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Article ; Online: Streptococcus pneumoniae coinfection in hospitalised patients with COVID-19.

Anton-Vazquez, Vanesa / Clivillé, Raquel

European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology

2021 Volume 40, Issue 6, Page(s) 1353–1355

MeSH term(s)	Adenosine Monophosphate/analogs & derivatives ; Adenosine Monophosphate/therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Alanine/analogs & derivatives ; Alanine/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; Antiviral Agents/therapeutic use ; Azithromycin/therapeutic use ; COVID-19/drug therapy ; COVID-19/epidemiology ; COVID-19/pathology ; COVID-19 Testing/methods ; Ceftriaxone/therapeutic use ; Coinfection/epidemiology ; Coinfection/pathology ; Dexamethasone/therapeutic use ; Female ; Humans ; Hydroxychloroquine/therapeutic use ; Male ; Middle Aged ; Pneumococcal Infections/drug therapy ; Pneumococcal Infections/epidemiology ; Pneumococcal Infections/pathology ; SARS-CoV-2/isolation & purification ; Streptococcus pneumoniae/isolation & purification
Chemical Substances	Anti-Bacterial Agents ; Anti-Inflammatory Agents ; Antiviral Agents ; remdesivir (3QKI37EEHE) ; Adenosine Monophosphate (415SHH325A) ; Hydroxychloroquine (4QWG6N8QKH) ; Ceftriaxone (75J73V1629) ; Dexamethasone (7S5I7G3JQL) ; Azithromycin (83905-01-5) ; Alanine (OF5P57N2ZX)
Language	English
Publishing date	2021-01-19
Publishing country	Germany
Document type	Letter
ZDB-ID	603155-9
ISSN	1435-4373 ; 0934-9723 ; 0722-2211
ISSN (online)	1435-4373
ISSN	0934-9723 ; 0722-2211
DOI	10.1007/s10096-021-04166-w
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Zs.A 1732: Show issues

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Article ; Online: Gram-negative blood stream infections: prospects and challenges of rapid antimicrobial susceptibility testing.

Anton-Vazquez, Vanesa / Planche, Timothy

Expert review of anti-infective therapy

2021 Volume 20, Issue 4, Page(s) 483–485

MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents/pharmacology ; Bacteremia/drug therapy ; Gram-Negative Bacteria ; Gram-Negative Bacterial Infections/drug therapy ; Humans ; Microbial Sensitivity Tests
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents
Language	English
Publishing date	2021-11-02
Publishing country	England
Document type	Editorial
ZDB-ID	2181279-2
ISSN	1744-8336 ; 1478-7210
ISSN (online)	1744-8336
ISSN	1478-7210
DOI	10.1080/14787210.2022.1999805
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Zs.A 6106: Show issues

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Article ; Online: Impact of rapid susceptibility testing on antimicrobial therapy and clinical outcomes in Gram-negative bloodstream infections.

Anton-Vazquez, Vanesa / Suarez, Cristina / Planche, Timothy

The Journal of antimicrobial chemotherapy

2022 Volume 77, Issue 3, Page(s) 771–781

Abstract: Background: Rapid antimicrobial susceptibility testing (rAST) has the potential to improve care of bloodstream infections.: Objectives: The aim of this service evaluation was to assess the impact of rAST on antimicrobial therapy and clinical outcomes ...

Abstract	Background: Rapid antimicrobial susceptibility testing (rAST) has the potential to improve care of bloodstream infections. Objectives: The aim of this service evaluation was to assess the impact of rAST on antimicrobial therapy and clinical outcomes in patients with Gram-negative bloodstream infection. Methods: A prospective service evaluation was conducted from March 2018 to December 2018. A rAST system (Alfred 60AST) was run Monday-Friday before midday and results were communicated to clinicians on the same day as positive blood culture, with subsequent conventional AST performed. Times to antibiotic therapy and clinical outcomes were compared between rAST and conventional AST. Results: One hundred and ninety-one patients with Gram-negative bacteraemia were included (93 in the rapid group and 98 in the conventional group). Aminoglycoside combination therapy was stopped earlier in the rapid group [32 h (0-795) versus 54 h (4-216), P = 0.002]. The median time to optimal antibiotic based on AST results was significantly shorter than that in the conventional group [50 h (10-339) versus 69.5 h (20-872), P = 0.034]. In the subgroup of patients on ineffective empirical antibiotic, time to effective antibiotic was shorter in the rapid group [39.5 h (32-97) versus 57 h (49-83), P = 0.036]. No differences were found in 28 day mortality or length of stay. Conclusions: Rapid susceptibility testing resulted in faster discontinuation of aminoglycosides and a shorter time to starting effective and optimal antibiotic when compared with conventional AST results. rAST has potential clinical benefits and points to the need for larger future studies in areas of high antibiotic resistance.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents ; Humans ; Microbial Sensitivity Tests ; Prospective Studies ; Sepsis/drug therapy
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents
Language	English
Publishing date	2022-01-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	191709-2
ISSN	1460-2091 ; 0305-7453
ISSN (online)	1460-2091
ISSN	0305-7453
DOI	10.1093/jac/dkab449
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Zs.A 1197: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Reactivation of

Feria, Lucia / Torrado, Missia / Anton-Vazquez, Vanesa

Medicina clinica (English ed.)

2022 Volume 158, Issue 5, Page(s) 242–243

Language	English
Publishing date	2022-01-14
Publishing country	Spain
Document type	Journal Article
ISSN	2387-0206
ISSN (online)	2387-0206
DOI	10.1016/j.medcle.2021.05.011
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Article ; Online: Reactivación de Strongyloides stercoralis en pacientes con neumonía por SARS-CoV-2 en tratamiento con dexametasona.

Feria, Lucia / Torrado, Missia / Anton-Vazquez, Vanesa

Medicina clinica

2021 Volume 158, Issue 5, Page(s) 242–243

Title translation	Reactivation of Strongyloides stercoralis in patients with SARS-CoV-2 pneumonia receiving dexamethasone.
MeSH term(s)	Animals ; Dexamethasone/adverse effects ; Humans ; Pneumonia ; SARS-CoV-2 ; Strongyloides stercoralis ; Strongyloidiasis/diagnosis ; Strongyloidiasis/drug therapy ; COVID-19 Drug Treatment
Chemical Substances	Dexamethasone (7S5I7G3JQL)
Language	Spanish
Publishing date	2021-05-27
Publishing country	Spain
Document type	Letter
ZDB-ID	411607-0
ISSN	1578-8989 ; 0025-7753
ISSN (online)	1578-8989
ISSN	0025-7753
DOI	10.1016/j.medcli.2021.05.004
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Article ; Online: COVID-19 cardiac injury and the use of colchicine.

Anton-Vazquez, Vanesa / Byrne, Laura / Anderson, Lisa / Hamzah, Lisa

BMJ case reports

2021 Volume 14, Issue 2

Abstract: We report a case of cardiac injury in a 46-year-old man affected by COVID-19. The patient presented with shortness of breath and fever. ECG revealed sinus tachycardia with ventricular extrasystoles and T-wave inversion in anterior leads. Troponin T and N- ...

Abstract	We report a case of cardiac injury in a 46-year-old man affected by COVID-19. The patient presented with shortness of breath and fever. ECG revealed sinus tachycardia with ventricular extrasystoles and T-wave inversion in anterior leads. Troponin T and N-terminal pro B-type natriuretic peptide were elevated. Transthoracic echocardiography showed severely reduced systolic function with an estimated left ventricle ejection fraction of 30%. A nasopharingeal swab was positive for SARS-CoV-2. On day 6, 11 days after onset of symptoms, the patient deteriorated clinically with new chest pain and type 1 respiratory failure. Treatment with colchicine 0.5 mg 8-hourly resulted in rapid clinical resolution. This case report highlights how cardiac injury can dominate the clinical picture in COVID-19 infection. The role of colchicine therapy should be further studied to determine its usefulness in reducing myocardial and possibly lung parenchymal inflammatory responses.
MeSH term(s)	COVID-19/complications ; COVID-19/drug therapy ; Chest Pain/virology ; Colchicine/therapeutic use ; Echocardiography ; Heart Diseases/drug therapy ; Heart Diseases/virology ; Humans ; Male ; Middle Aged ; Myocardium/pathology ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Systole ; Troponin T/blood
Chemical Substances	Peptide Fragments ; Troponin T ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0) ; Colchicine (SML2Y3J35T)
Language	English
Publishing date	2021-02-23
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2020-241047
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Article ; Online: Impact of penicillin allergy records on antimicrobial prescribing in hospitalised patients.

Anton-Vazquez, Vanesa / Ferretti, Francesca / Kaya, Deniz / Mishra, Shashwat / Kerneis, Sven / Eden, Charlotte / Doan, Hong / Leung, Hiu Fung / Baltazar, Jeanelli / Starkey, Sarah / Uwagwu, Juliet / Dall'Antonia, Martino / Cepeda, Jorge

Clinical medicine (London, England)

2024 Volume 24, Issue 2, Page(s) 100024

Abstract: Background: The overdiagnosis of penicillin allergy and misclassification of non-truly allergic reactions is a growing public health problem, associated with the overuse of broad-spectrum and restricted antimicrobials. We aimed to evaluate the impact of ...

Abstract	Background: The overdiagnosis of penicillin allergy and misclassification of non-truly allergic reactions is a growing public health problem, associated with the overuse of broad-spectrum and restricted antimicrobials. We aimed to evaluate the impact of penicillin allergy status on antimicrobial prescribing. Methods: A retrospective study of inpatients with a documented penicillin allergy receiving antimicrobials was conducted from 1 April to 1 July 2021. Antimicrobial prescribing and clinical characteristics were compared between patients with an active penicillin allergy label and those whose label was removed following antimicrobial stewardship team review. Antimicrobials were classified in two categories: i) 'Access' (recommended), ii) 'Watch and Reserve' (restricted) according to WHO AWaRe classification, a tool to guide appropriate antibiotic use. Results: 437 patients with a documented penicillin allergy receiving antimicrobials were included. 353 patients with an active penicillin allergy label, more frequently received antimicrobials from the 'Watch and Reserve list' (283;80% vs 30;37%; p<0.001). In contrast, 84 patients who were de-labelled received more often antimicrobials from the 'Access list' (53;63% vs 64;18%; p<0.001). Conclusions: Penicillin allergy reviews and de-labelling strategies may reduce the use of restricted antimicrobials under the 'Watch and Reserve list'. This practice should be encouraged and reinforced in all hospitals.
Language	English
Publishing date	2024-02-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2048646-7
ISSN	1473-4893 ; 1470-2118
ISSN (online)	1473-4893
ISSN	1470-2118
DOI	10.1016/j.clinme.2024.100024
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Zs.A 5439: Show issues

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Article ; Online: Rapid versus standard antimicrobial susceptibility testing to guide treatment of bloodstream infection.

Anton-Vazquez, Vanesa / Hine, Paul / Krishna, Sanjeev / Chaplin, Marty / Planche, Timothy

The Cochrane database of systematic reviews

2021 Volume 5, Page(s) CD013235

Abstract: Background: Rapid antimicrobial susceptibility tests are expected to reduce the time to clinically important results of a blood culture. This might enable clinicians to better target therapy to a person's needs, and thereby, improve health outcomes ( ... ...

Abstract	Background: Rapid antimicrobial susceptibility tests are expected to reduce the time to clinically important results of a blood culture. This might enable clinicians to better target therapy to a person's needs, and thereby, improve health outcomes (mortality, length of hospital stay), and reduce unnecessary prescribing of broad-spectrum antibiotics; thereby reducing antimicrobial resistance rates. Objectives: To assess the effects of rapid susceptibility testing versus standard susceptibility testing for bloodstream infections (BSIs). Search methods: To identify studies with selected outcomes, we searched the Cochrane Infectious Diseases Group Specialised Register, CENTRAL, MEDLINE, LILACS, and two trials registries, between 1987 and October 2020. We used 'bloodstream infection' and 'antimicrobial susceptibility tests' as search terms. We had no language or publication status limitations. Selection criteria: Randomized controlled trials (RCTs) comparing rapid antimicrobial susceptibility testing (with a time-to-result of ≤ 8 hours) versus conventional antimicrobial susceptibility testing in people with a BSI caused by any bacteria, as identified by a positive blood culture. Data collection and analysis: Two review authors independently screened references, full-text reports of potentially relevant studies, extracted data from the studies, and assessed risk of bias. Any disagreement was discussed and resolved with a third review author. For mortality, a dichotomous outcome, we extracted the number of events in each arm, and presented a risk ratio (RR) with 95% confidence interval (CI) to compare rapid susceptibility testing to conventional methods. We used Review Manager 5.4 to meta-analyse the data. For other outcomes, which are time-to-event outcomes (time-to-discharge from hospital, time-to-first appropriate antibiotic change), we conducted qualitative narrative synthesis, due to heterogeneity of outcome measures. MAIN RESULTS: We included six trials, with 1638 participants. For rapid antimicrobial susceptibility testing compared to conventional methods, there was little or no difference in mortality between groups (RR 1.10, 95% CI 0.82 to 1.46; 6 RCTs, 1638 participants; low-certainty evidence). In subgroup analysis, for rapid genotypic or molecular antimicrobial susceptibility testing compared to conventional methods, there was little or no difference in mortality between groups (RR 1.02, 95% CI 0.69 to 1.49; 4 RCTs, 1074 participants; low-certainty evidence). For phenotypic rapid susceptibility testing compared to conventional methods, there was little or no difference in mortality between groups (RR 1.37, 95% CI 0.80 to 2.35; 2 RCTs, 564 participants; low-certainty evidence). In qualitative analysis, rapid susceptibility testing may make little or no difference in time-to-discharge (4 RCTs, 1165 participants; low-certainty evidence). In qualitative analysis, rapid genotypic susceptibility testing compared to conventional testing may make little or no difference in time-to-appropriate antibiotic (3 RCTs, 929 participants; low-certainty evidence). In subgroup analysis, rapid phenotypic susceptibility testing compared to conventional testing may improve time-to-appropriate antibiotic (RR -17.29, CI -45.05 to 10.47; 2 RCTs, 564 participants; low-certainty evidence). AUTHORS' CONCLUSIONS: The theoretical benefits of rapid susceptibility testing have not been demonstrated to directly improve mortality, time-to-discharge, or time-to-appropriate antibiotic in these randomized studies. Future large prospective studies should be designed to focus on the most clinically meaningful outcomes, and aim to optimize blood culture pathways.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Bias ; Humans ; Microbial Sensitivity Tests/methods ; Odds Ratio ; Randomized Controlled Trials as Topic ; Sepsis/drug therapy ; Sepsis/microbiology ; Sepsis/mortality ; Time-to-Treatment
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2021-05-04
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ISSN	1469-493X
ISSN (online)	1469-493X
DOI	10.1002/14651858.CD013235.pub2
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Article ; Online: Drug reaction with eosinophilia and systemic symptoms related to antiretroviral treatment in human immunodeficiency virus patients.

Brandariz, David / Smithson, Alex / Anton-Vazquez, Vanesa

Indian journal of sexually transmitted diseases and AIDS

2018 Volume 38, Issue 2, Page(s) 163–170

Abstract: Background: The drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a life-threatening condition caused by different medications. The objective of this study was to analyze DRESS cases related to antiretroviral therapy in human ... ...

Abstract	Background: The drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a life-threatening condition caused by different medications. The objective of this study was to analyze DRESS cases related to antiretroviral therapy in human immunodeficiency virus (HIV) patients. Materials and methods: Systematic review of DRESS suspected cases in HIV patients associated to antiretrovirals published between January 1998 and April 2017. The registry of the severe cutaneous adverse reactions score was used to classify each report as a "definitive," "probable," "possible," or "no" DRESS case. Clinical characteristics, management, and outcomes were evaluated. Results: Thirty-five case reports were analyzed involving 5 antiretrovirals: Abacavir in 10 (28.6%) cases, efavirenz in 6 (17.1%), nevirapine in 12 (34.3%), raltegravir in 6 (17.1%), and tenofovir in 1 (2.9%). Mean age of the patients was 40 ± 13 years, 65% of which were male. A total of 57.1% reports were classified as having a "definitive-probable" DRESS case. Management was based on withdrawal of the causal antiretroviral and corticosteroids in 68.6% of the cases. None of the patients died. Treatment with nevirapine or raltegravir, the longer onset of symptoms and the presence of lymphadenopathy, eosinophilia, liver involvement, and a longer time for clinical resolution were more frequent among "definitive-probable" DRESS cases. Conclusions: A DRESS syndrome has to be suspected in HIV patients with lymphadenopathy, eosinophilia, and liver involvement developing weeks after the initiation of nevirapine or raltegravir. Suspension of the causal antiretroviral and in most cases treatment with corticosteroids allowed adequate clinical control.
Language	English
Publishing date	2018-06-07
Publishing country	India
Document type	Journal Article
ZDB-ID	2622183-4
ISSN	2589-0565 ; 2589-0565
ISSN (online)	2589-0565
ISSN	2589-0565
DOI	10.4103/ijstd.IJSTD_70_17
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Article ; Online: Evaluation of a new Rapid Antimicrobial Susceptibility system for Gram-negative and Gram-positive bloodstream infections: speed and accuracy of Alfred 60AST.

Anton-Vazquez, Vanesa / Adjepong, Samuel / Suarez, Cristina / Planche, Timothy

BMC microbiology

2019 Volume 19, Issue 1, Page(s) 268

Abstract: Background: Blood stream infections (BSIs) are a major cause of morbidity and mortality. The time from taking blood cultures to obtain results of antibiotic sensitivity can be up to five days which impacts patient care. The Alfred 60 AST™ can reduce ... ...

Abstract	Background: Blood stream infections (BSIs) are a major cause of morbidity and mortality. The time from taking blood cultures to obtain results of antibiotic sensitivity can be up to five days which impacts patient care. The Alfred 60 AST™ can reduce laboratory time from positive culture bottle to susceptibility results from 16 to 25 h to 5-6 h, transforming patient care. To evaluate the diagnostic accuracy of a rapid antimicrobial susceptibility system, the Alfred 60 AST™, in clinical isolates from patients with BSIs and confirm time to results. 301 Gram-negative and 86 Gram-positive isolates were analysed directly from positive blood culture bottles following Gram staining. Antimicrobial susceptibility results and time-to-results obtained by rapid Alfred 60 AST system and BD Phoenix were compared . Results: A total of 2196 antimicrobial susceptibility test results (AST) were performed: 1863 Gram-negative and 333 Gram-positive. AST categorical agreement (CA) for Alfred 60 AST™ was 95% (1772/1863) for Gram-negative and 89% (295/333) for Gram-positive isolates. Gram-negative CA: ampicillin 96% (290/301); ciprofloxacin 95% (283/297); ceftriaxone 96% (75/78); meropenem 97% (288/297); piperacillin-tazobactam 95% (280/295); gentamicin 94% (279/297) and amikacin 93% (277/298). The median time to susceptibility results from blood culture flagging positive was 6.3 h vs 20 h (p < 0.01) for Alfred system vs BD Phoenix™. Conclusion: Alfred 60 AST system greatly reduced time to antimicrobial susceptibility results in Gram-negative and Gram-positive BSIs with good performance and cost, particularly for Gram-negative bacteraemia.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Automation, Laboratory/instrumentation ; Automation, Laboratory/methods ; Bacteremia/diagnosis ; Bacteremia/microbiology ; Blood Culture/methods ; Clinical Laboratory Techniques/instrumentation ; Clinical Laboratory Techniques/methods ; Gram-Negative Bacteria/drug effects ; Gram-Negative Bacterial Infections/diagnosis ; Gram-Negative Bacterial Infections/microbiology ; Gram-Positive Bacteria/drug effects ; Gram-Positive Bacterial Infections/diagnosis ; Gram-Positive Bacterial Infections/microbiology ; Humans ; Microbial Sensitivity Tests ; Prospective Studies ; Reproducibility of Results ; Time Factors
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2019-11-29
Publishing country	England
Document type	Evaluation Study ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1471-2180
ISSN (online)	1471-2180
DOI	10.1186/s12866-019-1654-9
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