Publications by authors named "Maria C Farinas"

Article Synopsis
  • The study investigates the genetic factors linked to severe COVID-19, specifically focusing on hospitalized cases in admixed Americans.
  • Researchers conducted the largest genome-wide association study (GWAS) for COVID-19 hospitalization in this population, identifying four significant genetic associations, including two novel loci found in Latin Americans.
  • The findings highlight the importance of including diverse populations in genomic research, aiming to improve understanding of genetic risks associated with COVID-19 across different ethnic groups.
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  • * A working group has developed new consensus recommendations for CMV management in SOT recipients, integrating recent advancements in cell-mediated immunity monitoring.
  • * These recommendations were rated for their evidence strength and quality using the GRADE system and were formally endorsed by a consensus meeting of experts.
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  • A study analyzed data from 5667 patients diagnosed with infective endocarditis (IE) across 46 hospitals in Spain from 2008 to 2021, finding that only 1.7% were HIV-infected.
  • HIV-infected patients tended to be younger, predominantly male, and had specific features like higher rates of tricuspid location and community-acquired infections, but fewer surgical interventions.
  • Despite these differences, the study concluded that HIV status did not significantly affect in-hospital or one-year mortality rates for patients with IE.
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  • The study tracks the emergence of resistance to ceftazidime-avibactam in a type of antibiotic-resistant bacteria (GES-type carbapenemases) during an unusual outbreak of Serratia marcescens in Spain during COVID-19.* ! -
  • Researchers conducted a retrospective analysis using whole genome sequencing to understand the relationships between bacterial samples from patients and their environment, discovering a genetic connection and plasmid transfer related to resistance.* ! -
  • Key findings include the appearance of a mutation that facilitated the development of resistance to ceftazidime-avibactam, highlighting the urgent need for improved diagnostic tools and better antimicrobial usage strategies to combat such outbreaks.* !
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Antimicrobial resistance poses a significant challenge in modern medicine, affecting public health. Klebsiella pneumoniae infections compound this issue due to their broad range of infections and the emergence of multiple antibiotic resistance mechanisms. Efficient detection of its capsular serotypes is crucial for immediate patient treatment, epidemiological tracking and outbreak containment.

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  • Isavuconazole (ISA) and voriconazole (VORI) are both recommended first-line treatments for invasive aspergillosis, but there hasn't been a direct comparison in solid organ transplant recipients.
  • A study analyzed data from two cohorts of patients treated with either ISA or VORI, focusing on clinical response, mortality rates, adverse events, and treatment discontinuation after 12 weeks.
  • Results showed no significant difference in clinical outcomes between ISA and VORI, but ISA had fewer adverse events and lower rates of treatment discontinuation, indicating better tolerability.
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  • The study investigates the effectiveness and safety of combining beta-lactam and aminoglycoside (C-BA) treatments versus using third-generation cephalosporin alone for endocarditis caused by viridans and gallolyticus group streptococci (VGS-GGS) with penicillin intermediate susceptibility.
  • A retrospective analysis of 914 endocarditis cases from 40 Spanish hospitals found that 75.3% were penicillin-susceptible and 24.7% had intermediate susceptibility, with C-BA used in 54.6% of cases.
  • The results indicate that cephalosporin monotherapy is effective and associated with lower rates of nephrotoxicity, as it
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We aimed to compare the efficacy of ceftazidime-avibactam (CAZ-AVI) versus the best available therapy (BAT) in solid organ transplant (SOT) recipients with bloodstream infection caused by carbapenemase-producing Klebsiella pneumoniae (CPKP-BSI). A retrospective (2016-2021) observational cohort study was performed in 14 INCREMENT-SOT centers (ClinicalTrials.gov identifier: NCT02852902; Impact of Specific Antimicrobials and MIC Values on the Outcome of Bloodstream Infections Due to ESBL- or Carbapenemase-producing Enterobacterales in Solid Organ Transplantation: an Observational Multinational Study).

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  • Heart transplantation (HT) can be a last resort for patients with severe infective endocarditis (IE) and significant heart issues, as shown in a study involving 20 patients across several countries from 1991 to 2021.
  • The study found that the average age of these patients was 50, with a mix of native and prosthetic valve infections primarily affecting aortic and mitral valves; patients experienced major complications like heart failure and abscesses.
  • Despite a 35% mortality rate, particularly in the first month post-transplant, most patients who survived the hospital stay did well after 35.5 months of follow-up, indicating that HT can be a viable option for select individuals with persistent IE.
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One of the problems that most affect hospitals is infections by pathogenic microorganisms. Rapid identification and adequate, timely treatment can avoid fatal consequences and the development of antibiotic resistance, so it is crucial to use fast, reliable, and not too laborious techniques to obtain quick results. Raman spectroscopy has proven to be a powerful tool for molecular analysis, meeting these requirements better than traditional techniques.

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  • The study investigates the role of genetic polymorphisms in the innate immune system that may increase the risk of cytomegalovirus (CMV) infection in transplant patients, particularly those receiving organs from CMV-positive donors.
  • A total of 116 CMV-seronegative transplant recipients were monitored for CMV infection post-surgery, with notable findings that 53% experienced some level of infection, including asymptomatic and symptomatic cases.
  • A polygenic score based on specific genetic markers was developed to predict the risk of CMV disease, showing moderate effectiveness (AUC of 0.68), emphasizing the need for additional validation studies to enhance predictive models for at-risk transplant recipients.
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Background: Risk factors for nontuberculous mycobacteria (NTM) infections after solid organ transplant (SOT) are not well characterized. Here we aimed to describe these factors.

Methods: Retrospective, multinational, 1:2 matched case-control study that included SOT recipients ≥12 years old diagnosed with NTM infection from 1 January 2008 to 31 December 2018.

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  • * Vaccines have helped reduce severity, but many patients remain vulnerable due to ineffective immune responses, highlighting the need for deeper understanding of how the immune system reacts to the virus.
  • * This study identifies Neddylation, a process that modifies proteins, as a critical factor in controlling the immune response to SARS-CoV-2, showing increased neddylation levels in COVID-19 patients and suggesting potential therapeutic approaches to modulate the immune response.
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Cytomegalovirus (CMV) reactivation is an important cause of complications after hematopoietic stem cell transplantation (HSCT). Discrepancies between serologic and cellular CMV-specific immune response have been reported. This study evaluated the impact of lack of CMV-specific CD8 T cell response in seropositive donors (ie, discordant donors) on the reconstitution of CMV-specific cell-mediated immunity (CMI) after related HSCT in seropositive recipients.

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Article Synopsis
  • Ceftazidime/avibactam has shown potential as an effective treatment for infections caused by carbapenemase-producing Enterobacterales (CPE), particularly for patients with higher INCREMENT-CPE scores.
  • In a study of 339 patients, those treated with ceftazidime/avibactam had lower mortality rates compared to those receiving the best available therapy after 30 days.
  • The results suggest that ceftazidime/avibactam not only improves survival but also aids in achieving better clinical and microbiological outcomes, indicating the need for further randomized controlled trials to validate these findings.
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Objectives: (1) To describe the incidence, clinical characteristics, treatment and outcome of Aspergillus Endocarditis (AE) in a nationwide multicentric cohort (GAMES). (2) To compare the AE cases of the GAMES cohort, with the AE cases reported in the literature since 2010. (3) To identify variables related to mortality.

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  • This document is a collaborative effort by three Spanish medical organizations focused on addressing sternal wound infections following surgery.
  • A diverse group of specialists, including surgeons, microbiologists, and internal medicine doctors, has come together to formulate this consensus.
  • The aim is to create evidence-based guidelines for preventing, diagnosing, and managing post-surgical mediastinitis, ultimately improving patient care and outcomes.
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  • The study investigates healthcare-associated (HCA) bacteremic urinary tract infections (BUTI), comparing community-onset (CO-HCA) and hospital-acquired (HA) cases, particularly focusing on multidrug resistance (MDR) and outcomes.
  • Conducted as a multicenter cohort study, it involved adult patients with specific inclusion and exclusion criteria, looking at factors like mortality and treatment appropriateness.
  • Results showed a high prevalence of MDR (61.2%) among patients, with CO-HCA-BUTI patients generally older and sicker than those with HA-BUTI; however, mortality rates were not influenced by infection acquisition site or MDR presence.
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  • During the COVID-19 pandemic, researchers studied various immune system components to identify biomarkers that could predict disease severity in patients infected with SARS-CoV-2.
  • The study involved 155 patients who were classified into mild or severe cases based on their need for oxygen therapy, revealing that severe cases were associated with older age and higher levels of several inflammatory markers.
  • A predictive model created from factors like age, ferritin, and lymphocyte counts demonstrated an ability to predict severe disease with an accuracy of 78%, suggesting that certain immune parameters may serve as potential prognostic indicators for COVID-19.
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  • - The study assessed the effectiveness of ertapenem vs. meropenem in treating bacteremia caused by ESBL-producing bacteria in kidney transplant recipients, using a large cohort from 29 international centers.
  • - Among the 201 patients, clinical cure rates at day 14 were similar: 45% for ertapenem and 50.5% for meropenem, indicating that both treatments are comparable in effectiveness.
  • - Additionally, over 49% of patients treated with ertapenem showed better outcomes when considering factors like hospital stay and cost, suggesting that ertapenem might offer some advantages over meropenem in this context.
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The objective of this study was to analyse the mechanisms of resistance to carbapenems and other extended-spectrum-β-lactams and to determine the genetic relatedness of multidrug-resistant Enterobacterales (MDR-E) causing colonization or infection in solid-organ transplantation (SOT) recipients. Prospective cohort study in kidney (n = 142), liver (n = 98) or kidney/pancreas (n = 7) transplant recipients between 2014 and 2018 in seven Spanish hospitals. We included 531 MDR-E isolates from rectal swabs obtained before transplantation and weekly for 4-6 weeks after the procedure and 10 MDR-E from clinical samples related to an infection.

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  • The study aimed to evaluate the effectiveness of the COVID-GRAM and CURB-65 scores in predicting the severity of COVID-19 in Caucasian patients.
  • A total of 523 patients were analyzed, revealing that a higher COVID-GRAM score significantly correlated with increased rates of critical illness and mortality compared to CURB-65 scores.
  • The findings suggest that the COVID-GRAM score is a reliable tool for assessing the risk of severe illness in these patients, with the CURB-65 score serving as a useful alternative.
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Background: The diagnosis of invasive aspergillosis (IA) can be problematic in solid organ transplantation (SOT). The prognosis greatly varies according to the type of transplant, and the impact of prophylaxis is not well defined.

Patients And Methods: The Diaspersot cohort analyses the impact of IA in SOT in Spain during the last 10 years.

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Article Synopsis
  • The study analyzed outcomes of solid organ transplant recipients (SOTRs) hospitalized with COVID-19 in Spain, focusing on factors linked to severe complications and death.
  • It involved 210 patients and found that males were predominant, with common symptoms like pneumonia, fever, and cough; various antiviral treatments were employed.
  • Key predictors for worse outcomes included older age, high respiratory rates, low lymphocyte counts, and high lactate dehydrogenase levels, emphasizing the need for preventive measures right after transplantation.
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  • * In SOT patients, there were notable findings such as a lower average age, more comorbidities, a higher incidence of healthcare-related IE, and a significant prevalence of Staphylococcus infections.
  • * Despite the increased complications, including kidney issues and septic shock, mortality rates for SOT patients were similar to those without SOT, suggesting that while SOT recipients have different challenges, the overall survival outcome is comparable.
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