Publications by authors named "Adrian Sousa"

Objectives: Bloodstream infections (BSI) are an important cause of mortality, although they show heterogeneity depending on patients and aetiological factors. Comprehensive and specific mortality scores for BSI are scarce. The objective of this study was to develop a mortality predictive score in BSI based on a multicentre prospective cohort.

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DENOVA-score is useful to stratify the risk of infective endocarditis (IE) in Enterococcus faecalis bacteremia. Recently, time to positive (TTP) of blood cultures has also been related with a higher risk of IE. The objective was to evaluate DENOVA- score with TTP to improve its specificity.

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Article Synopsis
  • - The study reclassified Klebsiella aerogenes into the Klebsiella genus and aimed to evaluate the clinical outcomes of bloodstream infections (BSI) caused by K. aerogenes compared to K. pneumoniae and Enterobacter cloacae.
  • - Researchers analyzed data from hospitalized patients with monomicrobial BSI from October 2016 to March 2017, using various outcomes to compare the infections, including mortality and recurrence rates within 30 days.
  • - Findings indicated that K. aerogenes infections had a lower frequency of mortality or recurrence (6.9%) compared to E. cloacae (20.8%) and K. pneumoniae (19.0%), suggesting a potentially better
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Objectives: The early initiation of the empirical antibiotic treatment and its impact on mortality in patients with bacteraemia has been extensively studied. However, information on the impact of precocity of the targeted antibiotic treatment is scarce. We aimed to study the impact of further delay in active antibiotic therapy on 30-day mortality among patients with bloodstream infection who had not received appropriate empirical therapy.

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Positron emission tomography (FDG PET-CT) is a widely used method to help in the diagnosis of infective endocarditis (IE). Lipomatous hypertrophy of the interatrial septum (LHIS) is an uncommon fat deposition in the region of the interatrial septum. PET-CT images of LHIS may be indistinguishable from changes associated with IE.

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Objectives: Due to its long half-life, dalbavancin offers benefits for long-duration treatments, especially osteoarticular and infective endocarditis (IE). We evaluated the efficacy and costs of IE treatment, comparing dalbavancin with standard of care (SOC).

Methods: Retrospective multicenter cohort study of adult patients with Gram-positive cocci definite IE.

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Objectives: To determine the incidence of cardiac device-related infection (CDRI) among patients with cardiac device (CD) during late-onset bloodstream infection (BSI) and to identify the risk factors associated with CDRI.

Methods: Patients with a CD (cardiac implantable electronic devices -CIED- and/or prosthetic heart valve -PHV-) and late-onset-BSI (>1 year after the CD implantation/last manipulation) were selected from the PROBAC project, a prospective, observational cohort study including adult patients with bacteraemia consecutively admitted to 26 Spanish hospitals from October 2016 to March 2017. Multivariate analyses using logistic regression were performed to identify the risk factors associated with CDRI.

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Article Synopsis
  • * A retrospective analysis was conducted on 30 adult patients in a Spanish hospital, focusing on clinical outcomes, microbiology, and treatment impact, with low recurrence and no reported side effects.
  • * The findings suggest that after appropriate source control, OST is a safe and effective option for treating these infections, particularly with trimethoprim-sulfamethoxazole being the preferred antibiotic.
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Article Synopsis
  • Ceftazidime/avibactam has shown potential as an effective treatment for infections caused by carbapenemase-producing Enterobacterales (CPE), particularly for patients with higher INCREMENT-CPE scores.
  • In a study of 339 patients, those treated with ceftazidime/avibactam had lower mortality rates compared to those receiving the best available therapy after 30 days.
  • The results suggest that ceftazidime/avibactam not only improves survival but also aids in achieving better clinical and microbiological outcomes, indicating the need for further randomized controlled trials to validate these findings.
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Objectives: Acute cholangitis is one of the most frequent complications in patients carrying biliary stents. The aim of our study is to analyze the demographic and clinical characteristics, as well as the microbiological profile and evolution of patients with acute bacteremic cholangitis, comparing them based upon they were or not biliary stent carriers.

Methods: We performed a retrospective analysis of all consecutive patients over 18 years-old with a stent placement in our center between 2008 and 2017 were included.

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Introduction: This study was aimed to identify risk factors associated with unfavorable outcomes (composite outcome variable: mortality and need for mechanical ventilation) in patients hospitalized in Galicia with COVID-19 pneumonia.

Methods: Retrospective, multicenter, observational study carried out in the 8 Galician tertiary hospitals. All Patients admitted with confirmed COVID-19 pneumonia from 1st of March to April 24th, 2020 were included.

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Article Synopsis
  • A study was done to see if taking antibiotics by mouth (oral sequential therapy, OST) is a good choice for treating serious infections caused by Staphylococcus aureus bacteremia (SAB).
  • 125 out of 201 patients used oral antibiotics, and the rate of getting the infection again after 90 days was low for both groups (OST and intravenous therapy).
  • The results showed that patients on OST had shorter hospital stays and needed less time on intravenous antibiotics than those on traditional intravenous therapy (CIT).
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Objectives: Acute cholangitis is one of the most frequent complications in patients carrying biliary stents. The aim of our study is to analyze the demographic and clinical characteristics, as well as the microbiological profile and evolution of patients with acute bacteremic cholangitis, comparing them based upon they were or not biliary stent carriers.

Methods: We performed a retrospective analysis of all consecutive patients over 18 years-old with a stent placement in our center between 2008 and 2017 were included.

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Background: Catheter-related bloodstream infections (CRBSIs) increase morbidity and mortality, prolong hospitalization and generate considerable medical costs. Recent guidelines for CRBSI recommend empirical therapy against Gram-positive bacteria (GPB) and restrict coverage for Gram-negative bacteria (GNB) only to specific circumstances.

Objectives: To investigate predictors of GNB aetiology in CRBSI and to assess the predictors of outcome in patients with CRBSI.

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Background: Some evidence-based bundles have tried to standardize the management of Staphylococcus aureus bacteraemia (SAB) to improve the outcome. The aim of our study was to analyse the additional impact on mortality of a structured intervention in patients with SAB.

Methods: Compliance with the bundle was evaluated in an ambispective cohort of patients with SAB, which included a retrospective cohort [including patients treated before and after the implementation of a bacteraemia programme (no-BP and BP, respectively)] and a prospective cohort (i-BP), in which an additional specific intervention for bundle application was implemented.

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Bacteremia due to gram-negative bacilli (GNB) is one of the most frequent causes of admission and prolongation of hospital stay. Nevertheless, optimal duration of antibiotic treatment is not clearly established. We designed an observational, prospective study of a cohort of adult patients with uncomplicated GNB bacteremia.

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Background: In recent years, several scores and algorithms have been developed in order to guide empirical antibiotic treatment in patients with gram-negative bacilli (GNB) bacteraemia according to the risk of extended-spectrum β-lactamase (BL) producing. Some of these algorithms do not have easy applicability or present some limitations in their validation. The aim of our study was to validate a recently designed decision tree in our prospective cohort of bacteraemia due to gram-negative bacilli.

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Background: Experience in real clinical practice with ceftazidime/avibactam is limited, and there are even fewer data on infections due to OXA-48-producing Enterobacteriaceae.

Methods: We designed an observational study of a prospectively collected cohort of adult patients receiving ceftazidime/avibactam in our centre. Only the first treatment course of each patient was analysed.

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Introduction: Invasive pneumococcal disease (IPD) typically presents as bacterial pneumonia, meningitis or primary bacteraemia. However, Streptococcus pneumoniae can produce infection at any level of the body (endocarditis, arthritis, spontaneous bacterial peritonitis, etc.), which is also known as unusual IPD (uIPD).

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Systemic capillary leak syndrome is a rare and potentially lethal disorder characterized by episodes of vascular hyperpermeability, which lead to shock. Although the pathogenesis is unknown, some viral infections can act as triggers. We present the first case associated with influenza A virus in adulthood, perform a literature review and discuss its treatment.

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Objective: There are few data regarding the existence of clinical differences between patients with systemic sclerosis (scleroderma) exposed to silica (SSc-si) and "idiopathic" cases (SSc-id). Our goal is to describe the clinical characteristics of patients with SSc-si and see if they differ from the SSc-id cases.

Methods: We performed a systematic review of the literature by searching the MEDLINE, EMBASE and Web of Science databases.

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