Publications by authors named "Gudiol C"

Profound metabolomic alterations occur during COVID-19. Early identification of the subset of hospitalised COVID-19 patients at risk of developing severe disease is critical for optimal resource utilization and prompt treatment. This work explores the metabolomic profile of hospitalised adult COVID-19 patients with severe disease, and establishes a predictive signature for disease progression.

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Febrile neutropenia is a very common complication in cancer patients, especially in hematologic patients and hematopoietic stem cell transplant (HSCT) recipients, and is associated with increased morbidity and mortality [...

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Article Synopsis
  • The study aimed to evaluate whether extended infusions (EI) of β-lactam antibiotics are more effective than intermittent infusions (II) in treating febrile neutropenia, a condition common in patients receiving chemotherapy and stem cell transplants.
  • In a clinical trial involving 150 patients from four Spanish hospitals, those receiving EI experienced a slightly lower success rate at day 5 compared to those on II (50.6% vs. 63.0%), although not statistically significant.
  • The research concluded that routine use of EI for β-lactams in this patient group is not supported, suggesting the need for further studies to address the diverse clinical aspects of febrile neutropenia.
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Importance: Ambient air pollution and antimicrobial resistance pose significant global public health challenges. It is not known whether ambient air pollution is associated with increased consumption of antimicrobials.

Objective: To assess whether a short-term association exists between ambient air pollution levels and antimicrobial consumption among the general population seeking primary care consultations for acute respiratory symptoms.

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  • - The study aimed to determine if using multiplex real-time PCR combined with conventional microbiological testing is safer and more effective in reducing antibiotic use for community-acquired pneumonia (CAP) compared to just conventional testing alone.
  • - A total of 242 hospitalized adults with CAP participated in a randomized trial across four Spanish hospitals, where they were assigned to either the combined testing method or conventional testing only.
  • - Results showed that the median days of antibiotic therapy were slightly lower in the multiplex PCR group but not significantly so, and both methods had similar rates of adverse events and 30-day mortality, suggesting that the combined approach should not be routinely implemented.
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Purpose Of Review: This review describes the latest information in the management of bloodstream infections caused by multidrug-resistant Gram-negative bacilli (MDRGNB) in critically ill patients.

Recent Findings: The prevalence of bloodstream infections due to MDRGNB is high, and they pose a significant risk in critically ill patients. Recently, novel antimicrobial agents, including new β-lactam/β-lactamase inhibitor combinations and cefiderocol, have been introduced for treating these infections.

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Purpose: Data on short courses of antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients are limited. The aim of the study was to describe and compare the frequency of bacteremia relapse, 30-day overall and infection-related mortality, Clostridiodes difficile infection and length of hospital stay since bacteremia among those who received antibiotic therapy for 7 or 14 days.

Methods: This is a multicenter, prospective, observational cohort study in adult high-risk neutropenic patients with hematologic malignancies or hematopoietic stem cell transplant and monomicrobial Enterobacterales bacteremia.

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  • - The study analyzed 1,213 cases of blood-stream infections in onco-hematological neutropenic patients, finding that 33% experienced septic shock, with factors like solid tumors, high-risk MASCC index, pneumonia, and multidrug-resistant infections significantly more common among these patients.
  • - Patients with septic shock were more likely to receive inadequate antibiotic therapy and had worse outcomes, including a high need for ICU support, mechanical ventilation, and increased mortality rates at 7 and 30 days.
  • - Key risk factors for death included need for intubation and inadequate antibiotic therapy, while treatments with granulate colony-stimulating factor and urinary tract infections were linked to better survival, highlighting the need for individualized care strategies for these
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  • 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.
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We assessed the antibiotic use in SARS-CoV-2-infected patients during four different waves of the COVID-19 pandemic, as well as its trends over the period and associated risk factors. We performed a cross-sectional retrospective analysis nested in a prospectively collected cohort of hospitalized adult patients with COVID-19 at a university hospital in Spain. A total of 2415 patients were included in this study, among whom 1120 corresponded to the first wave.

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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.

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Background: The optimisation of the use of β-lactam antibiotics (BLA) via prolonged infusions in life-threatening complications such as febrile neutropenia (FN) is still controversial. This systematic review and meta-analysis aim to evaluate the efficacy of this strategy in onco-haematological patients with FN.

Methods: A systematic search was performed of PubMed, Web of Science, Cochrane, EMBASE, World Health Organization, and ClinicalTrials.

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  • 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.
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Campylobacter bacteremia is an uncommon disease that mainly occurs in immunocompromised patients and is associated with antibiotic resistance, particularly in Campylobacter coli. We report a patient with persistent blood infection because of a multidrug-resistant (MDR) C. coli strain over a 3-month period.

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Background: Cancer has been associated with an increased risk of in-hospital mortality in CDI patients. However, data on delayed mortality in cancer patients with CDI are scarce.

Aim/objective: The aim of the present study was to compare outcomes between oncological patients and the general population with infection (CDI) after 90 days of follow-up.

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The clinical manifestations of SARS-CoV-2 infection vary widely, from asymptomatic infection to the development of acute respiratory distress syndrome (ARDS) and death. The host response elicited by SARS-CoV-2 plays a key role in determining the clinical outcome. We hypothesized that determining the dynamic whole blood transcriptomic profile of hospitalized adult COVID-19 patients and characterizing the subgroup that develops severe disease and ARDS would broaden our understanding of the heterogeneity in clinical outcomes.

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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.

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The administration of antifungals for therapeutic and, especially, prophylactic purposes is virtually a constant in patients requiring hematology-oncology treatment. Any attempt to prevent or treat Aspergillus or Mucor infections requires the administration of some drugs in the azole group, which include voriconazole, posaconazole and isavuconazole, noted for their activity against these pathogens. One very relevant aspect is the potential risk of interaction when associated with one of the antineoplastic drugs used to treat hematologic tumors, with serious complications.

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: We aimed to assess the incidence, etiology and outcomes of catheter-related bloodstream infection (CRBSI) in onco-hematological patients, to assess the differences between patients with hematological malignancies (HMs) and solid tumors (STs) and to identify the risk factors for Gram-negative (GN) CRBSI. : All consecutive episodes of BSI in adult cancer patients were prospectively collected (2006-2020). The etiology of CRBSI was analyzed in three different 5-year periods.

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(1) Background: Information regarding gene expression profiles and the prognosis of community-acquired pneumonia (CAP) is scarce. We aimed to examine the differences in the gene expression profiles in peripheral blood at hospital admission between patients with CAP who died during hospitalization and those who survived. (2) Methods: This is a multicenter study of nonimmunosuppressed adult patients who required hospitalization for CAP.

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In 2012, The Spanish Societies of Infectious Diseases and Clinical Microbiology (SEIMC), Hospital Pharmacy (SEFH), and Preventive Medicine, Public Health and Healthcare Management (SEMPSGS) lead a consensus document including recommendations for the implementation of antimicrobial stewardship (AMS) programs (AMSP; PROA in Spanish) in acute care hospitals in Spain. While these recommendations were critical for the development of these programs in many centres, there is a need for guidance in the development of AMS activities for specific patient populations, syndromes or other specific aspects which were not included in the previous document or have developed significantly since then. The objective of this expert recommendation guidance document is to review the available information about these activities in these patient populations or circumstances, and to provide guidance recommendations about them.

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Use of immune checkpoint inhibitors (ICIs), a revolutionary treatment in modern oncology, is frequently complicated by immune-related adverse events (irAEs), which can be confused with infections, and vice versa, thus complicating management decisions. In this study, we review the published cases of infections as simulators of irAEs in cancer patients.

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The 2016 cumulative incidence of infection (CDI) in Spain was reported by the European Center for Disease Control to be above the mean of other European countries. The aim of this multicenter prospective observational cohort study was to examine the risk factors that determine 90-day CDI recurrence in Catalonia, Spain. The study included 558 consecutive adults admitted to hospital who had a symptomatic, first positive CDI diagnosis.

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