Publications by authors named "Clara Natera-Kindelan"

Background: Data about antibiotic de-escalation in sepsis associated with the bloodstream and caused by Enterobacterales are scarce. The objectives of this study are to identify factors associated with early de-escalation and to analyse the impact of de-escalation on mortality in patients with Enterobacterales bloodstream infection (BSI) with a Sequential Organ Failure Assessment (SOFA) score ≥ 2.

Methods: A prospective, multicentre cohort study was performed including episodes of BSI due to Enterobacterales and a SOFA score ≥ 2 who were receiving an active antipseudomonal β-lactam; the isolate should be susceptible to at least 1 narrower-spectrum antibiotic.

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Purposes: Enterococcal BSI is associated with significant morbidity and mortality, with fatality rates of approximately 20-30%. There are microbiological and clinical differences between E. faecalis and E.

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Objectives: Bloodstream infections (BSI) are an important cause of mortality, although they show heterogeneity depending on patients and aetiological factors. Comprehensive and specific mortality scores for BSI are scarce. The objective of this study was to develop a mortality predictive score in BSI based on a multicentre prospective cohort.

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Article Synopsis
  • - The study reclassified Klebsiella aerogenes into the Klebsiella genus and aimed to evaluate the clinical outcomes of bloodstream infections (BSI) caused by K. aerogenes compared to K. pneumoniae and Enterobacter cloacae.
  • - Researchers analyzed data from hospitalized patients with monomicrobial BSI from October 2016 to March 2017, using various outcomes to compare the infections, including mortality and recurrence rates within 30 days.
  • - Findings indicated that K. aerogenes infections had a lower frequency of mortality or recurrence (6.9%) compared to E. cloacae (20.8%) and K. pneumoniae (19.0%), suggesting a potentially better
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Objectives: This study aimed to determine the association of Escherichia coli microbiological factors with 30-day mortality in patients with bloodstream infection (BSI) presenting with a dysregulated response to infection (i.e. sepsis or septic shock).

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Article Synopsis
  • - The study focuses on characterizing *Escherichia coli* (E. coli) blood isolates that cause sepsis or septic shock, as these infections are common and often severe, leading to critical health outcomes in affected patients.
  • - Data from a multicenter study in Spain involved whole-genome sequencing of E. coli blood isolates from patients over 14 with diagnosed sepsis or septic shock, identifying various microbiological features, including phylogroups, sequence types, virulence factors, and antimicrobial resistance (AMR) genes.
  • - Results showed that most isolates belonged to phylogenetic group 1, with specific sequence types such as ST131 and ST73 being the most common, but there were no significant geographical
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Article Synopsis
  • Fosfomycin trometamol is being explored as a potential step-down therapy for patients with bacteraemic urinary tract infections caused by multidrug-resistant E. coli (MDR-Ec), though data is limited.
  • In the FOREST trial, patients who transitioned from IV treatments to either oral fosfomycin or other oral medications showed similar clinical and microbiological cure rates, with fosfomycin achieving 78.7% success compared to 80.9% for other drugs.
  • However, fosfomycin had a significantly higher relapse rate (15% vs. 4.3%), indicating that while it is a viable option, its effectiveness needs further evaluation due to this concern.
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It is not known whether sequential outpatient parenteral antimicrobial (OPAT) is as safe and effective as conventional hospitalization in patients with S. aureus bacteremia (SAB). A post-hoc analysis of the comparative effectiveness of conventional hospitalization versus sequential OPAT was performed in two prospective Spanish cohorts of patients with S.

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Community-onset bloodstream infections (CO-BSI) caused by gram-negative bacilli are common and associated with significant mortality; those caused by Pseudomonas aeruginosa are associated with worse prognosis and higher rates of inadequateempirical antibiotic treatment. The aims of this study were to describe the characteristics of patients with CO-BSI caused by P. aeruginosa, to identify predictors, and to develop a predictive score for P.

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Importance: The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option.

Objective: To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli.

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The epidemiology of bloodstream infections (BSIs) is dynamic as it depends on microbiological, host and healthcare system factors. The aim of this study was to update the information regarding the epidemiology of BSIs in Spain considering the type of acquisition. An observational, prospective cohort study in 26 Spanish hospitals from October 2016 through March 2017 including all episodes of BSI in adults was performed.

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The development of an antimicrobial stewardship program (ASP) requires institutional support. However, obtaining sufficient institutional support is often a complex task that requires convincing the hospital's managers of the benefits of these programs. Additionally, in the design and implementation of an ASP, antimicrobial stewardship (AS) leaders need tools for diverse purposes, such as measuring antimicrobial consumption, education and training and designing protocols.

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Background And Objective: To include a specific antibiotic in the empiric therapy, it is necessary to predict when a nosocomial pneumonia (NP) is caused by methicillin-resistant Staphylococcus aureus (MRSA). We have developed a model for the prediction of the probability of a NP being caused by MRSA, when the carrier status and the microbiological diagnosis are unknown.

Patients And Methods: A retrospective case-control study (1999-2005) was designed.

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Background And Objective: Antiretroviral treatment of human immunodeficiency virus (HIV)-infected patients seems to increase the coronary risk (CR) in these patients. Adequate assessment of CR has significant implications for the management of these patients. Our objective was to compare 2 systems for assessing 10-year CR in HIV-infected patients.

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