Publications by authors named "Koulenti D"

The isolation of may be related to comorbidity, prolonged mechanical ventilation, and survival during intensive care unit (ICU) stay, especially with non-albicans (NAC). To examine the frequency of isolation, associated comorbidities and outcomes in the surgical ICU in Osijek University Hospital, Croatia, the data from the electronic database from May 2016 to 30 June 2023 were analyzed. In a cross-sectional study examining 15,790 microbiological samples, different strains of were observed in 581 samples from 236 patients.

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  • The D-PRISM study investigated global practices for diagnosing and treating pneumonia in ICU settings, focusing on community-acquired, hospital-acquired, and ventilator-associated pneumonia across different countries.
  • A survey gathered responses from 1,296 ICU clinicians across 72 countries, revealing varied diagnostic processes and a lack of standardized microbiological testing, particularly in lower-income regions.
  • Findings indicated that the typical antibiotic treatment duration was 5-7 days, with shorter durations linked to effective antimicrobial stewardship programs in higher-income countries.
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During the COVID-19 pandemic, changes occurred within the surgical patient population. An increase in the frequency of resistant Gram-negative bacteria has since been recorded worldwide. After the start of the COVID-19 pandemic, microbiological diagnostics in our institution was performed using MALDI-TOF mass spectrometry.

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  • The study analyzed intra-abdominal infections (IAI) in immunocompromised versus non-immunocompromised ICU patients using data from the "AbSeS" database, which included 2,589 patients across 309 ICUs in 42 countries.
  • Immunocompromised patients (9.2% of the cohort) showed different infection patterns, such as more frequent typhlitis and a higher incidence of healthcare-associated infections, but had similar mortality rates compared to immunocompetent patients (31.1% vs. 28.9%).
  • Key risk factors for mortality in immunocompromised patients included septic shock at presentation and ongoing inflammation after source control, indicating that despite presenting with more severe conditions
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  • Nosocomial pneumonia, particularly hospital-acquired and ventilator-associated forms, is the top killer from hospital infections in critically ill patients, significantly exacerbated by multi-drug-resistant (MDR) Gram-negative bacteria (GNB).
  • The rise of MDR-GNB pneumonia results in delayed treatments, longer hospital stays, and higher rates of illness and death, compounded by the toxic side effects of traditional antibiotics.
  • Recently approved novel antibiotics show promise in treating MDR-GNB pneumonia, but rising antibiotic resistance poses a global challenge, emphasizing the need for careful usage to extend their effectiveness and evaluating their clinical efficacy specifically for patients with nosocomial pneumonia.
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  • The COVID-19 pandemic resulted in a notable increase in invasive fungal infections among critically ill patients, leading to new diagnostic and treatment challenges.
  • This review specifically examines the rise of mold infections caused by certain species in COVID-19 patients, detailing their incidence, causes, and management.
  • The study emphasizes that traditional risk factors for these infections were often overlooked in COVID-19 cases, resulting in poorer outcomes for patients with these co-infections compared to those without.
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() is a difficult-to-treat (DTR) pathogen that causes ventilator-associated pneumonia (VAP) associated with high mortality. To improve the outcome of DTR A. VAP, nebulized colistin (NC) was introduced with promising but conflicting results on mortality in earlier studies.

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Chest trauma is one of the most serious and difficult injuries, with various complications that can lead to ventilation-perfusion (V/Q) mismatch and systemic hypoxia. We are presenting a case of a 53-year-old male with no chronic therapy who was admitted to the Intensive Care Unit due to severe respiratory failure after chest trauma. He developed a right-sided pneumothorax, and then a thoracic drain was placed.

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  • The classification system for intra-abdominal infections categorizes patients based on infection onset, peritonitis type, and disease severity, and has shown effective risk stratification in ICU settings.
  • A study focusing on 165 ICU patients with pancreatic infections found a mortality rate of 35.2%, with older age, localized peritonitis, and persistent inflammation as key risk factors.
  • Ultimately, the research indicates that ongoing inflammation and complications in managing pancreatic infections are critical for predicting short-term patient outcomes.
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  • Nosocomial pneumonia, which is a lung infection that people can get while in the hospital, leads to higher rates of sickness and death and costs a lot to treat, especially in ICUs (Intensive Care Units).
  • Most cases of this type of pneumonia happen in patients on ventilators, which helps them breathe.
  • The PneumoINSPIRE study is looking at how this pneumonia is diagnosed and treated in ICUs from over 20 countries to gather important information about it and improve future care.
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  • * Invasive infections are tied more to procedures like mechanical ventilation than to traditional risk factors seen in other patients, highlighting the unique challenges posed by COVID-19.
  • * The review emphasizes the concerning rise in fluconazole-resistant fungal strains and how these co-infections significantly worsen patient outcomes, increasing morbidity and mortality rates.
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Purpose Of Review: This article aims to review the epidemiology of nonfermenting Gram-negative bacilli (NFGNB) based on recent literature reports, particularly, of the less common, but with emerging clinical significance species.

Recent Findings: The reported frequency of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa is increasing, with very significant variability, however, between different countries. Apart from the major NFGNB, that is, A.

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Sepsis, defined as the life-threatening dysregulated host response to an infection leading to organ dysfunction, is considered as one of the leading causes of mortality worldwide, especially in intensive care units (ICU). Moreover, sepsis remains an enigmatic clinical syndrome, with complex pathophysiology incompletely understood and a great heterogeneity both in terms of clinical expression, patient response to currently available therapeutic interventions and outcomes. This heterogeneity proves to be a major obstacle in our quest to deliver improved treatment in septic critical care patients; thus, identification of clinical phenotypes is absolutely necessary.

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Purpose Of Review: In the absence of histopathological proof, the diagnosis of invasive pulmonary aspergillosis (IPA) is usually based on mycology (not on tissue), medical imaging, and the patient's risk profile for acquiring invasive fungal disease. Here, we review the changes in risk profile for IPA that took place over the past decades.

Recent Findings: In the early 2000s IPA was considered exclusively a disease of immunocompromised patients.

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The coronavirus disease (COVID-19) pandemic increased the incidence of severe infections caused by multidrug-resistant (MDR) pathogens among critically ill patients, such as (AB), whose bloodstream infections (BSIs) have been associated with significant mortality. Whether there is any difference in outcome between COVID-19 and non-COVID-19 patients with AB BSI still remains unknown. We conducted a retrospective study comparing clinical characteristics and outcomes of COVID-19 versus non-COVID-19 critically ill patients with AB BSI.

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VAP due to multidrug-resistant (MDR) bacteria is a frequent infection among patients in ICUs. Patient characteristics and mortality in mono- and polybacterial cases of VAP may differ. A single-centre, retrospective 3-year study was conducted in the four ICUs of a Lithuanian referral university hospital, aiming to compare both the clinical features and the 60-day ICU all-cause mortality of monobacterial and polybacterial MDR spp.

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  • Gram-negative bacteria have increasingly shown resistance to antimicrobials over recent decades, posing significant challenges in hospital settings worldwide.
  • In response, researchers and the pharmaceutical industry have introduced several new antimicrobials in the last five years, including cefiderocol and omadacycline, which are designed to tackle resistant bacterial strains.
  • The review examines the properties and clinical data of these new drugs, as well as other promising agents currently in advanced phase 3 clinical trials, like aztreonam-avibactam and sulopenem.
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Purpose: We aimed to determine whether interferon gamma-1b prevents hospital-acquired pneumonia in mechanically ventilated patients.

Methods: In a multicenter, placebo-controlled, randomized trial conducted in 11 European hospitals, we randomly assigned critically ill adults, with one or more acute organ failures, under mechanical ventilation to receive interferon gamma-1b (100 µg every 48 h from day 1 to 9) or placebo (following the same regimen). The primary outcome was a composite of hospital-acquired pneumonia or all-cause mortality on day 28.

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  • Ventilator-associated pneumonia from Pseudomonas aeruginosa in hospitalized patients leads to high mortality, prompting the testing of the bispecific monoclonal antibody MEDI3902 (gremubamab) to prevent this condition in patients who are colonized with the bacteria.
  • The EVADE study (NCT02696902) was a double-blind, placebo-controlled trial that recruited mechanically ventilated adults colonized with Pseudomonas aeruginosa and randomized them to receive either MEDI3902 or a placebo, focusing on the incidence of pneumonia over 21 days post-treatment.
  • Results showed no significant difference in the incidence of pneumonia between the MEDI3902 and placebo groups, with 22.4
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Rationale: Septic patients admitted to the intensive care unit (ICU) suffer from immune dysregulation, potentially leading to a secondary sepsis episode. This study aims to (i) assess the secondary sepsis rate, (ii) compare the second with the first episodes in terms of demographics, clinical and laboratory characteristics, and outcomes, and iii) evaluate the outcome of secondary sepsis.

Methods: A single-center, retrospective study (2014-2017) was conducted in a Greek ICU, including consecutive cases of adult patients admitted to the ICU for at least 48 h with a principal admission diagnosis of sepsis and stayed for at least 48 h.

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Purpose: To describe data on epidemiology, microbiology, clinical characteristics and outcome of adult patients admitted in the intensive care unit (ICU) with secondary peritonitis, with special emphasis on antimicrobial therapy and source control.

Methods: Post hoc analysis of a multicenter observational study (Abdominal Sepsis Study, AbSeS) including 2621 adult ICU patients with intra-abdominal infection in 306 ICUs from 42 countries. Time-till-source control intervention was calculated as from time of diagnosis and classified into 'emergency' (< 2 h), 'urgent' (2-6 h), and 'delayed' (> 6 h).

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