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  1. Article: Isolated splenic cystic echinococcosis and albendazole hepatotoxicity.

    Moussas, Nikolaos / Adamidis, Sotirios / Adamidis, Nikolaos / Stratopoulos, Charalabos / Gargalianos-Kakolyris, Panagiotis

    IDCases

    2022  Volume 28, Page(s) e01501

    Abstract: Isolated splenic cystic echinococcosis is a rare condition. In Greece the number of cases has declined substantially in the last 20 years. The spleen is the second most common extrahepatic site of cystic echinococcosis. Albendazole is safe, but ... ...

    Abstract Isolated splenic cystic echinococcosis is a rare condition. In Greece the number of cases has declined substantially in the last 20 years. The spleen is the second most common extrahepatic site of cystic echinococcosis. Albendazole is safe, but mebendazole can be used as a substitute, in case of adverse reaction. Our patient was diagnosed with isolated splenic echinococcal cyst, during the investigation for newly diagnosed type 2 diabetes mellitus. We opted for elective splenectomy, based on a risk assessment due to the patient's working conditions, and treatment with albendazole represented a safety measure until surgery was possible. The patient developed acute hepatocellular injury to albendazole after eight weeks of treatment. This was confirmed through rechallenge with albendazole after discontinuation of the drug. Postsplenectomy the treatment with mebendazole proved to be safe with no adverse reactions. Even though, albendazole is known to be safe, monitoring of hepatic enzymes and full blood count should be offered. In case of toxicities, mebendazole with or without praziquantel can be used. Toxicity to mebendazole can be similar to albendazole but a trial is worthwhile. In our patient, treatment with mebendazole was uneventful.
    Language English
    Publishing date 2022-04-12
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2745454-X
    ISSN 2214-2509
    ISSN 2214-2509
    DOI 10.1016/j.idcr.2022.e01501
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  2. Article ; Online: Central-line-associated bloodstream infections, multi-drug-resistant bacteraemias and infection control interventions: a 6-year time-series analysis in a tertiary care hospital in Greece.

    Papanikolopoulou, A / Maltezou, H C / Gargalianos-Kakolyris, P / Michou, I / Kalofissoudis, Y / Moussas, N / Pantazis, N / Kotteas, E / Syrigos, K N / Pantos, C / Tountas, Y / Tsakris, A / Kantzanou, M

    The Journal of hospital infection

    2022  Volume 123, Page(s) 27–33

    Abstract: Background: Central-line-associated bloodstream infections (CLABSIs) are serious healthcare-associated infections with substantial morbidity and hospital costs.: Aim: To investigate the association between the incidence of CLABSIs, the implementation ...

    Abstract Background: Central-line-associated bloodstream infections (CLABSIs) are serious healthcare-associated infections with substantial morbidity and hospital costs.
    Aim: To investigate the association between the incidence of CLABSIs, the implementation of specific infection control measures, and the incidence of multi-drug-resistant (MDR) bacteraemias in a tertiary care hospital in Greece from 2013 to 2018.
    Methods: Analysis was applied for the following indices, calculated monthly: CLABSI rate; use of hand hygiene disinfectants; isolation rate of patients with MDR bacteria; and incidence of bacteraemias [total Gram-negative carbapenem-resistant Acinetobacter baumanii, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Klebsiella pneumoniae; and Gram-positive meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci].
    Findings: The total number of bacteraemias from carbapenem-resistant Gram-negative pathogens was significantly correlated with an increased CLABSI rate for all (total) hospital departments [incidence rate ratio (IRR) 1.17, 95% confidence interval (CI) 1.05-1.31, P=0.006] and the adult intensive care unit (ICU) (IRR 1.37, 95% CI 1.07-1.75, P=0.013). In the adult ICU, every increase in the incidence of each resistant Gram-negative pathogen was significantly correlated with a decreased CLABSI rate (carbapenem-resistant A. baumanii: IRR 0.59, 95% CI 0.39-0.90, P=0.015; carbapenem-resistant K. pneumoniae: IRR 0.48, 95% CI 0.25-0.94, P=0.031; carbapenem-resistant P. aeruginosa: IRR 0.54, 95% CI 0.33-0.89, P=0.015). The use of hand disinfectants was correlated with a decreased CLABSI rate 1-3 months before the application of this intervention for all (total) hospital departments (IRR 0.80, 95% CI 0.69-0.93, P=0.005), and for scrub disinfectants in the current month for the adult ICU (IRR 0.34, 95% CI 0.11-1.03, P=0.057). Isolation of patients with MDR pathogens was not associated with the incidence of CLABSIs.
    Conclusion: Hand hygiene was associated with a significant reduction in the incidence of CLABSIs at the study hospital. Time-series analysis is an important tool to evaluate infection control interventions.
    MeSH term(s) Adult ; Bacteremia/epidemiology ; Bacteremia/microbiology ; Bacteremia/prevention & control ; Carbapenems ; Catheter-Related Infections/epidemiology ; Catheter-Related Infections/microbiology ; Catheter-Related Infections/prevention & control ; Cross Infection/epidemiology ; Cross Infection/microbiology ; Cross Infection/prevention & control ; Disinfectants ; Greece/epidemiology ; Humans ; Incidence ; Infection Control ; Intensive Care Units ; Klebsiella pneumoniae ; Methicillin-Resistant Staphylococcus aureus ; Tertiary Care Centers
    Chemical Substances Carbapenems ; Disinfectants
    Language English
    Publishing date 2022-02-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 779366-2
    ISSN 1532-2939 ; 0195-6701
    ISSN (online) 1532-2939
    ISSN 0195-6701
    DOI 10.1016/j.jhin.2022.01.020
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  3. Article ; Online: Association between consumption of antibiotics, infection control interventions and Clostridioides difficile infections: Analysis of six-year time-series data in a tertiary-care hospital in Greece.

    Papanikolopoulou, Amalia / Maltezou, Helena C / Gargalianos-Kakolyris, Panagiotis / Pangalis, Anastasia / Pantazis, Nikos / Pantos, Constantinos / Tountas, Yannis / Tsakris, Athanasios / Kantzanou, Maria

    Infection, disease & health

    2022  Volume 27, Issue 3, Page(s) 119–128

    Abstract: Background: To investigate the association between Clostridioides difficile infection (CDI), antibiotic use, and infection control interventions, during an antibiotic stewardship program (ASP) implemented in a tertiary-care hospital in Greece from 2013 ... ...

    Abstract Background: To investigate the association between Clostridioides difficile infection (CDI), antibiotic use, and infection control interventions, during an antibiotic stewardship program (ASP) implemented in a tertiary-care hospital in Greece from 2013 to 2018.
    Methods: Analysis was applied for the following monthly indices: 1. consumption of antibiotics; 2. use of hand hygiene disinfectant solutions; 3. percentage of isolations of patients either with multidrug-resistant (MDR) bacteria, or CDI, or admitted from another hospital; and 4. percentage of patients with CDI divided into two groups: community-acquired CDI (CACDI) and hospital-associated CDI (HACDI) (onset ≤72 h and >72 h after admission, respectively).
    Results: During the study, a significant reduction in CACDI rate from 0.3%/admissions [95% CI 0.1-0.6] to 0.1%/admissions [95% CI 0.0-0.3] (p-value = 0.035) was observed in adults ICU, while CDI rates were stable in the rest of the hospital. Antibiotic consumption showed a significant reduction in total hospital, from 91.7 DDDs [95% CI 89.7-93.7] to 80.1 DDDs [95% CI 79.1-81.1] (p-value<0.001), except adults ICU. Non-advanced antibiotics correlated with decreased CDI rates in Adults Clinic Departments and ICU. Isolation of patients one and two months earlier correlated with decreased CACDI rates per 20% [95% CI 0.64-1.00, p-value = 0.046] and HACDI per 23% [95% CI 0.60-1.00, p-value = 0.050] in Adults Clinic Departments. Consumption of disinfectant solutions current month correlated with decreased rate for CACDI per 33% [95% CI 0.49-0.91, p-value = 0.011] and HACDI per 38% [95% CI 0.40-0.98, p-value = 0.040] in total Hospital Clinics.
    Conclusion: Rational antibiotic prescribing during ASP along with multipronged intervention strategy focusing on hand hygiene and patient isolation measures prevent and control CDI outbreaks in the hospital setting.
    MeSH term(s) Adult ; Anti-Bacterial Agents/therapeutic use ; Clostridioides difficile ; Clostridium Infections/epidemiology ; Clostridium Infections/microbiology ; Clostridium Infections/prevention & control ; Cross Infection/epidemiology ; Disinfectants/therapeutic use ; Greece/epidemiology ; Humans ; Infection Control ; Tertiary Care Centers
    Chemical Substances Anti-Bacterial Agents ; Disinfectants
    Language English
    Publishing date 2022-02-10
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2902143-1
    ISSN 2468-0869 ; 2468-0451
    ISSN (online) 2468-0869
    ISSN 2468-0451
    DOI 10.1016/j.idh.2022.01.002
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  4. Article: Carbapenem-Resistant

    Papanikolopoulou, Amalia / Gargalianos-Kakolyris, Panagiotis / Stoupis, Athina / Moussas, Nikos / Pangalis, Anastasia / Theodoridou, Kalliopi / Chronopoulou, Genovefa / Pantazis, Nikos / Kantzanou, Maria / Maltezou, Helena C / Tsakris, Athanasios

    Microorganisms

    2023  Volume 11, Issue 5

    Abstract: Background: Carbapenem-resistant : Methods: We prospectively recorded the incidence of CRPA bacteremia, antibiotic consumption, use of hand-hygiene solutions, and isolation rates of multidrug-resistant (MDR) carrier patients.: Findings: The ... ...

    Abstract Background: Carbapenem-resistant
    Methods: We prospectively recorded the incidence of CRPA bacteremia, antibiotic consumption, use of hand-hygiene solutions, and isolation rates of multidrug-resistant (MDR) carrier patients.
    Findings: The consumption of colistin, aminoglycosides, and third-generation cephalosporins decreased significantly in the total hospital and its divisions (
    Conclusion: In our hospital, multimodal infection control interventions resulted in a significant reduction of CRPA bacteremia, mostly due to the reduction of all classes of antibiotics.
    Language English
    Publishing date 2023-05-17
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2720891-6
    ISSN 2076-2607
    ISSN 2076-2607
    DOI 10.3390/microorganisms11051315
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  5. Article: The Effect of Different Colistin Dosing Regimens on Nephrotoxicity: A Cohort Study.

    Samarkos, Michael / Papanikolaou, Konstantinos / Sourdi, Athena / Paisios, Nikolaos / Mainas, Efstratios / Paramythiotou, Elisabeth / Antoniadou, Anastasia / Sambatakou, Helen / Gargalianos-Kakolyris, Panayiotis / Skoutelis, Athanasios / Daikos, George L

    Antibiotics (Basel, Switzerland)

    2022  Volume 11, Issue 8

    Abstract: 1) Background: It is not known whether different daily dosing schemes have different effects on colistin nephrotoxicity. We examined the effect of once- versus twice- or thrice-daily doses of colistin on renal function. (2) Methods: We performed a ... ...

    Abstract (1) Background: It is not known whether different daily dosing schemes have different effects on colistin nephrotoxicity. We examined the effect of once- versus twice- or thrice-daily doses of colistin on renal function. (2) Methods: We performed a multicenter retrospective cohort study of hospitalized patients with a baseline glomerular filtration rate ≥ 50 mL/min who received intravenously the same colistin dose once (regimen A), twice (regimen B) or thrice daily (regimen C). The primary endpoint was acute kidney injury (AKI), defined as fulfilment of any of the RIFLE (Risk-Injury-Failure-Loss-End stage renal disease) criteria. (3) Results: We included 306 patients; 132 (43.1%) received regimen A, 151 (49.3%) regimen B, and 23 (7.5%) regimen C. Ninety-nine (32.4%) patients developed AKI; there was no difference between regimen A vs. B and C [45 (34.1%) vs. 54 (31.0%), p = 0.57]. In a propensity score−matched cohort, AKI was similar in patients receiving Regimen A, Regimen B, and Regimen C (31.6% vs. 33.3%, p = 0.78). On logistic regression analysis, diabetes was an independent predictor of AKI (OR = 4.59, 95% CI 2.03−10.39, p = 0.001) while eGFR > 80 mL/min (OR = 0.50, 95% CI 0.25−0.99, p = 0.048) was inversely associated with AKI. (4) Conclusions: Colistin once daily is not more nephrotoxic than the standard colistin regimens. The only independent predictor of nephrotoxicity was diabetes mellitus, while eGFR > 80 mL/min had a protective effect.
    Language English
    Publishing date 2022-08-05
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics11081066
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  6. Article ; Online: Six-Year Time-Series Data on Multidrug-Resistant Bacteremia, Antibiotic Consumption, and Infection Control Interventions in a Hospital.

    Papanikolopoulou, Amalia / Maltezou, Helena C / Kritikou, Helen / Papadopoulos, Thomas / Kandalepas, George / Pentzouris, Andronikos / Kartsonakis, Ioannis / Chronopoulou, Genovefa / Gargalianos-Kakolyris, Panagiotis / Pantazis, Nikos / Tsakris, Athanasios / Kantzanou, Maria

    Microbial drug resistance (Larchmont, N.Y.)

    2022  Volume 28, Issue 7, Page(s) 806–818

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Adult ; Anti-Bacterial Agents/pharmacology ; Bacteremia/drug therapy ; Bacteremia/epidemiology ; Bacteremia/prevention & control ; Carbapenems/pharmacology ; Carbapenems/therapeutic use ; Drug Resistance, Multiple, Bacterial ; Hospitals ; Humans ; Infection Control ; Methicillin-Resistant Staphylococcus aureus ; Retrospective Studies
    Chemical Substances Anti-Bacterial Agents ; Carbapenems
    Language English
    Publishing date 2022-07-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1290490-9
    ISSN 1931-8448 ; 1076-6294
    ISSN (online) 1931-8448
    ISSN 1076-6294
    DOI 10.1089/mdr.2022.0074
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4435: Show issues Location:
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  7. Article ; Online: Long-term effectiveness of recommended boosted protease inhibitor-based antiretroviral therapy in Europe.

    Santos, J R / Cozzi-Lepri, A / Phillips, A / De Wit, S / Pedersen, C / Reiss, P / Blaxhult, A / Lazzarin, A / Sluzhynska, M / Orkin, C / Duvivier, C / Bogner, J / Gargalianos-Kakolyris, P / Schmid, P / Hassoun, G / Khromova, I / Beniowski, M / Hadziosmanovic, V / Sedlacek, D /
    Paredes, R / Lundgren, J D

    HIV medicine

    2018  Volume 19, Issue 5, Page(s) 324–338

    Abstract: Objectives: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens.: Methods: Data were ... ...

    Abstract Objectives: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens.
    Methods: Data were analysed for 5678 EuroSIDA-enrolled patients starting a DRV/r-, ATZ/r- or LPV/r-containing regimen between 1 January 2000 and 30 June 2013. Separate analyses were performed for the following subgroups of patients: (1) ART-naïve subjects (8%) at ritonavir-boosted protease inhibitor (PI/r) initiation; (2) ART-experienced individuals (44%) initiating the new PI/r with a viral load (VL) ≤500 HIV-1 RNA copies/mL; and (3) ART-experienced patients (48%) initiating the new PI/r with a VL >500 copies/mL. Virological failure (VF) was defined as two consecutive VL measurements >200 copies/mL ≥24 weeks after PI/r initiation. Kaplan-Meier and multivariable Cox models were used to compare risks of failure by PI/r-based regimen. The main analysis was performed with intention-to-treat (ITT) ignoring treatment switches.
    Results: The time to VF favoured DRV/r over ATZ/r, and both were superior to LPV/r (log-rank test; P < 0.02) in all analyses. Nevertheless, the risk of VF in ART-naïve patients was similar regardless of the PI/r initiated after controlling for potential confounders. The risk of VF in both treatment-experienced groups was lower for DRV/r than for ATZ/r, which, in turn, was lower than for LPV/r-based ART.
    Conclusions: Although confounding by indication and calendar year cannot be completely ruled out, in ART-experienced subjects the long-term effectiveness of DRV/r-containing regimens appears to be greater than that of ATZ/r and LPV/r.
    MeSH term(s) Adult ; Anti-HIV Agents/therapeutic use ; Antiretroviral Therapy, Highly Active/methods ; Europe ; Female ; HIV Infections/drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome
    Chemical Substances Anti-HIV Agents
    Language English
    Publishing date 2018-02-01
    Publishing country England
    Document type Comparative Study ; Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2001932-4
    ISSN 1468-1293 ; 1464-2662
    ISSN (online) 1468-1293
    ISSN 1464-2662
    DOI 10.1111/hiv.12581
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  8. Article ; Online: Pharmacokinetics and safety of fidaxomicin in patients with inflammatory bowel disease and Clostridium difficile infection: an open-label Phase IIIb/IV study (PROFILE).

    Högenauer, Christoph / Mahida, Yashwant / Stallmach, Andreas / Marteau, Philippe / Rydzewska, Grazyna / Ivashkin, Vladimir / Gargalianos-Kakolyris, Panagiotis / Michon, Ingrid / Adomakoh, Nicholas / Georgopali, Areti / Tretter, Reiner / Karas, Andreas / Reinisch, Walter

    The Journal of antimicrobial chemotherapy

    2018  Volume 73, Issue 12, Page(s) 3430–3441

    Abstract: Objectives: Inflammatory bowel disease (IBD) poses an increased risk for Clostridium difficile infection (CDI). Fidaxomicin has demonstrated non-inferiority to vancomycin for initial clinical cure of CDI in patients without IBD; however, lack of data ... ...

    Abstract Objectives: Inflammatory bowel disease (IBD) poses an increased risk for Clostridium difficile infection (CDI). Fidaxomicin has demonstrated non-inferiority to vancomycin for initial clinical cure of CDI in patients without IBD; however, lack of data has caused concerns regarding potential systemic absorption of fidaxomicin in patients with IBD.
    Methods: The plasma pharmacokinetics (PK) of fidaxomicin and its primary metabolite OP-1118 were evaluated in a multicentre, open-label, single-arm, Phase IIIb/IV study enrolling patients with active IBD and CDI. Patients received fidaxomicin, 200 mg twice daily for 10 days. The primary and secondary endpoints were, respectively, plasma and stool PK of fidaxomicin and OP-1118 on Days 1, 5 and 10 of treatment. Other secondary endpoints included safety of fidaxomicin treatment (assessed until Day 180). ClinicalTrials.gov identifier: NCT02437591.
    Results: Median Tmax of fidaxomicin and OP-1118 for the PK analysis set (PKAS; 24 patients) was 1-2 h across Days 1, 5 and 10. Cmax ranges were 1.2-154 ng/mL for fidaxomicin and 4.7-555 ng/mL for OP-1118 across Days 1, 5 and 10 (PKAS). The ranges of concentrations in stool were 17.8-2170 μg/g for fidaxomicin and 0-1940 μg/g for OP-1118. Sixty percent (15/25) of patients experienced treatment-emergent adverse events (TEAEs), none of which led to treatment discontinuation or death.
    Conclusions: Maximum fidaxomicin and OP-1118 plasma concentrations observed in this study population suggest no increase in absorption, compared with patients without IBD. Incidence of TEAEs was similar to previous Phase III trials, suggesting that fidaxomicin is comparatively well tolerated in patients with IBD.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/adverse effects ; Anti-Bacterial Agents/pharmacokinetics ; Clostridium Infections/drug therapy ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Drug-Related Side Effects and Adverse Reactions/pathology ; Feces/chemistry ; Female ; Fidaxomicin/administration & dosage ; Fidaxomicin/adverse effects ; Fidaxomicin/pharmacokinetics ; Humans ; Incidence ; Inflammatory Bowel Diseases/complications ; Male ; Middle Aged ; Plasma/chemistry ; Young Adult
    Chemical Substances Anti-Bacterial Agents ; Fidaxomicin (Z5N076G8YQ)
    Language English
    Publishing date 2018-09-25
    Publishing country England
    Document type Clinical Trial, Phase III ; Clinical Trial, Phase IV ; 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/dky368
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    Zs.A 1197: Show issues Location:
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    Zs.MO 124: Show issues

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  9. Article ; Online: The extent of B-cell activation and dysfunction preceding lymphoma development in HIV-positive people.

    Shepherd, L / Borges, Á H / Harvey, R / Bower, M / Grulich, A / Silverberg, M / Weber, J / Ristola, M / Viard, J-P / Bogner, J R / Gargalianos-Kakolyris, P / Mussini, C / Mansinho, K / Yust, I / Paduta, D / Jilich, D / Smiatacz, T / Radoi, R / Tomazic, J /
    Plomgaard, P / Frikke-Schmidt, R / Lundgren, J / Mocroft, A

    HIV medicine

    2017  Volume 19, Issue 2, Page(s) 90–101

    Abstract: Objectives: B-cell dysfunction and activation are thought to contribute to lymphoma development in HIV-positive people; however, the mechanisms are not well understood. We investigated levels of several markers of B-cell dysfunction [free light chain ( ... ...

    Abstract Objectives: B-cell dysfunction and activation are thought to contribute to lymphoma development in HIV-positive people; however, the mechanisms are not well understood. We investigated levels of several markers of B-cell dysfunction [free light chain (FLC)-κ, FLC-λ, immunoglobulin G (IgG), IgA, IgM and IgD] prior to lymphoma diagnosis in HIV-positive people.
    Methods: A nested matched case-control study was carried out within the EuroSIDA cohort, including 73 HIV-positive people with lymphoma and 143 HIV-positive lymphoma-free controls. Markers of B-cell dysfunction were measured in prospectively stored serial plasma samples collected before the diagnosis of lymphoma (or selection date in controls). Marker levels ≤ 2 and > 2 years prior to diagnosis were investigated.
    Results: Two-fold higher levels of FLC-κ [odds ratio (OR) 1.84; 95% confidence interval (CI) 1.19, 2.84], FLC-λ (OR 2.15; 95% CI 1.34, 3.46), IgG (OR 3.05; 95% CI 1.41, 6.59) and IgM (OR 1.46; 95% CI 1.01, 2.11) were associated with increased risk of lymphoma > 2 years prior to diagnosis, but not ≤ 2 years prior. Despite significant associations > 2 years prior to diagnosis, the predictive accuracy of each marker was poor, with FLC-λ emerging as the strongest candidate with a c-statistic of 0.67 (95% CI 0.58, 0.76).
    Conclusions: FLC-κ, FLC-λ and IgG levels were higher > 2 years before lymphoma diagnosis, suggesting that B-cell dysfunction occurs many years prior to lymphoma development. However, the predictive value of each marker was low and they are unlikely candidates for risk assessment for targeted intervention.
    MeSH term(s) Adult ; B-Lymphocytes/immunology ; B-Lymphocytes/pathology ; Case-Control Studies ; Female ; HIV Infections/complications ; Humans ; Immunoglobulin G/blood ; Immunoglobulin Light Chains/blood ; Lymphocyte Activation ; Lymphoma/pathology ; Male ; Middle Aged ; Prospective Studies
    Chemical Substances Immunoglobulin G ; Immunoglobulin Light Chains
    Language English
    Publishing date 2017-08-31
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2001932-4
    ISSN 1468-1293 ; 1464-2662
    ISSN (online) 1468-1293
    ISSN 1464-2662
    DOI 10.1111/hiv.12546
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  10. Article ; Online: Evolution of epidemiological characteristics of infective endocarditis in Greece.

    Giannitsioti, Efthymia / Pefanis, Angelos / Gogos, Charalampos / Lekkou, Alexandra / Dalekos, Georgios N / Gatselis, Nikolaos / Georgiadou, Sara / Nikou, Paraskevas / Vrettou, Agathi / Rigopoulos, Angelos / Tryfonopoulos, Christos / Tsaganos, Thomas / Karofilakis, Emmanouil / Psarrakis, Christos / Argyriou, Michail / Gargalianos-Kakolyris, Panagiotis / Adamis, Georgios / Lourida, Panagiota / Kofteridis, Diamantis /
    Andrianaki, Aggeliki / Loupa, Chariclia / Kostis, Evangelos / Sinapidis, Dimitris / Sympardi, Styliani / Alexiou, Nikolaos / Karaiskos, Ilias / Masgala, Aikaterini / Maltezos, Efstratios / Panagopoulos, Periklis / Sachpekidis, Vasileios / Evdoridis, Constantinos / Sipsas, Nikolaos V / Daikos, Georgios / Giamarellou, Helen

    International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

    2021  Volume 106, Page(s) 213–220

    Abstract: Objective: The clinical profile, management and outcome of infective endocarditis (IE) may be influenced by socioeconomic issues.: Methods: A nationwide prospective study evaluated IE during the era of deep economic crisis in Greece. Epidemiological ... ...

    Abstract Objective: The clinical profile, management and outcome of infective endocarditis (IE) may be influenced by socioeconomic issues.
    Methods: A nationwide prospective study evaluated IE during the era of deep economic crisis in Greece. Epidemiological data and factors associated with 60-day mortality were analyzed through descriptive statistics, logistic and Cox-regression models.
    Results: Among 224 patients (male 72.3%, mean age 62.4 years), Staphylococcus aureus (n = 62; methicillin-resistant S. aureus (MRSA) 33.8%) predominated in the young without impact on mortality (p = 0.593), whilst Enterococci (n = 36) predominated in the elderly. Complications of IE were associated with mortality: heart failure [OR 2.415 (95% CI: 1.159-5.029), p = 0.019], stroke [OR 3.206 (95% CI: 1.190-8.632), p = 0.018] and acute kidney injury [OR 2.283 (95% CI: 1.085-4.805), p = 0.029]. A 60-day survival benefit was solely related to cardiac surgery for IE during hospitalization [HR 0.386 (95% CI: 0.165-0.903), p = 0.028] and compliance with antimicrobial treatment guidelines [HR 0.487 (95% CI: 0.259-0.916), p = 0.026]. Compared with a previous country cohort study, history of rheumatic fever and native valve predisposition had declined, whilst underlying renal disease and right-sided IE had increased (p < 0.0001); HIV infection had emerged (p = 0.002). No difference in rates of surgery and outcome was assessed.
    Conclusions: A country-wide survey of IE highlighted emergence of HIV, right-sided IE and predominance of MRSA in the youth during a severe socioeconomic crisis. Compliance with treatment guidelines promoted survival.
    MeSH term(s) Adolescent ; Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Cohort Studies ; Endocarditis/epidemiology ; Endocarditis/microbiology ; Endocarditis/mortality ; Endocarditis/virology ; Greece/epidemiology ; Humans ; Male ; Middle Aged ; Prospective Studies
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2021-03-09
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 1331197-9
    ISSN 1878-3511 ; 1201-9712
    ISSN (online) 1878-3511
    ISSN 1201-9712
    DOI 10.1016/j.ijid.2021.03.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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