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Article ; Online: Does selective digestive decontamination (SDD) increase antibiotic resistance? Long-term comparison of two intensive care units (with and without SDD) of the same tertiary hospital.

Rodríguez-Gascón, Alicia / Lloréns-Villar, Yanire / Solinís, María Ángeles / Barrasa, Helena / Canut-Blasco, Andrés

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

2024

Abstract: Purpose: The aim of this study was to to compare the antimicrobial resistance rate and its relationship with the antibiotic consumption in two separate Intensive Care Units (ICUs) of the same hospital, one with and other without selective ... ...

Abstract	Purpose: The aim of this study was to to compare the antimicrobial resistance rate and its relationship with the antibiotic consumption in two separate Intensive Care Units (ICUs) of the same hospital, one with and other without selective decontamination of the digestive tract (SDD). Methods: We performed a retrospective study in the two ICUs of the Araba University Hospital. Trauma and neurosurgical patients are admitted to the SDD-ICU, and general digestive surgery patients go to the no SDD-ICU. From 2014 to 2018 we analyzed the number of isolates, and the bacterial resistance trends of 47 antimicrobial-microorganism combinations. Additionally, antimicrobial consumption was estimated in both ICUs. Resistance rates were also compared with those reported in ENVIN-HELICS Spanish national registry. Results: In the ICU with SDD protocol, there was a significant decrease in the resistance of E. coli to amoxicillin/clavulanic acid and in the resistance of E. faecalis to high concentration of gentamycin and high concentration of streptomycin. A significant increase of resistance of Staphylococcus coagulasa negative (CoNS) to linezolid in the no SDD-ICU was also detected. Overall, the level of resistance in the SDD-ICU was lower or of the same order than in the ICU without SDD and that reported in the Spanish national registry. Conclusions: SDD had neither a clinically relevant impact on emergence and spread of resistance, nor in the overall systemic antimicrobial use. The patient type rather than the SDD protocol showed to condition the ecology and therefore, the resistance rate in the ICUs.
Language	English
Publishing date	2024-03-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	603155-9
ISSN	1435-4373 ; 0934-9723 ; 0722-2211
ISSN (online)	1435-4373
ISSN	0934-9723 ; 0722-2211
DOI	10.1007/s10096-024-04792-0
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Article ; Online: Gonococcal bacteremia: Report of two clinical cases linked with pharyngeal asymptomatic infection.

Aguirre-Quiñonero, Amaia / Alonso, Rodrigo / Marroyo-Salazar, Maitane / Canut-Blasco, Andrés

Enfermedades infecciosas y microbiologia clinica (English ed.)

2022 Volume 40, Issue 5, Page(s) 282–283

MeSH term(s)	Asymptomatic Infections ; Bacteremia/diagnosis ; Gonorrhea/complications ; Gonorrhea/diagnosis ; Gonorrhea/drug therapy ; Humans ; Neisseria gonorrhoeae ; Pharyngitis/etiology
Language	English
Publishing date	2022-05-14
Publishing country	Spain
Document type	Case Reports
ISSN	2529-993X
ISSN (online)	2529-993X
DOI	10.1016/j.eimce.2021.11.010
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Article ; Online: Ceftaroline and Avibactam Removal by Continuous Renal Replacement Therapies: An in vitro Study.

Alarcia-Lacalle, Ana / Barrasa, Helena / Maynar, Javier / Canut-Blasco, Andrés / Solinís, María Ángeles / Isla, Arantxa / Rodríguez-Gascón, Alicia

Blood purification

2023 Volume 52, Issue 5, Page(s) 464–473

Abstract: Introduction: Continuous renal replacement therapies (CRRTs) are frequently used in critically ill patients; however, there are scarce in vitro and in vivo studies showing the extracorporeal elimination of ceftaroline and avibactam. The aim of this ... ...

Abstract	Introduction: Continuous renal replacement therapies (CRRTs) are frequently used in critically ill patients; however, there are scarce in vitro and in vivo studies showing the extracorporeal elimination of ceftaroline and avibactam. The aim of this study was to assess, through an in vitro model, the extracorporeal elimination of ceftaroline and avibactam by continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodiafiltration (CVVHDF), and continuous veno-venous hemodialysis (CVVHD), using a polysulfone hemofilter. Methods: Simulated in vitro experiments were performed using a multiFiltrate machine with a 1.4 m2 Ultraflux® AV600S polysulfone hemofilter. Isofundin® without or with bovine serum albumin was circulated as vehicle for ceftaroline or avibactam. Pre-filter, post-filter, and effluent samples were taken over a period of 60 min, and they were immediately stored at 4°C until processed in the same day. The quantification of ceftaroline and avibactam in the samples was performed by high-performance liquid chromatography with ultraviolet detection. Protein binding, extraction coefficient (EC), and extracorporeal clearance (CLCRRT) were calculated. Results: The elimination of both ceftaroline and avibactam during the three extracorporeal modalities followed first-order pharmacokinetics. Regardless of the CRRT technique, EC values for both molecules were around 1, similar to the unbound fraction of avibactam (0.96) and higher than the unbound fraction of ceftaroline (0.79). CLCRRT of ceftaroline ranged from 15.63 to 17.66 mL/min when CVVH and CVVHD were used with a flow rate of 1,000 mL/h, and from 29.25 to 32.95 mL/min for the CVVHDF modality with a flow rate of 2,000 mL/h. For avibactam, CLCRRT ranged from 15.07 to 18.82 mL/min for CVVH and CVVHD, and from 33.74 to 34.13 mL/min for CVVHDF. Discussion: Avibactam and ceftaroline are extensively removed through the polysulfone membrane, and a dose adjustment may be recommended for patients under CRRT to ensure pharmacodynamic target achievement.
MeSH term(s)	Humans ; Continuous Renal Replacement Therapy ; Hemofiltration/methods ; Renal Dialysis ; Ceftaroline
Chemical Substances	polysulfone P 1700 (25135-51-7) ; avibactam (7352665165)
Language	English
Publishing date	2023-03-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	605548-5
ISSN	1421-9735 ; 0253-5068
ISSN (online)	1421-9735
ISSN	0253-5068
DOI	10.1159/000529264
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Article ; Online: Are oral cefuroxime axetil, cefixime and cefditoren pivoxil adequate to treat uncomplicated acute pyelonephritis after switching from intravenous therapy? A pharmacokinetic/pharmacodynamic perspective.

Rodríguez-Gascón, Alicia / Aguirre-Quiñonero, Amaia / Canut-Blasco, Andrés

Enfermedades infecciosas y microbiologia clinica (English ed.)

2020 Volume 38, Issue 7, Page(s) 306–311

Abstract: Objectives: The goal of this study is to assess, by means of pharmacokinetic/pharmacodynamic (PK/PD) analysis using the Monte Carlo simulation, the adequacy of oral cephalosporins cefuroxime axetil, cefixime and cefditoren at different dosing regimens ... ...

Abstract	Objectives: The goal of this study is to assess, by means of pharmacokinetic/pharmacodynamic (PK/PD) analysis using the Monte Carlo simulation, the adequacy of oral cephalosporins cefuroxime axetil, cefixime and cefditoren at different dosing regimens as switch therapy after intravenous cephalosporin treatment in uncomplicated acute pyelonephritis. Methods: The methodology included: (i) dosing regimen selection and acquisition of pharmacokinetic data; (ii) microbiological data acquisition; and (iii) Monte Carlo simulation to estimate the PTA (probability of PK/PD target attainment) and CFR (cumulative fraction of response), as indicators of treatment success. Results: At the current susceptibility breakpoints defined by EUCAST and CLSI for either cefuroxime axetil or cefixime, the probability of bactericidal target attainment is zero for the dosage regimens simulated. Considering the bactericidal target %fT Conclusions: The results of the PK/PD target attainment analysis reveal that the likelihood of treatment success based upon the current breakpoints proposed by either EUCAST or CLSI is low. Of the three cephalosporins, cefixime 400mg q12h prove to be the best option in oral APN treatment, although this regimen is currently off label.
MeSH term(s)	Administration, Intravenous ; Administration, Oral ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/therapeutic use ; Cefixime/administration & dosage ; Cefixime/therapeutic use ; Cefuroxime/administration & dosage ; Cefuroxime/analogs & derivatives ; Cefuroxime/therapeutic use ; Cephalosporins/administration & dosage ; Cephalosporins/therapeutic use ; Humans ; Pyelonephritis/drug therapy
Chemical Substances	Anti-Bacterial Agents ; Cephalosporins ; cefditoren pivoxil (78THA212DH) ; Cefixime (97I1C92E55) ; Cefuroxime (O1R9FJ93ED) ; cefuroxime axetil (Z49QDT0J8Z)
Language	Spanish
Publishing date	2020-02-19
Document type	Journal Article
ISSN	2529-993X
ISSN (online)	2529-993X
DOI	10.1016/j.eimc.2019.12.017
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Article: Pharmacokinetic/Pharmacodynamic Analysis of Tedizolid Phosphate Compared to Linezolid for the Treatment of Infections Caused by Gram-Positive Bacteria.

Rodríguez-Gascón, Alicia / Aguirre-Quiñonero, Amaia / Aspiazu, María Angeles Solinís / Canut-Blasco, Andrés

Antibiotics (Basel, Switzerland)

2021 Volume 10, Issue 7

Abstract: Tedizolid and linezolid have antibacterial activity against the most important acute bacterial skin and skin-structure infection (ABSSSIs) pathogens. The objective of this work was to apply PK/PD analysis to evaluate the probability of attaining the ... ...

Abstract	Tedizolid and linezolid have antibacterial activity against the most important acute bacterial skin and skin-structure infection (ABSSSIs) pathogens. The objective of this work was to apply PK/PD analysis to evaluate the probability of attaining the pharmacodynamic target of these antimicrobials based on the susceptibility patterns of different clinical isolates causing ABSSSI. Pharmacokinetic and microbiological data were obtained from the literature. PK/PD breakpoints, the probability of target attainment (PTA) and the cumulative fraction of response (CFR) were calculated by Monte Carlo simulation. PTA and CFR are indicative of treatment success. PK/PD breakpoints of tedizolid and linezolid were 0.5 and 1 mg/L, respectively. Probability of treatment success of tedizolid was very high (>90%) for most staphylococci strains, including MRSA and coagulase-negative staphylococci (CoNS). Only for methicillin- and linezolid-resistant
Language	English
Publishing date	2021-06-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics10070755
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Article ; Online: Evaluation of the adequacy of the antimicrobial therapy of invasive Haemophilus influenzae infections: A pharmacokinetic/pharmacodynamic perspective.

Ibar-Bariain, Maitane / Rodríguez-Gascón, Alicia / Isla, Arantxa / Solinís, María Ángeles / Canut-Blasco, Andrés

Enfermedades infecciosas y microbiologia clinica (English ed.)

2020 Volume 39, Issue 2, Page(s) 65–71

Abstract: Introduction: In Europe, non-typeable H. influenzae (NTHi) is the leading cause of invasive H. influenzae disease in adults and is associated with high mortality. The goal of this study was to determine whether current antimicrobial treatments for H. ... ...

Abstract	Introduction: In Europe, non-typeable H. influenzae (NTHi) is the leading cause of invasive H. influenzae disease in adults and is associated with high mortality. The goal of this study was to determine whether current antimicrobial treatments for H. influenzae infection in Spain are suitable based on their probability of achieving pharmacokinetic/pharmacodynamic (PK/PD) targets. Methods: Pharmacokinetic parameters for the antibiotics studied (amoxicillin, amoxicillin/clavulanic acid, ampicillin, cefotaxime, ceftriaxone, imipenem and ciprofloxacin) and susceptibility data for H. influenzae were obtained from literature. A Monte Carlo simulation was used to estimate the probability of target attainment (PTA), defined as the probability that at least a specific value of a PK/PD index is achieved at a certain MIC, and the cumulative fraction of response (CFR), defined as the expected population PTA for a specific drug dose and a specific microorganism population. Results: Regardless of dosing regimen, all antibiotics yielded CFR values of 100% or nearly 100% for all strains, including BL+, BL- and BLNAR, except amoxicillin and ampicillin for BL+. Thus, if an infection is caused by BL+ strains, treatment with amoxicillin and ampicillin has a high probability of failure (CFR≤8%). For standard doses of amoxicillin, amoxicillin/clavulanic acid and imipenem, PK/PD breakpoints were consistent with EUCAST clinical breakpoints. For the other antimicrobials, PK/PD breakpoints were higher than EUCAST clinical breakpoints. Conclusions: Our study confirms by PK/PD analysis that, with the antimicrobials used as empirical treatment of invasive H. influenzae disease, a high probability of therapeutic success can be expected.
MeSH term(s)	Adult ; Anti-Bacterial Agents/therapeutic use ; Haemophilus Infections/drug therapy ; Haemophilus influenzae ; Humans ; Microbial Sensitivity Tests ; Respiratory Tract Infections
Chemical Substances	Anti-Bacterial Agents
Language	Spanish
Publishing date	2020-07-04
Document type	Journal Article
ISSN	2529-993X
ISSN (online)	2529-993X
DOI	10.1016/j.eimc.2020.05.025
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Article ; Online: High rate of infections during ICU admission of patients with severe SARS-CoV-2 pneumonia: A matter of time?

Barrasa, Helena / Martín, Alejandro / Maynar, Javier / Rello, Jordi / Fernández-Torres, Marina / Aguirre-Quiñonero, Amaia / Canut-Blasco, Andrés

The Journal of infection

2020 Volume 82, Issue 5, Page(s) 186–230

MeSH term(s)	COVID-19 ; Hospitalization ; Humans ; Intensive Care Units ; Pneumonia ; SARS-CoV-2
Language	English
Publishing date	2020-12-05
Publishing country	England
Document type	Letter
ZDB-ID	424417-5
ISSN	1532-2742 ; 0163-4453
ISSN (online)	1532-2742
ISSN	0163-4453
DOI	10.1016/j.jinf.2020.12.001
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Article ; Online: Spanish Antibiogram Committee (COESANT) recommendations for cumulative antibiogram reports.

Larrosa, María Nieves / Canut-Blasco, Andrés / Benito, Natividad / Cantón, Rafael / Cercenado, Emilia / Docobo-Pérez, Fernando / Fernández-Cuenca, Felipe / Fernández-Domínguez, Javier / Guinea, Jesús / López-Navas, Antonio / Moreno, Miguel Ángel / Morosini, Mª Isabel / Navarro, Ferran / Martínez-Martínez, Luis / Oliver, Antonio

Enfermedades infecciosas y microbiologia clinica (English ed.)

2022 Volume 41, Issue 7, Page(s) 430–435

Abstract: The Spanish Antibiogram Committee (Comité Español del Antibiograma, COESANT) presents in this document a series of recommendations intending to unify how cumulative antibiogram reports must be made in Clinical Microbiology Spanish laboratories. This ... ...

Abstract	The Spanish Antibiogram Committee (Comité Español del Antibiograma, COESANT) presents in this document a series of recommendations intending to unify how cumulative antibiogram reports must be made in Clinical Microbiology Spanish laboratories. This article is based on the information included in the Clinical Microbiology Procedure No. 51, «Preparation of cumulative reports on antimicrobial susceptibility» of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), published in 2014. The recommendations also include the modifications in the definition of clinical interpretive categories recently published by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) in 2019. Its final objective is to establish a homogeneous way of preparing these summaries to compare results from different centers or aggregate the information from these in order to carry out an adequate local or even national surveillance regarding the evolution of antimicrobial susceptibility.
Language	English
Publishing date	2022-09-26
Publishing country	Spain
Document type	Journal Article ; Review
ISSN	2529-993X
ISSN (online)	2529-993X
DOI	10.1016/j.eimce.2022.09.002
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Article: Quantification of Ceftaroline in Human Plasma Using High-Performance Liquid Chromatography with Ultraviolet Detection: Application to Pharmacokinetic Studies.

Alarcia-Lacalle, Ana / Barrasa, Helena / Maynar, Javier / Canut-Blasco, Andrés / Gómez-González, Carmen / Solinís, María Ángeles / Isla, Arantxazu / Rodríguez-Gascón, Alicia

Pharmaceutics

2021 Volume 13, Issue 7

Abstract: This study was conducted to develop a rapid, simple and reproducible method for the quantification of ceftaroline in plasma samples by high-performance liquid chromatography with ultraviolet detection (HPLC-UV). Sample processing consisted of methanol ... ...

Abstract	This study was conducted to develop a rapid, simple and reproducible method for the quantification of ceftaroline in plasma samples by high-performance liquid chromatography with ultraviolet detection (HPLC-UV). Sample processing consisted of methanol precipitation and then, after centrifugation, the supernatant was injected into the HPLC system, working in isocratic mode. Ceftaroline was detected at 238 nm at a short acquisition time (less than 5 min). The calibration curve was linear over the concentration range from 0.25 to 40 µg/mL, and the method appeared to be selective, precise and accurate. Ceftaroline in plasma samples was stable at -80 °C for at least 3 months. The method was successfully applied to characterize the pharmacokinetic profile of ceftaroline in two critically ill patients and to evaluate whether the pharmacokinetic/pharmacodynamic (PK/PD) target was reached or not with the dose regimen administered.
Language	English
Publishing date	2021-06-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527217-2
ISSN	1999-4923
ISSN	1999-4923
DOI	10.3390/pharmaceutics13070959
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Article ; Online: Pielonefritis aguda complicada y no complicada en urgencias: indicadores de proceso y resultado.

Delgado Vicente, Miriam / Lecaroz Agara, Mª Concepción / Barrios Andrés, José Luis / Canut Blasco, Andrés

Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias

2017 Volume 29, Issue 1, Page(s) 27–32

Abstract: Objectives: To assess process-of-care indicators and outcomes in acute pyelonephritis (APN) in a general hospital emergency department, and compare them between uncomplicaed and complicated APN.: Material and methods: Retrospective study of ... ...

Title translation	Acute complicated and uncomplicated pyelonephritis in the emergency department: process-of-care indicators and outcomes.
Abstract	Objectives: To assess process-of-care indicators and outcomes in acute pyelonephritis (APN) in a general hospital emergency department, and compare them between uncomplicaed and complicated APN. Material and methods: Retrospective study of consecutive patients discharged with a diagnosis of APN. We studied health processof- care indicators (percentage admitted, avoidable hospitalization, appropriate initial antibiotic therapy, urine and blood cultures) and outcomes (hospital length of stay [LOS], discharge from the emergency department, revisits, mortality, yields of microbiological tests ordered). Results: A total of 529 cases (59% of them complicated) were included. Patients with uncomplicated APN were significantly younger on average (mean, 39 years) than patients with complicated APN (56 years). Escherichia coli was the most common pathogen identified, although the percentage of E coli infection was lower in patients with complicated APN (78%) than in patients with uncomplicated APN (95%). The rates of admission and orders for urine and blood cultures were significantly higher and hospital LOS was longer in the group with complicated APN. Moreover, these patients had even longer stays if the initial antibiotic therapy was inappropriate. Significantly more patients with uncomplicated APN were discharged from the emergency department. Sixty-one percent of patients with uncomplicated APN were admitted; 9% of these cases were considered avoidable hospitalizations. Conclusion: Complicated APN is diagnosed more often in older patients, and E coli infection causes a smaller proportion of these cases. Hospital LOS is longer in complicated APN and more urine and blood cultures are ordered. Patients with uncomplicated APN are more often discharged from the emergency department, although the number of avoidable hospitalizations seems high based on the rate found in this study.
MeSH term(s)	Acute Disease ; Adult ; Anti-Bacterial Agents/therapeutic use ; Emergency Service, Hospital ; Escherichia coli Infections/drug therapy ; Escherichia coli Infections/epidemiology ; Escherichia coli Infections/therapy ; Hospitalization ; Hospitals, University ; Humans ; Length of Stay ; Middle Aged ; Pyelonephritis/complications ; Pyelonephritis/drug therapy ; Pyelonephritis/epidemiology ; Pyelonephritis/therapy ; Retrospective Studies ; Sepsis/etiology ; Treatment Outcome
Chemical Substances	Anti-Bacterial Agents
Language	Spanish
Publishing date	2017
Publishing country	Spain
Document type	Journal Article ; Observational Study
ZDB-ID	2127173-2
ISSN	2386-5857 ; 1137-6821
ISSN (online)	2386-5857
ISSN	1137-6821
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