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Article ; Online: Optimising utilisation of GLASS data to inform cross-border antimicrobial resistance strategy is a priority.

Pallett, Scott John Charles / Charani, Esmita / Lamb, Georgia / Mazzella, Andrea / Alqahtani, Saleh A / Moore, Luke Stephen Prockter

Lancet regional health. Americas

2023 Volume 29, Page(s) 100655

Language	English
Publishing date	2023-12-22
Publishing country	England
Document type	Journal Article
ISSN	2667-193X
ISSN (online)	2667-193X
DOI	10.1016/j.lana.2023.100655
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Risk of omicron infection for high-risk older adults in long-term care facilities.

Pallett, Scott J C / Heskin, Joseph / Keating, Fergus / Mazzella, Andrea / O'Shea, Matthew K / Moore, Luke S P

The Lancet. Infectious diseases

2023 Volume 23, Issue 5, Page(s) 526–527

MeSH term(s)	Humans ; Aged ; Long-Term Care ; Skilled Nursing Facilities ; Health Facilities
Language	English
Publishing date	2023-03-17
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2061641-7
ISSN	1474-4457 ; 1473-3099
ISSN (online)	1474-4457
ISSN	1473-3099
DOI	10.1016/S1473-3099(23)00179-2
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Article ; Online: Neutralising antibody titres as predictors of protection against SARS-CoV-2 variants.

Pallett, Scott J C / Heskin, Joseph / Groppelli, Elisabetta / Mazzella, Andrea / Moore, Luke S P

The Lancet. Microbe

2021 Volume 3, Issue 3, Page(s) e167

MeSH term(s)	Antibodies, Neutralizing/immunology ; Antibodies, Viral/immunology ; COVID-19 ; Humans ; SARS-CoV-2/genetics
Chemical Substances	Antibodies, Neutralizing ; Antibodies, Viral
Language	English
Publishing date	2021-12-23
Publishing country	England
Document type	Letter ; Comment
ISSN	2666-5247
ISSN (online)	2666-5247
DOI	10.1016/S2666-5247(21)00337-2
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Article: A retrospective analysis of the utility and safety of kidney transplant biopsies by nephrology trainees and consultants.

Reschen, Michael E / Mazzella, Andrea / Sharples, Edward

Annals of medicine and surgery (2012)

2018 Volume 28, Page(s) 6–10

Abstract: Background and aims: Dysfunction of a kidney transplant often requires histological sampling by percutaneous ultrasound-guided core needle biopsy. Transplant biopsy is more specialized than native kidney biopsy, the indications and complications are ... ...

Abstract	Background and aims: Dysfunction of a kidney transplant often requires histological sampling by percutaneous ultrasound-guided core needle biopsy. Transplant biopsy is more specialized than native kidney biopsy, the indications and complications are less well defined and in England are performed mainly by nephrologists. The aims of the study were to evaluate the adequacy and complication rate in living and deceased donor recipients according to training status of the nephrologist, assess the accuracy of physicians in predicting rejection, the threshold creatinine rise for biopsy, and the change in drug management post-biopsy. Materials and methods: We performed a retrospective analysis of all adult patients undergoing a kidney transplant biopsy in 2015 at a major teaching hospital in the UK as part of a service evaluation program. The primary outcome measure was the rate of major complications and secondary measures included sample adequacy, seniority of operator, clinician-predicted diagnosis, biopsy diagnosis and change in drug management. Results: One hundred and seven (n = 107) transplant biopsies were performed across 27 living donor (LD) recipients and 57 deceased donor (DD) recipients. LDs were statistically less likely to have diabetes, more likely to take azathioprine. Biopsies were performed by trainees rather than consultants at a ratio of 3:1. The complication rate was low with no major bleeding complications. Visible haematuria occurred in 4.7% and 2.8% of patients developed transplant pyelonephritis. 3.7% of biopsies contained no glomeruli. There was no effect attributed to training status. The pre-biopsy rise in creatinine was significantly less for LD compared to DD recipients (45% vs 70%). A clinician-suspected diagnosis of rejection was confirmed on biopsy in 42.9% of cases and overall about 47.9% of biopsies led to a change in drug management. Conclusions: Kidney transplant biopsies were safe, performed adequately by trainee nephrologists and were often associated with a change in drug management.
Language	English
Publishing date	2018-02-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2018.02.001
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Article ; Online: The impact of immunosuppressive therapy on secondary infections and antimicrobial use in COVID-19 inpatients: a retrospective cohort study.

Crook, Peter / Logan, Clare / Mazzella, Andrea / Wake, Rachel M / Cusinato, Martina / Yau, Ting / Ong, Yee-Ean / Planche, Timothy / Basarab, Marina / Bicanic, Tihana

BMC infectious diseases

2023 Volume 23, Issue 1, Page(s) 808

Abstract: Background: Immunosuppressive therapies have become a cornerstone of the management of severe COVID-19. The impact of these therapies on secondary infections and antimicrobial prescribing remains unclear. We sought to assess antimicrobial use and the ... ...

Abstract	Background: Immunosuppressive therapies have become a cornerstone of the management of severe COVID-19. The impact of these therapies on secondary infections and antimicrobial prescribing remains unclear. We sought to assess antimicrobial use and the incidence of bacterial and fungal infections in patients with severe COVID-19, and to explore their associations with receipt of immunosuppressive therapies. Methods: Our retrospective cohort study included 715 hospitalised, adult patients with severe COVID-19 admitted to St George's Hospital, London, UK, during the first UK pandemic wave (1 Results: Microbiologically confirmed co-infection occurred in 4.2% (n = 30) and secondary infection in 9.3% (n = 66) of the cohort (n = 715) and were associated with in-hospital mortality (48% vs 35%, OR 1.8, 95%CI 1.1-2.7, p = 0.01). Respiratory (n = 41, 39%) and bloodstream infections (n = 38, 36%) predominated, with primarily Gram-negative pathogens. 606 (84.7%) patients received an antimicrobial, amounting to 742 days of therapy per 1000 patient-days (DOTs). In multivariable models, receipt of high-dose steroids (≥ 30 mg prednisolone or equivalent) or tocilizumab was significantly associated with increased antimicrobial consumption (+ 5.5 DOTs, 95%CI 3.4-7.7 days) but not secondary infection (HR 0.56, 95%CI 0.26-1.18). Conclusions: Bacterial and fungal infections in severe COVID-19 were uncommon. Receipt of steroids or tocilizumab was independently associated with antimicrobial consumption despite its lack of association with secondary infection. These findings should galvanise efforts to promote antimicrobial stewardship in patients with COVID-19.
MeSH term(s)	Adult ; Humans ; Inpatients ; Coinfection/drug therapy ; Retrospective Studies ; COVID-19 ; Immunosuppression Therapy ; Anti-Infective Agents/therapeutic use ; Mycoses/drug therapy ; Mycoses/epidemiology ; Steroids ; Bacterial Infections
Chemical Substances	Anti-Infective Agents ; Steroids
Language	English
Publishing date	2023-11-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-023-08697-9
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Article ; Online: National action plans for antimicrobial resistance and variations in surveillance data platforms.

Pallett, Scott Jc / Charani, Esmita / Hawkins, Lois / Mazzella, Andrea / Anton-Vazquez, Vanesa / Banerjee, Rishi / Evans, Terry J / Patterson, Benjamin / Subbarao, Sathyavani / Alqahtani, Saleh / Basarab, Marina / Breathnach, Aodhan S / Mughal, Nabeela / Moore, Luke Sp

Bulletin of the World Health Organization

2023 Volume 101, Issue 8, Page(s) 501–512F

Abstract: Objective: To assess how national antimicrobial susceptibility data used to inform national action plans vary across surveillance platforms.: Methods: We identified available open-access, supranational, interactive surveillance platforms and cross- ... ...

Abstract	Objective: To assess how national antimicrobial susceptibility data used to inform national action plans vary across surveillance platforms. Methods: We identified available open-access, supranational, interactive surveillance platforms and cross-checked their data in accordance with the World Health Organization's (WHO's) Data Quality Assurance: module 1. We compared platform usability and completeness of time-matched data on the antimicrobial susceptibilities of four blood isolate species: Findings: Of 71 countries actively submitting data to WHO, 28 also submit to Pfizer's database; 19 to ECDC; and 16 to all three platforms. Limits of agreement between WHO's and Pfizer's platforms for organism-country susceptibility data ranged from -26% to 35%. While mean susceptibilities of WHO's and ECDC's platforms did not differ (bias: 0%, 95% confidence interval: -2 to 2), concordance between organism-country susceptibility was low (limits of agreement -18% to 18%). Significant differences exist in isolate numbers reported between WHO-Pfizer (mean of difference: 674, Conclusion: The considerable heterogeneity of nationally submitted data to commonly used antimicrobial resistance surveillance platforms compromises their validity, thus undermining local and global antimicrobial resistance strategies. Hence, we need to understand and address surveillance platform variability and its underlying mechanisms.
MeSH term(s)	Humans ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Drug Resistance, Bacterial ; Microbial Sensitivity Tests ; Anti-Infective Agents
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents
Language	English
Publishing date	2023-05-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	80213-x
ISSN	1564-0604 ; 0042-9686 ; 0366-4996 ; 0510-8659
ISSN (online)	1564-0604
ISSN	0042-9686 ; 0366-4996 ; 0510-8659
DOI	10.2471/BLT.22.289403
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Article ; Online: COVID-19-associated pulmonary aspergillosis in mechanically ventilated patients: a prospective, multicentre UK study.

Hurt, William / Youngs, Jonathan / Ball, Jonathan / Edgeworth, Jonathan / Hopkins, Philip / Jenkins, David R / Leaver, Susannah / Mazzella, Andrea / Molloy, Síle F / Schelenz, Silke / Wise, Matt P / White, P Lewis / Yusuff, Hakeem / Wyncoll, Duncan / Bicanic, Tihana

Thorax

2023 Volume 79, Issue 1, Page(s) 75–82

Abstract: Background: Invasive pulmonary aspergillosis is a complication of severe COVID-19, with regional variation in reported incidence and mortality. We describe the incidence, risk factors and mortality associated with COVID-19-associated pulmonary ... ...

Abstract	Background: Invasive pulmonary aspergillosis is a complication of severe COVID-19, with regional variation in reported incidence and mortality. We describe the incidence, risk factors and mortality associated with COVID-19-associated pulmonary aspergillosis (CAPA) in a prospective, multicentre UK cohort. Methods: From March 2020 to March 2021, 266 mechanically ventilated adults with COVID-19 were enrolled across 5 UK hospital intensive care units (ICUs). CAPA was defined using European Confederation for Medical Mycology and the International Society for Human and Animal Mycology criteria and fungal diagnostics performed on respiratory and serum samples. Results: Twenty-nine of 266 patients (10.9%) had probable CAPA, 14 (5.2%) possible CAPA and none proven CAPA. Probable CAPA was diagnosed a median of 9 (IQR 7-16) days after ICU admission. Factors associated with probable CAPA after multivariable logistic regression were cumulative steroid dose given within 28 days prior to ICU admission (adjusted OR (aOR) 1.16; 95% CI 1.01 to 1.43 per 100 mg prednisolone-equivalent), receipt of an interleukin (IL)-6 inhibitor (aOR 2.79; 95% CI 1.22 to 6.48) and chronic obstructive pulmonary disease (COPD) (aOR 4.78; 95% CI 1.13 to 18.13). Mortality in patients with probable CAPA was 55%, vs 46% in those without. After adjustment for immortal time bias, CAPA was associated with an increased risk of 90-day mortality (HR 1.85; 95% CI 1.07 to 3.19); however, this association did not remain statistically significant after further adjustment for confounders (adjusted HR 1.57; 95% CI 0.88 to 2.80). There was no difference in mortality between patients with CAPA prescribed antifungals (9 of 17; 53%) and those who were not (7 of 12; 58%) (p=0.77). Interpretation: In this first prospective UK study, probable CAPA was associated with corticosteroid use, receipt of IL-6 inhibitors and pre-existing COPD. CAPA did not impact mortality following adjustment for prognostic variables.
MeSH term(s)	Adult ; Animals ; Humans ; COVID-19/complications ; Prospective Studies ; Respiration, Artificial/adverse effects ; Pulmonary Aspergillosis/epidemiology ; Pulmonary Disease, Chronic Obstructive ; United Kingdom/epidemiology
Language	English
Publishing date	2023-12-15
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thorax-2023-220002
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Article: HIV-associated disseminated histoplasmosis successfully treated with isavuconazole consolidation therapy

Mazzella, Andrea / Stone, Neil R.H / Pool, Erica R.M / García Mingo, Ana / Bolache, Sorina / Wood, Chris

Medical mycology case reports. 2020 Mar., v. 27

2020

Abstract: A 30-year-old man with advanced HIV and disseminated histoplasmosis deteriorated after stepping down from intravenous liposomal amphotericin B to itraconazole.Therapeutic levels of itraconazole and posaconazole were not achieved, therefore liposomal ... ...

Abstract	A 30-year-old man with advanced HIV and disseminated histoplasmosis deteriorated after stepping down from intravenous liposomal amphotericin B to itraconazole.Therapeutic levels of itraconazole and posaconazole were not achieved, therefore liposomal amphotericin B was reintroduced. Stepdown treatment was switched to oral isavuconazole; since then the patient has remained well.
Keywords	HIV infections ; Human immunodeficiency virus ; amphotericin B ; case studies ; drug carriers ; histoplasmosis ; itraconazole ; liposomes (artificial) ; patients
Language	English
Dates of publication	2020-03
Size	p. 42-43.
Publishing place	Elsevier B.V.
Document type	Article
ISSN	2211-7539
DOI	10.1016/j.mmcr.2019.12.013
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Article ; Online: Implicit learning in cotton-top tamarins (Saguinus oedipus) and pigeons (Columba livia).

Locurto, Charles / Fox, Maura / Mazzella, Andrea

Learning & behavior

2015 Volume 43, Issue 2, Page(s) 129–142

Abstract: There is considerable interest in the conditions under which human subjects learn patterned information without explicit instructions to learn that information. This form of learning, termed implicit or incidental learning, can be approximated in ... ...

Abstract	There is considerable interest in the conditions under which human subjects learn patterned information without explicit instructions to learn that information. This form of learning, termed implicit or incidental learning, can be approximated in nonhumans by exposing subjects to patterned information but delivering reinforcement randomly, thereby not requiring the subjects to learn the information in order to be reinforced. Following acquisition, nonhuman subjects are queried as to what they have learned about the patterned information. In the present experiment, we extended the study of implicit learning in nonhumans by comparing two species, cotton-top tamarins (Saguinus oedipus) and pigeons (Columba livia), on an implicit learning task that used an artificial grammar to generate the patterned elements for training. We equated the conditions of training and testing as much as possible between the two species. The results indicated that both species demonstrated approximately the same magnitude of implicit learning, judged both by a random test and by choice tests between pairs of training elements. This finding suggests that the ability to extract patterned information from situations in which such learning is not demanded is of longstanding origin.
MeSH term(s)	Animals ; Choice Behavior ; Columbidae ; Learning ; Male ; Reinforcement (Psychology) ; Saguinus/psychology
Language	English
Publishing date	2015-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2048665-0
ISSN	1543-4508 ; 1543-4494
ISSN (online)	1543-4508
ISSN	1543-4494
DOI	10.3758/s13420-015-0167-0
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Article ; Online: Early identification of high-risk individuals for monoclonal antibody therapy and prophylaxis is feasible by SARS-CoV-2 anti-spike antibody specific lateral flow assay.

Pallett, Scott J C / Rayment, Michael / Heskin, Joseph / Mazzella, Andrea / Jones, Rachael / Mughal, Nabeela / Randell, Paul / Davies, Gary W / Moore, Luke S P

Diagnostic microbiology and infectious disease

2022 Volume 104, Issue 3, Page(s) 115788

Abstract: Monoclonal antibody therapy has been approved for prophylaxis and treatment of severe COVID-19 infection. Greatest benefit appears limited to those yet to mount an effective immune response from natural infection or vaccination, but concern exists around ...

Abstract	Monoclonal antibody therapy has been approved for prophylaxis and treatment of severe COVID-19 infection. Greatest benefit appears limited to those yet to mount an effective immune response from natural infection or vaccination, but concern exists around ability to make timely assessment of immune status of community-based patients where laboratory-based serodiagnostics predominate. Participants were invited to undergo paired laboratory-based (Abbott Architect SARS-CoV-2 IgG Quant II chemiluminescent microparticle immunoassay) and lateral flow assays (LFA; a split SARS-CoV-2 IgM/IgG and total antibody test) able to detect SARS-CoV-2 anti-spike antibodies. LFA band strength was compared with CMIA titer by log-linear regression. Two hundred individuals (median age 43.5 years, IQR 30-59; 60.5% female) underwent testing, with a further 100 control sera tested. Both LFA band strengths correlated strongly with CMIA antibody titers (P < 0.001). LFAs have the potential to assist in early identification of seronegative patients who may demonstrate the greatest benefit from monoclonal antibody treatment.
MeSH term(s)	Adult ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Viral ; COVID-19/diagnosis ; COVID-19/drug therapy ; Female ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Male ; SARS-CoV-2
Chemical Substances	Antibodies, Monoclonal ; Antibodies, Viral ; Immunoglobulin G ; Immunoglobulin M
Language	English
Publishing date	2022-08-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	604920-5
ISSN	1879-0070 ; 0732-8893
ISSN (online)	1879-0070
ISSN	0732-8893
DOI	10.1016/j.diagmicrobio.2022.115788
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