR34/L98H.
- Findings showed that all azole-resistant cases had significant hematologic conditions and risk factors, indicating a pressing need for better monitoring and development of new antifungal treatments.
Article Synopsis
- The study evaluated the safety and effectiveness of isavuconazole in treating non-neutropenic patients with invasive fungal infections (IFIs) across 12 university hospitals from 2018 to 2022.
- A total of 238 cases were analyzed, with aspergillosis being the most common infection, and only 5.9% of patients experienced toxic effects, mostly related to liver issues.
- The treatment showed a successful clinical response in about 50.5% of patients after 12 weeks, indicating isavuconazole is a viable option for this patient group.
Article Synopsis
- The study investigates the effectiveness of remdesivir on reducing mortality in COVID-19 patients, focusing on identifying specific patient groups that benefit the most from the treatment.
- Researchers analyzed data from 1160 hospitalized patients, identifying five distinct clusters based on factors like symptoms duration and lymphocyte counts, which revealed varying mortality rates among these groups.
- The findings suggest that patients with higher viral loads—characterized by lower lymphocyte counts and shorter symptom duration—showed significant mortality improvement when treated with remdesivir, validating these results in a separate patient cohort.
Background: We aimed to describe a cohort of hematologic patients with COVID-19 treated with antivirals early.
Methods: Non-interventional chart review study. Comparison of baseline characteristics and outcomes in high-risk hematologic patients treated with remdesivir between December 2021 and April 2022 versus those treated with nirmatrelvir/ritonavir between May and August 2022.
Introduction: Artificial intelligence (AI) and machine learning (ML) have the potential to revolutionize the management of febrile neutropenia (FN) and drive progress toward personalized medicine.
Areas Covered: In this review, we detail how the collection of a large number of high-quality data can be used to conduct precise mathematical studies with ML and AI. We explain the foundations of these techniques, covering the fundamentals of supervised and unsupervised learning, as well as the most important challenges, e.
Objectives: to assess the current epidemiology, antibiotic therapy and outcomes of onco- hematological patients with bacteremic skin and soft-tissue infections (SSTIs), and to identify the risk factors for Gram-negative bacilli (GNB) infection and for early and overall mortality.
Methods: episodes of bacteremic SSTIs occurring in cancer patients at two hospitals were prospectively recorded and retrospectively analyzed.
Results: Of 164 episodes of bacteremic SSTIs, 53% occurred in patients with solid tumors and 47% with hematological malignancies.
Background: We described the real-life epidemiology and causes of infections on the different therapy phases in patients undergoing chimeric antigen receptor (CAR) T-cells directed towards CD19+ or BCMA+ cells.
Methods: All consecutive patients receiving CAR T-cell therapy at our institution were prospectively followed-up. We performed various comparative analyses of all patients and subgroups with and without infections.
We aimed to describe the characteristics and outcomes of biliary source bloodstream infections (BSIs) in oncological patients. Secondarily, we analyzed risk factors for recurrent BSI episodes. All episodes of biliary source BSIs in oncological patients were prospectively collected (2008-2019) and retrospectively analyzed.
View Article and Find Full Text PDFPurpose: We aimed to evaluate the performance of the FilmArray (FA) meningitis/encephalitis (ME) panel. Secondarily, we analyzed the false positive (FP) and false negative (FN) results, as well as the predictive values of the technique, regarding the cerebrospinal fluid (CSF) characteristics.
Methods: FA is a multiplex real-time PCR detecting 14 of the most common ME pathogens in CSF.
Article Synopsis
- Pseudomonas aeruginosa bloodstream infections (BSI) in febrile neutropenic patients show a growing challenge due to increasing antibiotic resistance, complicating effective treatment based on international guidelines.
- A study involving 280 BSI cases revealed that 36% of isolated P. aeruginosa strains were resistant to recommended β-lactam antibiotics, with 21.1% classified as multidrug-resistant (MDR) and 11.4% as extensively drug-resistant (XDR).
- Inappropriate empirical antibiotic treatment (IEAT) was administered to 16.8% of patients, contributing to a 30-day mortality rate of 27.1%, highlighting an urgent need for new treatment strategies.
Objectives: We describe the current epidemiology, causes, and outcomes of breakthrough invasive fungal infections (BtIFI) in patients with haematologic malignancies.
Methods: BtIFI in patients with ≥ 7 days of prior antifungals were prospectively diagnosed (36 months across 13 Spanish hospitals) according to revised EORTC/MSG definitions.
Results: 121 episodes of BtIFI were documented, of which 41 (33.
Objectives: We aimed to describe the clinical outcomes and duration of viral shedding in high-risk patients with haematological malignancies hospitalized with COVID-19 during Omicron variant predominance who received early treatment with antivirals.
Methods: We conducted a prospective observational study on high-risk haematological patients admitted in our hospital between December 2021 and March 2022. We performed detection techniques on viral subgenomic mRNAs until negative results were obtained to document active, prolonged viral replication.
Article Synopsis
- The study examined the epidemiology of invasive fungal infections (IFIs) in hospitalized patients over a four-year period, finding a total of 367 diagnosed cases.
- Key risk factors included corticosteroid use (41.4%) and prior viral infection (31.3%), with the most common infections being candidemia (42.2%) and invasive aspergillosis (26.7%).
- The overall mortality rate at 12 weeks post-diagnosis was 32.2%, highlighting the need for improved awareness and aggressive treatment methods among healthcare providers, especially given the increasing occurrences of resistant fungal strains.
Background: The prevalence of antimicrobial resistance of () in solid organ transplant (SOT) recipients is higher than that of the general population. However, the literature supporting this statement is scarce. Identifying patients at risk of carbapenem resistance (CR) is of great importance, as CR strains more often receive inappropriate empiric antibiotic therapy, which is independently associated with mortality in bloodstream infections (BSIs).
View Article and Find Full Text PDFPurpose: Assess the impact of viral load estimated by cycle threshold (Ct) of reverse transcription real time-polymerase chain reaction (rRT-PCR) and the days from symptoms onset on mortality in hospitalized patients with COVID19.
Methods: Retrospective observational study of 782 patients with a positive rRT-PCR from a nasopharyngeal swab was performed within the first 24 h from admission. Demographic data, clinical manifestations and laboratory parameters were collected.
Introduction: Increased mortality has been reported in the Latin American population. The objective is to compare the clinical characteristics and outcome of Latin American and Spanish populations in a cohort of patients hospitalized with COVID-19 during the first year of the pandemic.
Methods: We retrospectively analysed all the Latin American patients (born in South or Central America) hospitalized in our centre from February 2020 to February 2021 and compared them with an age- and gender-matched group of Spanish subjects.
Objectives: To describe current resistance to the β-lactams empirically recommended in the guidelines in bloodstream infection (BSI) episodes caused by Gram-negative bacilli (GNB).
Methods: Retrospective, multicentre cohort study of the last 50 BSI episodes in haematological patients across 14 university hospitals in Spain. Rates of inappropriate empirical antibiotic therapy (IEAT) and impact on mortality were evaluated.
Dexamethasone and tocilizumab have been associated with reduction in mortality, however, the beneficial effect is not for all patients and the impact on viral replication is not well defined. We hypostatized that C-reactive protein (CRP) could help in the identification of patients requiring anti-inflammatory therapy. Patients admitted for > 48 h in our hospital for a confirmed or suspected infection by SARS-CoV-2 from February 2020 to February 2021 were retrospectively evaluated.
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