Browsing by Author "Blasi, F"

Now showing 1 - 5 of 5

Open Access
Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study.
(European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2020-08) Carugati, Manuela; Aliberti, S; Sotgiu, G; Blasi, F; Gori, A; Menendez, R; Encheva, M; Gallego, M; Leuschner, P; Ruiz-Buitrago, S; Battaglia, S; Fantini, R; Pascual-Guardia, S; Marin-Corral, J; Restrepo, MI; GLIMP Collaborators
An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p < 0.01). S. pneumoniae remains the most common pathogen in patients hospitalized with CAP. Multinational CPG recommendations for patients with CAP seem to appropriately cover the most common pathogens and should be strongly encouraged for the management of CAP patients.
Open Access
Correction to: Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study.
(European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2021-09) Carugati, Manuela; Aliberti, S; Sotgiu, G; Blasi, F; Gori, A; Menendez, R; Encheva, M; Gallego, M; Leuschner, P; Ruiz-Buitrago, S; Battaglia, S; Fantini, R; Pascual-Guardia, S; Marin-Corral, J; Restrepo, MI; GLIMP Collaborators
In the originally published article, the individual collaborator names were not captured under the group name “GLIMP Collaborators”. The names are now captured correctly under this group accordingly. The original article has been corrected.
Open Access
Corrigendum to "De-escalation therapy among bacteraemic patients with community-acquired pneumonia" [Clin Microbiol Infect 21 (2015) 936.e11-936.e18]
(Clinical Microbiology and Infection, 2015-01-01) Carugati, M; Franzetti, F; Wiemken, T; Kelley, RR; Peyrani, P; Blasi, F; Ramirez, J; Aliberti, S
Open Access
De-escalation therapy among bacteraemic patients with community-acquired pneumonia.
(Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2015-10) Carugati, M; Franzetti, F; Wiemken, T; Kelley, RR; Peyrani, P; Blasi, F; Ramirez, J; Aliberti, S
There is no evidence supporting the use of de-escalation therapy (DET) among patients with community-acquired pneumonia (CAP). We assessed the outcomes associated with DET among bacteraemic CAP patients. We performed a secondary analysis of the Community-Acquired Pneumonia Organization database, which contains data on 660 bacteraemic patients hospitalized because of CAP in 35 countries (2001-2013). Exclusion criteria were death within 72 h from admission and an inappropriate empirical antibiotic regimen. DET was defined as changing an appropriate empirical broad-spectrum regimen to a narrower-spectrum regimen according to culture results within 7 days from hospital admission. Two study groups were identified: patients whose antibiotic therapy was de-escalated (the DET group), and patients whose antibiotic therapy was not de-escalated (the N-DET group). The primary study outcome was 30-day mortality. Two hundred and sixty-one bacteraemic CAP patients were included. Gram-positive bacteria were responsible for 88.1% of the cases (Streptococcus pneumoniae, 75.9%). Gram-negative bacteria were responsible for for 7.3% of the cases. DET was performed in 165 patients (63.2%). The N-DET group was characterized by a more severe presentation at admission. After adjustment for confounders, DET was not associated with an increased risk of 30-day mortality. DET seems to be safe among bacteraemic patients with CAP. Randomized clinical trials are warranted to further explore these findings.
Open Access
Fatal respiratory infection due to ST308 VIM-1-producing Pseudomonas aeruginosa in a lung transplant recipient: case report and review of the literature.
(BMC infectious diseases, 2020-08-26) Carugati, M; Piazza, A; Peri, AM; Cariani, L; Brilli, M; Girelli, D; Di Carlo, D; Gramegna, A; Pappalettera, M; Comandatore, F; Grasselli, G; Cantù, AP; Arghittu, M; Gori, A; Bandi, C; Blasi, F; Bandera, A; IFALT working group
BACKGROUND:Data regarding the prevalence of metallo-β-lactamases (MBLs) among Pseudomonas aeruginosa isolates in cystic fibrosis patients are scarce. Furthermore, there is limited knowledge on the effect of MBL production on patient outcomes. Here we describe a fatal respiratory infection due to P. aeruginosa producing VIM-type MBLs in a lung transplant recipient and the results of the subsequent epidemiological investigation. CASE PRESENTATION:P. aeruginosa isolates collected in the index patient and among patients temporally or spatially linked with the index patient were analyzed in terms of antibiotic susceptibility profile and MBL production. Whole-genome sequencing and phylogenetic reconstruction were also performed for all P. aeruginosa isolates producing VIM-type MBLs. A VIM-producing P. aeruginosa strain was identified in a lung biopsy of a lung transplant recipient with cystic fibrosis. The strain was VIM-1-producer and belonged to the ST308. Despite aggressive treatment, the transplant patient succumbed to the pulmonary infection due to the ST308 strain. A VIM-producing P. aeruginosa strain was also collected from the respiratory samples of a different cystic fibrosis patient attending the same cystic fibrosis center. This isolate harbored the blaVIM-2 gene and belonged to the clone ST175. This patient did not experience an adverse outcome. CONCLUSIONS:This is the first description of a fatal infection due to P. aeruginosa producing VIM-type MBLs in a lung transplant recipient. The circulation of P. aeruginosa isolates harboring MBLs pose a substantial risk to the cystic fibrosis population due to the limited therapeutic options available and their spreading potential.