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Article ; Online: Best practice in the use of peripheral venous catheters: A scoping review and expert consensus.

Zingg, Walter / Barton, Andrew / Bitmead, James / Eggimann, Philippe / Pujol, Miquel / Simon, Arne / Tatzel, Johannes

Infection prevention in practice

2023 Volume 5, Issue 2, Page(s) 100271

Abstract: Background: Peripheral intravenous catheters (PIVCs) are the most commonly used invasive medical device in health care with an overall failure rate of 35-50%. Most complications are non-infectious, but local site and bloodstream infections can also ... ...

Abstract	Background: Peripheral intravenous catheters (PIVCs) are the most commonly used invasive medical device in health care with an overall failure rate of 35-50%. Most complications are non-infectious, but local site and bloodstream infections can also occur. Even if PIVC-related infections are rare, the total number of affected patients and the preponderance of Methods: A panel of experts discussed this topic based on evidence and proposed practice points by consensus. Discussion: Despite published evidence-based guidelines, current practice concerning aseptic techniques during insertion and care of PIVCs often are substandard. These devices have become commonplace and tend to be perceived as safe. An overall lack of awareness about the true risks associated with the use of PIVCs results in limited surveillance and prevention efforts. Conclusion: Successful insertion and maintenance bundles in central venous lines are a blueprint to the implementation of adapted bundle strategies in the prevention of PIVC-associated infections. There is a need for studies to specifically investigate infection prevention in PIVCs and to agree on effective and implementable bundles.
Language	English
Publishing date	2023-02-03
Publishing country	England
Document type	Journal Article
ISSN	2590-0889
ISSN (online)	2590-0889
DOI	10.1016/j.infpip.2023.100271
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Article ; Online: Importancia de los centros geriátricos o de las instituciones sanitarias de estancia prolongada en la persistencia de la endemia por SARM.

Pujol, Miquel

Enfermedades infecciosas y microbiologia clinica

2011 Volume 29, Issue 6, Page(s) 403–404

Title translation	Importance of geriatric centres or long-stay health institutions due to the endemic persistence of MRSA.
MeSH term(s)	Aged ; Carrier State ; Endemic Diseases ; Homes for the Aged ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Staphylococcal Infections/epidemiology
Language	Spanish
Publishing date	2011-06
Publishing country	Spain
Document type	Editorial
ZDB-ID	1070941-1
ISSN	1578-1852 ; 0213-005X
ISSN (online)	1578-1852
ISSN	0213-005X
DOI	10.1016/j.eimc.2011.05.002
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Zs.A 3204: Show issues

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Article: The Effectiveness of Combination Therapy for Treating Methicillin-Susceptible

Grillo, Sara / Puig-Asensio, Mireia / Schweizer, Marin L / Cuervo, Guillermo / Oriol, Isabel / Pujol, Miquel / Carratalà, Jordi

Microorganisms

2022 Volume 10, Issue 5

Abstract: Background: This meta-analysis aims to evaluate the effectiveness of combination therapy for treating MSSA bacteremia.: Methods: We searched Ovid MEDLINE, EMBASE, Cochrane CENTRAL, and clinicaltrials.gov for studies including adults with MSSA ... ...

Abstract	Background: This meta-analysis aims to evaluate the effectiveness of combination therapy for treating MSSA bacteremia. Methods: We searched Ovid MEDLINE, EMBASE, Cochrane CENTRAL, and clinicaltrials.gov for studies including adults with MSSA bacteremia. The monotherapy group used a first-line antibiotic active against MSSA and the combination group used a first-line antibiotic plus additional antibiotic/s. The primary outcome was all-cause mortality. Secondary outcomes included persistent bacteremia, duration of bacteremia, relapse, and adverse events. Random-effects models with inverse variance weighting were used to estimate pooled risk ratios (pRR). Heterogeneity was assessed using the Results: A total of 12 studies (6 randomized controlled trials [RCTs]) were included. Combination therapy did not significantly reduce 30-day mortality (pRR 0.92, 95% CI, 0.70-1.20), 90-day mortality (pRR 0.89, 95% CI, 0.74-1.06), or any-time mortality (pRR 0.91, 95% CI, 0.76-1.08). Among patients with deep-seated infections, adjunctive rifampicin may reduce 90-day mortality (3 studies with moderate-high risk of bias; pRR 0.62, 95% CI, 0.42-0.92). For secondary outcomes, combination therapy decreased the risk of relapse (pRR 0.38, 95% CI, 0.22-0.66), but this benefit was not maintained when pooling RCTs (pRR 0.54, 95% CI, 0.12-2.51). Combination therapy was associated with an increased risk of adverse events (pRR 1.74, 95% CI, 1.31-2.31). Conclusions: Combination therapy not only did not decrease mortality in patients with MSSA bacteremia, but also increased the risk of adverse events. Combination therapy may reduce the risk of relapse, but additional high-quality studies are needed.
Language	English
Publishing date	2022-04-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms10050848
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Article ; Online: Reply to Pacios-Martínez and García-Monzón.

Pujol, Miquel / Tebé, Cristian / Pallarès, Natalia / Miró, Jose M / Carratalà, Jordi

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

2020 Volume 72, Issue 11, Page(s) e923

Language	English
Publishing date	2020-10-02
Publishing country	United States
Document type	Letter ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa1498
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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)
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Article ; Online: Reducing the duration of antibiotic therapy in surgical patients through a specific nationwide antimicrobial stewardship program. A prospective, interventional cohort study.

Batlle, Maria / Badia, Josep M / Hernández, Sergi / Grau, Santiago / Padulles, Ariadna / Boix-Palop, Lucía / Giménez-Pérez, Montserrat / Ferrer, Ricard / Calbo, Esther / Limón, Enric / Pujol, Miquel / Horcajada, Juan P

International journal of antimicrobial agents

2023 Volume 62, Issue 5, Page(s) 106943

Abstract: Background: Guidelines recommend 5-7 days of antibiotic treatment in patients with surgical infection and adequate source control. This nationwide stewardship intervention aimed to reduce the duration of treatments in surgical patients to <7 days.: ... ...

Abstract	Background: Guidelines recommend 5-7 days of antibiotic treatment in patients with surgical infection and adequate source control. This nationwide stewardship intervention aimed to reduce the duration of treatments in surgical patients to <7 days. Methods: Prospective cohort study evaluating surgical patients receiving antibiotics ≥7 days in 32 hospitals. Indication for treatment, quality of source control, type of recommendations issued, and adherence to the recommendations were analysed. Temporal trends in the percentages of patients with treatment >7 days were evaluated using a linear regression model and Pearson's correlation coefficients. Results: A total of 32 499 patients were included. Of these, 13.7% had treatments ≥7 days. In all, 3912 stewardship interventions were performed, primarily in general surgery (90.7%) and urology (8.1%). The main types of infection were intra-abdominal (73.4%), skin/soft tissues (9.8%) and urinary (9.2%). The septic focus was considered controlled in 59.9% of cases. Out of 5458 antibiotic prescriptions, the most frequently analysed drugs were piperacillin/tazobactam (21.7%), metronidazole (11.2%), amoxicillin/clavulanate (10.3%), meropenem (10.7%), ceftriaxone (9.3%) and ciprofloxacin (6.7%). The main recommendations issued were: treatment discontinuation (35.0%), maintenance (40.0%) or de-escalation (15.5%), and the overall adherence rate was 91.5%. With adequate source control, the most frequent recommendation was to terminate treatment (51.2%). Throughout the study period, a significant decrease in the percentage of prolonged treatments was observed (Pc=-0.69;P < 0.001). Conclusions: This stewardship programme reduced the duration of treatments in surgical departments. Preference was given to general surgery services, intra-abdominal infection, and beta-lactam antibiotics, including carbapenems. Adherence to the issued recommendations was high.
MeSH term(s)	Humans ; Prospective Studies ; Cohort Studies ; Antimicrobial Stewardship ; Anti-Bacterial Agents/therapeutic use ; Piperacillin, Tazobactam Drug Combination/therapeutic use
Chemical Substances	Anti-Bacterial Agents ; Piperacillin, Tazobactam Drug Combination (157044-21-8)
Language	English
Publishing date	2023-08-02
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1093977-5
ISSN	1872-7913 ; 0924-8579
ISSN (online)	1872-7913
ISSN	0924-8579
DOI	10.1016/j.ijantimicag.2023.106943
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Zs.A 3368: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 500: Show issues

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Article ; Online: Eggerthella lenta bacteremia associated to colonic polyps and colon adenocarcinoma.

Soldevila Boixader, Laura / Berbel, Damaris / Pujol, Miquel

Medicina clinica

2017 Volume 149, Issue 9, Page(s) 418–419

Title translation	Bacteriemia por Eggerthella lenta asociada a poliposis colónica y adenocarcinoma de colon.
MeSH term(s)	Actinobacteria/isolation & purification ; Adenocarcinoma/complications ; Adenocarcinoma/diagnosis ; Adenocarcinoma/microbiology ; Aged, 80 and over ; Bacteremia/diagnosis ; Bacteremia/etiology ; Colonic Neoplasms/complications ; Colonic Neoplasms/diagnosis ; Colonic Neoplasms/microbiology ; Colonic Polyps/complications ; Colonic Polyps/diagnosis ; Colonic Polyps/microbiology ; Gram-Positive Bacterial Infections/diagnosis ; Gram-Positive Bacterial Infections/etiology ; Humans ; Male
Language	Spanish
Publishing date	2017-07-29
Publishing country	Spain
Document type	Case Reports ; Letter
ZDB-ID	411607-0
ISSN	1578-8989 ; 0025-7753
ISSN (online)	1578-8989
ISSN	0025-7753
DOI	10.1016/j.medcli.2017.04.025
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Ua VI Zs.279: Show issues

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Article: Bloodstream Infection and Endocarditis Caused by Staphylococcus aureus in Patients with Cancer: A Multicenter Cohort Study.

Grillo, Sara / Cuervo, Guillermo / Laporte-Amargós, Júlia / Tuells, Manel / Grau, Immaculada / Berbel, Dàmaris / Gudiol, Carlota / Pujol, Miquel / Carratalà, Jordi

Infectious diseases and therapy

2021 Volume 11, Issue 1, Page(s) 323–334

Abstract: Introduction: In a large cohort of patients with Staphylococcus aureus bloodstream infection (SABSI), we aimed to analyze the incidence and risk factors for infective endocarditis (IE) among patients with active cancer (PAC) in comparison with those ... ...

Abstract	Introduction: In a large cohort of patients with Staphylococcus aureus bloodstream infection (SABSI), we aimed to analyze the incidence and risk factors for infective endocarditis (IE) among patients with active cancer (PAC) in comparison with those without cancer (PWC). Methods: Multicenter cohort study of patients with SABSI admitted to two tertiary care hospitals, from 2011 to 2019. PAC were defined as those with an active solid organ cancer or hematological malignancies. SABSI and S. aureus IE were compared between PAC and PWC. Results: Among 978 episodes of SABSI, 217 (22.2%) occurred in PAC. PAC were younger, had fewer comorbidities, carried cardiac devices less often, and had less community-acquired SABSI than PWC. Compared to PWC, PAC more frequently had catheter-related SABSI, less IE (2.8% vs 10.9%, p < 0.001) and osteoarticular infection (2.3% vs 14.3%, p < 0.001). Independent risk factors for IE were cardiopathy (aOR 4.392, 95% CI 2.719-7.094) and persistent bacteremia (aOR 3.545, 95% CI 2.159-5.820). Thirty-day mortality was high, and similar between groups (24.2% vs 25.5%, p = 0.282). Conclusions: PAC with SABSI developed IE less frequently than PWC did. This finding seems related to the differences in baseline characteristics and may have significant clinical implications, such as transesophageal echocardiography in PAC without cardiopathy or persistent bacteremia.
Language	English
Publishing date	2021-12-02
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2701611-0
ISSN	2193-6382 ; 2193-8229
ISSN (online)	2193-6382
ISSN	2193-8229
DOI	10.1007/s40121-021-00575-8
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Article ; Online: Epidemiología general de las infecciones nosocomiales. Sistemas y programas de vigilancia.

Pujol, Miquel / Limón, Enric

Enfermedades infecciosas y microbiologia clinica

2013 Volume 31, Issue 2, Page(s) 108–113

Abstract: Infections related to the health-care system are those associated with health care practices in hospitalized patients as well as in out-patients with health-care contact. Nosocomial infections affect 5% of in-patients, and carry a high morbidity, ... ...

Title translation	General epidemiology of nosocomial infections. Surveillance systems and programs.
Abstract	Infections related to the health-care system are those associated with health care practices in hospitalized patients as well as in out-patients with health-care contact. Nosocomial infections affect 5% of in-patients, and carry a high morbidity, mortality and economic cost. The main types of nosocomial infections are related to invasive procedures, and include respiratory tract infection, surgical site infections, urinary tract infections, and vascular catheter bacteremia. It has been shown that the application of checklists and a bundle of measures are useful in preventing these infections. Epidemiological surveillance, defined as the gathering of information to take actions, is the basis of infection control programs. These have evolved from a global surveillance targeted at processes and indicators of nosocomial infection. The comparison of these indicators can be useful in establishing preventive measures.
MeSH term(s)	Cross Infection/epidemiology ; Cross Infection/prevention & control ; Epidemiological Monitoring ; Humans ; National Health Programs
Language	Spanish
Publishing date	2013-02
Publishing country	Spain
Document type	English Abstract ; Journal Article
ZDB-ID	1070941-1
ISSN	1578-1852 ; 0213-005X
ISSN (online)	1578-1852
ISSN	0213-005X
DOI	10.1016/j.eimc.2013.01.001
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Article ; Online: Leveraging a nationwide infection surveillance program to implement a colorectal surgical site infection reduction bundle: a pragmatic, prospective, and multicenter cohort study.

Badia, Josep M / Arroyo-Garcia, Nares / Vázquez, Ana / Almendral, Alexander / Gomila-Grange, Aina / Fraccalvieri, Domenico / Parés, David / Abad-Torrent, Ana / Pascual, Marta / Solís-Peña, Alejandro / Puig-Asensio, Mireia / Pera, Miguel / Gudiol, Francesc / Limón, Enric / Pujol, Miquel

International journal of surgery (London, England)

2023 Volume 109, Issue 4, Page(s) 737–751

Abstract: Background: Bundled interventions usually reduce surgical site infection (SSI) when implemented at single hospitals, but the feasibility of their implementation at the nationwide level and their clinical results are not well established.: Materials ... ...

Abstract	Background: Bundled interventions usually reduce surgical site infection (SSI) when implemented at single hospitals, but the feasibility of their implementation at the nationwide level and their clinical results are not well established. Materials and methods: Pragmatic interventional study to analyze the implementation and outcomes of a colorectal surgery care bundle within a nationwide quality improvement program. The bundle consisted of antibiotic prophylaxis, oral antibiotic prophylaxis (OAP), mechanical bowel preparation, laparoscopy, normothermia, and a wound retractor. Control group (CG) and Intervention group (IG) were compared. Overall SSI, superficial (S-SSI), deep (D-SSI), and organ/space (O/S-SSI) rates were analyzed. Secondary endpoints included microbiology, 30-day mortality, and length of hospital stay. Results: A total of 37 849 procedures were included, 19 655 in the CG and 18 194 in the IG. In all, 5462 SSIs (14.43%) were detected: 1767 S-SSI (4.67%), 847 D-SSI (2.24%), and 2838 O/S-SSI (7.5%). Overall SSI fell from 18.38% (CG) to 10.17% (IG), odds ratio (OR) of 0.503 [0.473-0.524]. O/S-SSI rates were 9.15% (CG) and 5.72% (IG), OR of 0.602 [0.556-0.652]. The overall SSI rate was 16.71% when no measure was applied and 6.23% when all six were used. Bundle implementation reduced the probability of overall SSI (OR: 0.331; CI 95 : 0.242-0.453), and also O/S-SSI rate (OR: 0.643; CI 95 : 0.416-0.919). In the univariate analysis, all measures except normothermia were associated with a reduction in overall SSI, while only laparoscopy, OAP, and mechanical bowel preparation were related to a decrease in O/S-SSI. Laparoscopy, wound retractor, and OAP decreased overall SSI and O/S-SSI in the multivariate analysis. Conclusions: In this cohort study, the application of a specific care bundle within a nationwide nosocomial infection surveillance system proved feasible and resulted in a significant reduction in overall and O/S-SSI rates in the elective colon and rectal surgery. The OR for SSI fell between 1.5 and 3 times after the implementation of the bundle.
MeSH term(s)	Humans ; Cohort Studies ; Prospective Studies ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/prevention & control ; Colorectal Neoplasms/surgery
Language	English
Publishing date	2023-04-01
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1097/JS9.0000000000000277
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Zs.A 6502: Show issues

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Article ; Online: Pharmacotherapeutic options for treating Staphylococcus aureus bacteremia.

Gudiol, Carlota / Cuervo, Guillermo / Shaw, Evelyn / Pujol, Miquel / Carratalà, Jordi

Expert opinion on pharmacotherapy

2017

Abstract: Introduction: Case-fatality rates for Staphylococcus aureus bacteremia (SAB) remain unacceptably high and have improved only modestly in recent decades. Treatment of SAB is still a clinical challenge, especially if methicillin-resistant strains are ... ...

Abstract	Introduction: Case-fatality rates for Staphylococcus aureus bacteremia (SAB) remain unacceptably high and have improved only modestly in recent decades. Treatment of SAB is still a clinical challenge, especially if methicillin-resistant strains are involved. New drugs with anti-staphylococcal activity are currently available, and their role as alternatives to standard therapies is being investigated. Areas covered: In this review, we give an update of the current available antibiotics for the treatment of SAB. We provide information regarding the pharmacological characteristics, the accepted indications, and the most important adverse events of the old and new anti- staphylococcal agents, as well as the existing evidence on their use for the treatment of SAB. Expert opinion: The management of patients with SAB is very complex and needs a multidisciplinary approach. There are currently new available options for the treatment of methicillin-resistant SAB. However, more data from clinical trials are needed to assign specific roles to each antibiotic and to include them in the new antibacterial armamentarium. The role of combination therapy for the treatment of increasingly complex patients with SAB deserves thorough investigation.
Language	English
Publishing date	2017-11-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2001535-5
ISSN	1744-7666 ; 1465-6566
ISSN (online)	1744-7666
ISSN	1465-6566
DOI	10.1080/14656566.2017.1403585
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