Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 39
Filtrar
1.
Diagn Microbiol Infect Dis ; 110(4): 116536, 2024 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-39298935

RESUMEN

Current guidelines recommend urine culture after catheter replacement to diagnose catheter-associated urinary tract infections (CA-UTI) in patients with long-term catheters, but it's unclear if this applies to short-term catheterizations. We studied 52 patients with catheters for less than 28 days, showing symptoms of CA-UTI. We collected urine from the catheter port initially and from the new catheter within 2 hours of replacement. Positive culture rates were 36.5 % before and 28.8 % after replacement. Significant differences in urine culture results were observed in 32.7 % of cases postreplacement (P = .0184), increasing to 78.9 % after excluding negative pre-replacement cultures (P = 0.0003). Duration of catheterization didn't affect urine bacteriology changes post-replacement. This suggests that urine bacteriology often differs after catheter replacement in short-term catheterizations.

2.
JAMA Intern Med ; 2024 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-39186290
4.
Expert Rev Anti Infect Ther ; 22(6): 387-398, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38703093

RESUMEN

INTRODUCTION: The escalating threat of multidrug-resistant organisms necessitates constant exploration for novel antimicrobial agents. Eravacycline has emerged as a promising solution due to its unique chemical structure, which enhances potency and expands its spectrum of activity. AREA COVERED: This review provides a thorough examination of eravacycline, encompassing its in vitro activity against Gram-positive and Gram-negative aerobes, carbapenem-non-susceptible organisms, anaerobes, and other bacterial strains. Additionally, it evaluates evidence from clinical studies to establish its clinical effect and safety. EXPERT OPINION: Eravacycline, a synthetic fluorocycline, belongs to the tetracyclines class. Similar to other tetracycline, eravacycline exerts its antibacterial action by reversibly binding to the bacterial ribosomal 30S subunit. Eravacycline demonstrates potent in vitro activity against many Gram-positive and Gram-negative aerobes, anaerobes, and multidrug-resistant organisms. Randomized controlled trials and its associated meta-analysis affirm eravacycline's efficacy in treating complicated intra-abdominal infections. Moreover, real-world studies showcase eravacycline's adaptability and effectiveness in diverse clinical conditions, emphasizing its utility beyond labeled indications. Despite common gastrointestinal adverse events, eravacycline maintains an overall favorable safety profile, reinforcing its status as a tolerable antibiotic. However, ongoing research is essential for refining eravacycline's role, exploring combination therapy, and assessing its performance against biofilms, in combating challenging bacterial infections.


Asunto(s)
Antibacterianos , Farmacorresistencia Bacteriana Múltiple , Tetraciclinas , Humanos , Tetraciclinas/farmacología , Tetraciclinas/administración & dosificación , Tetraciclinas/efectos adversos , Antibacterianos/farmacología , Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Bacterias Grampositivas/efectos de los fármacos , Bacterias Gramnegativas/efectos de los fármacos , Animales , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/microbiología
5.
Int J Antimicrob Agents ; 64(2): 107205, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38754527

RESUMEN

OBJECTIVES: In the Asia-Pacific region, Mycoplasma pneumoniae (MP) could be a notable pathogen responsible for adult community-acquired pneumonia (CAP), with varying prevalence rates. This comprehensive review aimed to explore the epidemiology, clinical manifestations, macrolide resistance, and molecular characteristics of MP in adults across several countries in Asia. METHODS: PubMed, Embase, and Google Scholar were searched for relevant articles from 2010-2023 based on the following keywords: adult and Mycoplasma pneumoniae. RESULTS: The prevalence of MP in CAP patients in these countries ranged from 2.1% in Korea to 25.5% in Japan. Macrolide resistance was prominent, particularly in China, with rates ranging 26.9-100%. Clinical manifestations of MP infection included protean extrapulmonary manifestations, and complications such as rhabdomyolysis and thrombocytopenia. Molecular characteristics, especially the multiple locus variable-number tandem-repeat analysis type 4/5/7/2, remained predominant across various countries, emphasising the importance of ongoing surveillance. CONCLUSIONS: This review highlights the urgent need for continued monitoring of MP infections, macrolide resistance, and molecular characteristics to inform effective prevention and treatment strategies in the Asia-Pacific region.


Asunto(s)
Antibacterianos , Farmacorresistencia Bacteriana , Macrólidos , Mycoplasma pneumoniae , Neumonía por Mycoplasma , Humanos , Mycoplasma pneumoniae/efectos de los fármacos , Mycoplasma pneumoniae/genética , Macrólidos/uso terapéutico , Macrólidos/farmacología , Neumonía por Mycoplasma/epidemiología , Neumonía por Mycoplasma/microbiología , Neumonía por Mycoplasma/tratamiento farmacológico , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Asia/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Adulto , Prevalencia , Costo de Enfermedad
6.
Expert Rev Anti Infect Ther ; : 1-8, 2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38568820

RESUMEN

OBJECTIVES: This study investigated the association between nirmatrelvir plus ritonavir (NMV-r) or molnupiravir and the outcomes of non-hospitalized high-risk patients with COVID-19 during Omicron XBB subvariants. METHODS: The retrospective cohort study used the TriNetX US collaborative network to identify non-hospitalized high-risk adult patients with COVID-19 between 1 February 2023, and 31 August 2023. Propensity score matching (PSM) was used to match patients receiving NMV-r or MOV (the study group) with those not receiving antivirals (the control group). RESULTS: Using PSM, two cohorts of 17,654 patients each with balanced baseline characteristics were identified. During the follow-up period, the study group had a lower risk of all-cause hospitalization, or death (3.2% [n = 564] versus 3.8% [n = 669]; HR, 0.796; 95% confidence interval [CI], 95% CI, 0.712-0.891). Compared with the control group, the study group had a significantly lower risk of all-cause hospitalization (3.1% vs. 3.4%; HR, 0.847; 95% CI, 0.754-0.950) and mortality (0.1% vs. 0.4%; HR, 0.295; 95% CI, 0.183-0.476). CONCLUSION: The use of novel oral antiviral including NMV-r or MOV can be associated with a lower risk of all-cause hospitalization, or death in non-hospitalized high-risk patients with COVID-19 during Omicron XBB wave.

7.
Front Public Health ; 12: 1337646, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38435287

RESUMEN

Background: The outcomes of older adult people acquiring SARS-CoV-2 reinfection was unclear. This study aimed to compare the outcomes of older adult patients with COVID-19 reinfection and those with primary infection. Methods: This retrospective cohort study used electronic medical records from the TriNetX Research Network. Older adult patients (aged ≥65 years) with COVID-19 between January 1, 2022, and December 31, 2022, were included in the study. The patients were subsequently categorized into reinfection or primary infection groups, according to whether they manifested two distinct COVID-19 episodes with an intervening period of more than 90 days. Propensity score matching was performed for covariate adjustment between the reinfection and primary infection groups. The primary outcome was a composite outcome, including emergency department visits, hospitalization, intensive care unit admission, mechanical ventilation use, and mortality, following primary infection and reinfection. Results: After matching, 31,899 patients were identified in both the reinfection and primary infection groups. The risk of primary composite outcomes was 7.15% (n = 2,281) in the reinfection group and 7.53% (n = 2,403) in the primary infection group. No significant difference in the primary outcome was observed between groups (HR, 0.96; 95% CI, 0.91 to 1.02, p = 0.17). In addition, there was no significant differences between the reinfection and primary infection groups in terms of emergency department visit (HR, 1.03; 95% CI, 0.95 to 1.11, p = 0.49), all-cause hospitalization (HR, 0.94; 95% CI, 0.86 to 1.02, p = 0.14), intensive care unit admission (HR, 0.92; 95% CI, 0.67 to 1.28, p = 0.62), mechanical ventilation use (HR,1.35 95% CI, 0.69 to 2.64 p = 0.38), and all-cause mortality (HR, 0.94; 95% CI, 0.74 to 1.20, p = 0.62). Conclusion: There were no significant differences in clinical outcomes between older adult patients with COVID-19 reinfection and those with primary infection.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , Anciano , COVID-19/epidemiología , Reinfección/epidemiología , Estudios Retrospectivos
10.
Int J Antimicrob Agents ; 62(2): 106844, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37160243

RESUMEN

BACKGROUND: Carbapenem-sparing antibiotics are needed urgently for patients with complicated intra-abdominal infections (cIAIs). Although several novel antibiotics - novel ß-lactam/ß-lactamase inhibitor combinations (e.g. ceftolozane-tazobactam and ceftazidime-avibactam) and a novel tetracycline derivative (eravacycline) - have been developed for cIAIs, it remains unclear whether these antibiotics are comparable to carbapenems for the treatment of cIAIs. METHODS: A comprehensive search of PubMed, Embase, Cochrane Library and ClinicalTrials.gov was conducted until 1 October 2022. Only randomized controlled trials (RCTs) that compared the clinical efficacy and safety of novel antibiotics against carbapenems for patients with cIAIs were included. RESULTS: Among the 11 selected RCTs, no significant differences in clinical cure rate at the test-of-cure visit were observed between the study group and the control group on analysis of the clinically evaluable population [93.6% vs 93.7%, risk ratio (RR) 1.00, 95% confidence interval (CI) 0.98-1.01; P=0.84], microbiologically evaluable population (93.0% vs 94.5%, RR 0.98, 95% CI 0.96-1.00; P=0.10) and modified intention-to-treat population (85.9% vs 87.7%, RR 0.98, 95% CI 0.95-1.01; P=0.13). All findings were consistent across the subgroup analyses and sensitivity tests. Similarly, no significant difference in microbiological eradication was observed between the study group and the control group (87.8% vs 89.7%, RR 0.98, 95% CI 0.96-1.01; P=0.18). The risk of adverse events was similar in both groups. CONCLUSIONS: Clinical efficacy, microbiological response and safety of the novel antibiotics, including ceftazidime-avibactam, ceftolozane-tazobactam and eravacycline, are comparable to carbapenems for the treatment of patients with cIAIs. These agents can be potential therapeutic options as carbapenem-sparing antibiotics for cIAIs.


Asunto(s)
Antibacterianos , Infecciones Intraabdominales , Humanos , Antibacterianos/efectos adversos , Carbapenémicos/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Ceftazidima/efectos adversos , Infecciones Intraabdominales/tratamiento farmacológico , Infecciones Intraabdominales/microbiología , Tazobactam/uso terapéutico , Inhibidores de beta-Lactamasas/efectos adversos , Combinación de Medicamentos , Compuestos de Azabiciclo/uso terapéutico
11.
Ann Med ; 55(1): 2208872, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37199379

RESUMEN

OBJECTIVE: This study evaluated the clinical efficacy and safety of interleukin-1 (IL-1) blockade for patients with COVID-19. METHODS: The PubMed, Web of Science, Ovid Medline, Embase and Cochrane Library databases were searched for relevant articles from their inception to 25 September 2022. Only randomized clinical trials (RCTs) that assessed the clinical efficacy and safety of IL-1 blockade in the treatment of patients with COVID-19 were included. RESULTS: This meta-analysis included seven RCTs. No significant difference in the all-cause mortality rate of patients with COVID-19 was observed between the IL-1 blockade and control groups (7.7 vs. 10.5%, odds ratio [OR] = 0.83, 95% confidence interval [CI] 0.57-1.22; I2 = 18%). However, the study group was at significantly lower risk of requiring mechanical ventilation (MV) compared with the control group (OR = 0.53, 95% CI 0.32-0.86; I2 = 24%). Finally, the risk of adverse events was similar between the two groups. CONCLUSIONS: IL-1 blockade does not provide increased survival benefits in hospitalized patients with COVID-19, but it may reduce the need for MV. Furthermore, it is a safe agent for use in the treatment of COVID-19.>.


This systematic review and meta-analysis of randomized clinical trials (RCTs) evaluated the clinical efficacy and safety of interleukin-1 (IL-1) blockade for patients with COVID-19.Based on the analysis of six RCTs, no significant difference in the all-cause mortality rate of patients with COVID-19 was observed between the IL-1 blockade and control groups.The study group using IL1 was associated with a significantly lower risk of requiring mechanical ventilation compared with the control group.The risk of adverse events was similar between the study and the control groups.


Asunto(s)
Tratamiento Farmacológico de COVID-19 , COVID-19 , Interleucina-1 , Humanos , Interleucina-1/antagonistas & inhibidores , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
12.
Expert Rev Anti Infect Ther ; 21(6): 551-563, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37042813

RESUMEN

INTRODUCTION: Ceftobiprole, a fifth-generation cephalosporin, exhibits a broad-spectrum activity against common pathogens causing pneumonia, including multidrug-resistant organisms (MDROs), such as penicillin-resistant S. pneumoniae (PRSP) and methicillin-resistant Staphylococcus aureus (MRSA) and non-extended-spectrum ß -lactamase (non-ESBL) producing Enterobacterales strains. Therefore, ceftobiprole should be considered as a potential alternative for the empirical treatment of pneumonia in patients with high risk for MDROs. AREA COVERED: In this review, we discussed the role of ceftobiprole in the treatment of patients with pneumonia. EXPERT OPINION: Ceftobiprole has several advantages in the treatment of pneumonia. First, ceftobiprole exerts its bactericidal activity by inhibiting transpeptidases, especially showing strong affinities to penicillin-binding protein (PBP) 2a, PBP2× and PBP3. Second, its plasma protein binding is minimal, allowing it to penetrate lung tissue and achieve high concentrations in epithelial lung fluid. Third, ceftobiprole exhibits potent in vitro activity against a wide range of susceptible pathogens, including S. aureus, S. pneumoniae, Viridans streptococci, H. influenzae, M. catarrhalis, Enterobacterales, and particularly, MRSA and P. aeruginosa. Finally, several randomized controlled trials have demonstrated the clinical efficacy and safety of ceftobiprole in the treatment of pediatric and adult patients with community-acquired pneumonia and hospital-acquired pneumonia (excluding ventilator-associated pneumonia).


Asunto(s)
Staphylococcus aureus Resistente a Meticilina , Neumonía , Humanos , Niño , Antibacterianos/farmacología , Staphylococcus aureus , Cefalosporinas/uso terapéutico , Bacterias Gramnegativas , Neumonía/tratamiento farmacológico , Streptococcus pneumoniae , Pruebas de Sensibilidad Microbiana
13.
J Glob Antimicrob Resist ; 33: 201-207, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36944409

RESUMEN

OBJECTIVE: Both ertapenem and other carbapenems, including imipenem, meropenem, and doripenem, are recommended in the treatment of extended-spectrum-ß-lactamase (ESBL)-producing Enterobacterales infection. However, whether ertapenem is as effective as other carbapenems for ESBL-producing Enterobacterales remains unclear. Therefore, this meta-analysis was conducted to compare the clinical efficacy of ertapenem versus other carbapenems in the treatment of ESBL-producing Enterobacterales infection. METHODS: PubMed, Web of Science, and Cochrane Library were searched from their inception to 29 November 2022. Only studies comparing ertapenem and other carbapenems in the treatment of patients with ESBL-producing Enterobacterales infections were included. RESULTS: A total of six studies meeting selection criteria were identified. Overall, ertapenem was associated with a significantly lower 30-d mortality when compared with other carbapenems (10.7% [46/431] vs. 17.7% [104/586]; risk ratio [RR], 0.61; 95% CI: 0.40-0.91). The ertapenem group exhibited a significantly shorter length of hospital stay than the other carbapenem groups (mean differences, -6.02 d; 95% CI, -9.39 to -2.64). No significant differences were noted between ertapenem and other carbapenem groups in terms of rates of clinical cure or improvement (RR, 1.11; 95% CI: 0.97-1.25) and microbiological eradication (RR, 1.01; 95% CI: 0.97-1.06). CONCLUSIONS: Ertapenem could be as effective as other carbapenems in the treatment of patients with ESBL-producing Enterobacterales infections.


Asunto(s)
Carbapenémicos , Gammaproteobacteria , Humanos , Ertapenem/uso terapéutico , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , beta-Lactamas/farmacología , beta-Lactamas/uso terapéutico , beta-Lactamasas , Resultado del Tratamiento
15.
J Microbiol Immunol Infect ; 56(1): 1-9, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36283919

RESUMEN

At present, there are more than 560 million confirmed cases of the coronavirus disease 2019 (COVID-19) worldwide. Although more than 98% of patients with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection can survive acute COVID, a significant portion of survivors can develop residual health problems, which is termed as long COVID. Although severe COVID-19 is generally associated with a high risk of long COVID, patients with asymptomatic or mild disease can also show long COVID. The definition of long COVID is inconsistent and its clinical manifestations are protean. In addition to general symptoms, such as fatigue, long COVID can affect many organ systems, including the respiratory, neurological, psychosocial, cardiovascular, gastrointestinal, and metabolic systems. Moreover, patients with long COVID may experience exercise intolerance and impaired daily function and quality of life. Long COVID may be caused by SARS-CoV-2 direct injury or its associated immune/inflammatory response. Assessment of patients with long COVID requires comprehensive evaluation, including history taking, physical examination, laboratory tests, radiography, and functional tests. However, there is no known effective treatment for long COVID. Based on the limited evidence, vaccines may help to prevent the development of long COVID. As long COVID is a new clinical entity that is constantly evolving, there are still many unknowns, and further investigation is warranted to enhance our understanding of this disease.


Asunto(s)
COVID-19 , Humanos , COVID-19/complicaciones , SARS-CoV-2 , Síndrome Post Agudo de COVID-19 , Calidad de Vida , Pulmón , Progresión de la Enfermedad
17.
J Med Virol ; 95(2): e28426, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36571257

RESUMEN

Following the rapidly increasing number of multisystem inflammatory syndromes in children (MIS-C), a similar clinical scenario has been observed in adult patients. Although its prevalence is low and probably related to underdiagnosis, its development can be associated with high mortality. Multisystem inflammatory syndrome in adults (MIS-A) can develop following both asymptomatic and symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and in previously healthy people. Like MIS-C, MIS-A is a multisystem disease that can involve the cardiovascular, respiratory, gastrointestinal, dermatologic, hematologic, and neurologic systems. In addition to the clinical manifestations, the diagnosis of MIS-A requires laboratory evidence of inflammation and SARS-CoV-2 infection. The appropriate treatment for MIS-A remains unclear; anti-inflammatory agents, including intravenous immunoglobulin and corticosteroids, are commonly used. However, there are still many unknowns regarding MIS-A. Further studies are needed to determine the true prevalence, pathogenesis, and effective treatment for MIS-A.


Asunto(s)
COVID-19 , Niño , Humanos , Adulto , COVID-19/epidemiología , SARS-CoV-2 , Síndrome de Respuesta Inflamatoria Sistémica
19.
Alzheimers Dement ; 19(1): 369, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-35988054

Asunto(s)
COVID-19 , Humanos , SARS-CoV-2
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA