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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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Article ; Online: Response to Author Comments on "Clinical, microbiological characteristics and predictors of mortality in patients with carbapenemase-producing Enterobacterales blood stream infections".

Anton-Vazquez, Vanesa / Evans, Terry John / Fernando, Samitha / Somasunderam, Donald / David, Kate / Melzer, Mark / Hawkins, Lois / Morris-Jones, Stephen / Arias, Mauricio / Drazho, Borana / Dall'Antonia, Martino / Planche, Timothy

Infection prevention in practice

2023 Volume 5, Issue 4, Page(s) 100327

Language	English
Publishing date	2023-11-17
Publishing country	England
Document type	Journal Article
ISSN	2590-0889
ISSN (online)	2590-0889
DOI	10.1016/j.infpip.2023.100327
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Article ; Online: Clinical, microbiological characteristics and predictors of mortality in patients with carbapenemase-producing Enterobacterales bloodstream infections: a multicentre study.

Infection prevention in practice

2023 Volume 5, Issue 3, Page(s) 100298

Abstract: Objectives: To investigate the clinical, microbiological characteristics and outcomes of patients with bloodstream infections (BSI) due to carbapenemase-producing Enterobacterales (CPE).: Methods: A multicentre retrospective observational study of ... ...

Abstract	Objectives: To investigate the clinical, microbiological characteristics and outcomes of patients with bloodstream infections (BSI) due to carbapenemase-producing Enterobacterales (CPE). Methods: A multicentre retrospective observational study of patients with BSIs due to CPE admitted to six UK hospitals was conducted between 2011 and 2021. Multivariate analysis was used to identify factors predicting 30-day case fatality rate (CFR). Results: There were 84 episodes of CPE-BSIs, 37 (44%) due to OXA-48, 35 (42%) to metallo-betalactamases (MBL) and 12 (14%) to KPC. 63% of patients were male with a median age of 64 years. Common organisms included Conclusion: Strategies targeting high-risk patients and adherence to infection prevention bundles for urinary devices and central venous catheters can reduce OXA-48 and KPC-BSIs. Early recognition and management of severe sepsis, prompt initiation of appropriate antimicrobial therapy and development of novel antimicrobials are crucial to mitigate the high CFR associated with CPE-BSIs
Language	English
Publishing date	2023-07-08
Publishing country	England
Document type	Journal Article
ISSN	2590-0889
ISSN (online)	2590-0889
DOI	10.1016/j.infpip.2023.100298
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Article ; Online: Management of industrial high-pressure fluid injection injuries (IHPFII): the Water Jetting Association (WJA) experience with water driven injuries.

Rodríguez-Villar, Sancho / Kennedy, Robert Charles / Dall'Antonia, Martino / Menichetti, Carlos Pilasi

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2019 Volume 45, Issue 3, Page(s) 507–515

Abstract: Background: Industrial high-pressure fluid injection injuries (IHPFII) are largely occupational in nature, where these injuries are most often sustained by male manual workers. Such traumatic injuries are largely sustained with water, grease, paint, ... ...

Abstract	Background: Industrial high-pressure fluid injection injuries (IHPFII) are largely occupational in nature, where these injuries are most often sustained by male manual workers. Such traumatic injuries are largely sustained with water, grease, paint, gasoline or paint thinner. IHPFII are extremely serious injuries with life and limb-threatening potential carrying the risk of life-long disability. Methods: We reviewed the Water Jetting Association© adverse incident database of advisory alerts detailing cases from around the world that have been brought to the association's attention and the English-language literature on high-pressure hydrostatic injuries from 1937 to 2018. Results: Accidents involving high-pressure water jets in the industry are uncommon. The clinical impact in all of the cases reviewed and the effects of water jet impacts range from instant fatalities at scene to loss of limb function and amputation. The majority of observed fatalities are due to major hemorrhage (exsanguination) secondary to the direct dissection of great vessels or high-energy blunt soft tissue injury and traumatic brain injury. Conclusions: As with any other trauma, IHPWJI commonly result in amputation or death. Nonetheless, a lack of comprehension of the potential severity of injuries and range of infective complications appears to be largely due to the apparent benignity of the initial presentation of the wound. This in turn leads to delays (both avoidable and unavoidable) in the transfer to appropriate medical facilities and definitive care. There is an identifiable need for education (including for health care providers across multiple levels), training and the availability of personal trauma kits for the timely and effective management of IHPWJI from the initial jet impact on the scene, as well as a need for an established referral system.
MeSH term(s)	Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Amputation ; Brain Injuries, Traumatic/etiology ; Brain Injuries, Traumatic/mortality ; Brain Injuries, Traumatic/therapy ; Compartment Syndromes/etiology ; Compartment Syndromes/therapy ; Edema/etiology ; Exsanguination/etiology ; Exsanguination/mortality ; Exsanguination/therapy ; Humans ; Hydrostatic Pressure/adverse effects ; Occupational Injuries/etiology ; Occupational Injuries/mortality ; Occupational Injuries/therapy ; Rhabdomyolysis/etiology ; Rhabdomyolysis/therapy ; Soft Tissue Injuries/etiology ; Soft Tissue Injuries/therapy ; Subcutaneous Emphysema/diagnostic imaging ; Subcutaneous Emphysema/etiology ; Wound Infection/etiology ; Wound Infection/therapy
Language	English
Publishing date	2019-03-20
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-019-01106-4
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Zs.A 1221: 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: Correction to: Management of industrial high-pressure fluid injection injuries (IHPFII): the Water Jetting Association (WJA) experience with water driven injuries.

Rodríguez-Villar, Sancho / Kennedy, Robert Charles / Dall'Antonia, Martino / Menichetti, Carlos Pilasi

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2019 Volume 45, Issue 3, Page(s) 571–572

Abstract: The original article can be found online. ...

Abstract	The original article can be found online.
Language	English
Publishing date	2019-04-26
Publishing country	Germany
Document type	Journal Article ; Published Erratum
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-019-01124-2
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Zs.A 1221: 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)
Zs.MO 607: Show issues

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Article ; Online: Effect of Augmented Antimicrobial Prophylaxis and Rectal Swab Culture-guided Targeted Prophylaxis on the Risk of Sepsis Following Transrectal Prostate Biopsy.

Hadjipavlou, Marios / Eragat, Mazin / Kenny, Charlotte / Pantelidou, Maria / Mulhem, Waseem / Wood, Chris / Dall'Antonia, Martino / Hammadeh, Mohamed Y

European urology focus

2018 Volume 6, Issue 1, Page(s) 95–101

Abstract: Background: Sepsis is a severe complication following transrectal ultrasound-guided prostate biopsy (TRUSPBx). Ciprofloxacin is commonly used for prophylaxis; however, there is an increasing incidence of resistant enteric organisms worldwide.: ... ...

Abstract	Background: Sepsis is a severe complication following transrectal ultrasound-guided prostate biopsy (TRUSPBx). Ciprofloxacin is commonly used for prophylaxis; however, there is an increasing incidence of resistant enteric organisms worldwide. Objective: To investigate the effect of a targeted prophylactic antimicrobial regimen based on rectal swab cultures in reducing the rate of sepsis. Design, setting, and participants: A total of 1012 patients were included. Group A (609 patients) received an empirical prophylactic antimicrobial regimen of gentamicin, metronidazole, and ciprofloxacin. Targeted antimicrobial prophylaxis was introduced due to significant ciprofloxacin and gentamicin resistance in patients admitted with sepsis following TRUSPBx. The remaining 403 patients (Group B) had rectal swab cultures performed prior to biopsy. Patients with organisms resistant to ciprofloxacin or gentamicin received a targeted prophylaxis regimen of fosfomycin, amikacin, and metronidazole. Outcome measurements and statistical analysis: We retrospectively collected and analysed data on sepsis and bacteraemia for all patients as well as data on rectal swab culture, recent foreign travel, and recent antibiotic use for patients in Group B. Results and limitations: In group A, 12 (2.0%) patients developed sepsis following TRUSPBx, while in group B, 9 (2.2%) patients developed sepsis despite targeted prophylaxis (p=0.82). Patients with ciprofloxacin-resistant rectal flora had a significantly higher rate of sepsis (9.1% vs 1.1%; p=0.003). There was a reduction in patients admitted with bacteraemia and severe sepsis between group A (1.2%) and group B (0.3%) which did not reach statistical significance (p=0.16). In group B, 55 of 403 (13.6%) patients had ciprofloxacin-resistant rectal flora, while 66 (16.4%) had organisms resistant to both ciprofloxacin and gentamicin. A recent foreign travel history was associated with an increased incidence of ciprofloxacin-resistant rectal flora (23.6% vs 10.8%; p=0.007). The main limitations of our study include its retrospective nature and potential under-reporting of less severe infectious complications. Conclusions: Rectal swab cultures identify patients with ciprofloxacin-resistant rectal flora who have an eight-fold risk of sepsis. Targeted antimicrobial prophylaxis may not be beneficial in reducing the sepsis rate when compared with augmented empirical prophylaxis. In an era of increasing antimicrobial resistance, transperineal prostate biopsies should be considered to reduce the risk of infective complications. Patient summary: Performing rectal swab culture prior to transrectal prostate biopsy can help identify patients at risk of developing sepsis despite targeted prophylactic antibiotics.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis/methods ; Bacteriological Techniques ; Biopsy/methods ; Ciprofloxacin/therapeutic use ; Gentamicins/therapeutic use ; Humans ; Male ; Metronidazole/therapeutic use ; Postoperative Complications/epidemiology ; Postoperative Complications/microbiology ; Postoperative Complications/prevention & control ; Prostate/pathology ; Rectum/microbiology ; Retrospective Studies ; Risk Assessment ; Sepsis/epidemiology ; Sepsis/prevention & control
Chemical Substances	Anti-Bacterial Agents ; Gentamicins ; Metronidazole (140QMO216E) ; Ciprofloxacin (5E8K9I0O4U)
Language	English
Publishing date	2018-07-06
Publishing country	Netherlands
Document type	Journal Article
ISSN	2405-4569
ISSN (online)	2405-4569
DOI	10.1016/j.euf.2018.06.016
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Article: Detection of multiple-strain carriers: the value of re-sampling.

Coen, Pietro G / Wilks, Mark / Dall'antonia, Martino / Millar, Michael

Journal of theoretical biology

2006 Volume 240, Issue 1, Page(s) 98–103

Abstract: Bacteria may colonize a carrier with more than one strain of a species at any one time. Attempts to determine multiple colonization are labour intensive because of the large number of colonies per carrier which need to be tested. A possible solution -- ... ...

Abstract	Bacteria may colonize a carrier with more than one strain of a species at any one time. Attempts to determine multiple colonization are labour intensive because of the large number of colonies per carrier which need to be tested. A possible solution -- in which only 3 colonies per carrier are initially tested and only multiple-strain carriers are re-sampled -- was recently described. We evaluated the accuracy of the "re-sampling method" devised by Cespedes et al. with 500,000 stochastic simulations per scenario. Re-sampling is acceptable where > or = 5 colonies are initially tested or where one strain predominates over others in colony counts. The method introduces bias towards overestimation which decreases with the number of available carriers, increases with the proportion of truly multiple carriers, with decreasing number of colonies available for testing, and with decreasing number of colonies tested per carrier. Initial testing of 5-8 colonies tested with re-sampling are adequate for a large study (>100 carriers), or a small study where it is suspected that no strain predominates over the other in colony counts. Testing 9-20 colonies with re-sampling is necessary for small studies where one strain predominates over others. Re-sampling is unnecessary where >20 colonies are tested.
MeSH term(s)	Bacteria/classification ; Bacteria/isolation & purification ; Bacteriological Techniques/methods ; Bias ; Carrier State/microbiology ; Colony Count, Microbial ; Humans ; Methicillin ; Models, Biological ; Staphylococcus aureus/drug effects ; Staphylococcus aureus/isolation & purification ; Symbiosis
Chemical Substances	Methicillin (Q91FH1328A)
Language	English
Publishing date	2006-05-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2972-5
ISSN	1095-8541 ; 0022-5193
ISSN (online)	1095-8541
ISSN	0022-5193
DOI	10.1016/j.jtbi.2005.08.031
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Article ; Online: Erythromycin for prokinesis: imprudent prescribing?

Dall'Antonia, Martino / Wilks, Mark / Coen, Pietro G / Bragman, Susan / Millar, Michael R

Critical care (London, England)

2006 Volume 10, Issue 1, Page(s) 112

Abstract: Problems with antibiotic resistant bacteria are increasing in the hospital and particularly in the intensive care unit. Methicillin-resistant Staphylococcus aureus, Acinetobacter baumanii and extended spectrum beta-lactamase producing gram-negative ... ...

Abstract	Problems with antibiotic resistant bacteria are increasing in the hospital and particularly in the intensive care unit. Methicillin-resistant Staphylococcus aureus, Acinetobacter baumanii and extended spectrum beta-lactamase producing gram-negative bacilli constitute a therapeutic and infection control challenge. Early enteral feeding improves survival in patients in the intensive care unit. Prokinetic agents are routinely used in patients with inappropriate gastrointestinal motility. The use of erythromycin at sub-therapeutic doses as a prokinetic agent is a cause of concern for the following reasons: it can increase the emergence and spread of antibiotic resistance and the likelihood of Clostridium difficile disease. The use of an antibiotic as a prokinetic agent does not constitute prudent antimicrobial prescribing and should be avoided. Alternative agents, whenever possible, should be used.
MeSH term(s)	Anti-Bacterial Agents/adverse effects ; Anti-Bacterial Agents/therapeutic use ; Bacterial Infections/drug therapy ; Bacterial Infections/therapy ; Critical Care ; Drug Resistance ; Enteral Nutrition ; Erythromycin/adverse effects ; Erythromycin/therapeutic use ; Gastrointestinal Diseases/therapy ; Gastrointestinal Motility ; Humans ; Methicillin Resistance
Chemical Substances	Anti-Bacterial Agents ; Erythromycin (63937KV33D)
Language	English
Publishing date	2006-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2051256-9
ISSN	1466-609X ; 1466-609X
ISSN (online)	1466-609X
ISSN	1466-609X
DOI	10.1186/cc3956
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Article ; Online: Tsukamurella tyrosinosolvens intravascular catheter infection identified using 16S ribosomal DNA sequencing.

Sheridan, Elizabeth A S / Warwick, Simon / Chan, Anthony / Dall'Antonia, Martino / Koliou, Maria / Sefton, Armine

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2003 Volume 36, Issue 5, Page(s) e69–70

Abstract: Cultures of blood from a hemodialysis line repeatedly yielded a gram-positive rod. The organism was identified as Tsukamurella tyrosinosolvens by 16S ribosomal DNA sequencing, and the patient was treated successfully by removal of the line. ...

Abstract	Cultures of blood from a hemodialysis line repeatedly yielded a gram-positive rod. The organism was identified as Tsukamurella tyrosinosolvens by 16S ribosomal DNA sequencing, and the patient was treated successfully by removal of the line.
MeSH term(s)	Actinomycetales/genetics ; Actinomycetales/isolation & purification ; Adult ; Catheters, Indwelling/microbiology ; Humans ; Male ; Prosthesis-Related Infections/microbiology ; RNA, Ribosomal, 16S/analysis ; RNA, Ribosomal, 16S/genetics
Chemical Substances	RNA, Ribosomal, 16S
Language	English
Publishing date	2003-03-01
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1086/367654
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Zs.A 1505: 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)
Zs.MO 480: Show issues

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Article ; Online: In vitro activity of an aqueous allicin extract and a novel allicin topical gel formulation against Lancefield group B streptococci.

Cutler, Ronald R / Odent, Michel / Hajj-Ahmad, Hussein / Maharjan, Sunil / Bennett, Norman J / Josling, Peter D / Ball, Vanessa / Hatton, Paulette / Dall'Antonia, Martino

The Journal of antimicrobial chemotherapy

2009 Volume 63, Issue 1, Page(s) 151–154

Abstract: Background: Studies have shown the efficacy of intra-partum antibiotics in preventing early-onset group B streptococcal sepsis. This approach results in a high intra-partum antibiotic use. Worryingly, the same antibiotics used in prophylaxis are also ... ...

Abstract	Background: Studies have shown the efficacy of intra-partum antibiotics in preventing early-onset group B streptococcal sepsis. This approach results in a high intra-partum antibiotic use. Worryingly, the same antibiotics used in prophylaxis are also first-line treatment for neonatal sepsis, and antibiotic exposure in the peri-natal period has been shown to be a risk factor for late-onset serious bacterial infections and allergic disease. Antibiotic exposure in the peri-natal period is becoming a major public health issue; alternative strategies are needed. Garlic has been traditionally used to treat vaginal infections. Allicin is the main antibacterial agent isolated from garlic. Objectives: The aim of the study was to investigate the in vitro activity of a novel allicin extract in aqueous and gel formulation against 76 clinical isolates of Lancefield group B streptococci (GBS). Methods: MICs and MBCs of allicin were determined for 76 GBS isolates by agar dilution and microtitre plate methods. Killing kinetics were determined for a selected 16 of the 76 strains. Agar diffusion tests were compared for allicin liquid and gel (500 mg/L). Results and conclusions: MICs and MBCs of allicin liquid were 35 to 95 mg/L and 75 to 315 mg/L, respectively. Time/dose kill curves produced a 2-3 log reduction in cfu/mL within 3 h and no detectable growth at 8 and 24 h. A novel 500 mg/L allicin gel produced an average zone size of 23+/-6 mm compared with 21+/-6 mm for allicin in water. Aqueous allicin is bactericidal against GBS isolates and maintains activity in a novel gel formulation.
MeSH term(s)	Anti-Bacterial Agents/isolation & purification ; Anti-Bacterial Agents/pharmacology ; Colony Count, Microbial ; Female ; Garlic/chemistry ; Humans ; Microbial Sensitivity Tests ; Microbial Viability ; Streptococcal Infections/microbiology ; Streptococcus agalactiae/drug effects ; Streptococcus agalactiae/isolation & purification ; Sulfinic Acids/isolation & purification ; Sulfinic Acids/pharmacology
Chemical Substances	Anti-Bacterial Agents ; Sulfinic Acids ; allicin (3C39BY17Y6)
Language	English
Publishing date	2009-01
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/dkn457
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Zs.MO 124: Show issues

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