Browsing by Author "Rabagliati, Ricardo"
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- ItemA prospective, multi-center study of Candida bloodstream infections in Chile(2019) Santolaya de Pablo, María Elena; Thompson, Luis; Benadof, Dona; Tapia, Cecilia V.; Legarraga Raddatz, Paulette; Cortés, Claudia; Rabello, Marcela; Valenzuela, Romina; Cancino Rojas, Pamela; Rabagliati, Ricardo
- ItemAn Emergent Change in Epidemiologic and Microbiological Characteristics of Bloodstream Infections in Adults With Febrile Neutropenia Resulting From Chemotherapy for Acute Leukemia and Lymphoma at Reference Centers in Chile, Ecuador, and Peru(2024) Rabagliati, Ricardo; Salazar, Grace; Perez-Lazo, Giancarlo; Iturrieta, Maria Paz; Portillo, Diana; Soria-Segarra, Carmen; Ojeda, Maria Jose; Flores, Jimena; Galarza, Margarita; Sandoval-Ahumada, Roxana; Cartes Aguilera, Pablo; Dimitrakis, Lady; Reinoso, Fabiola Avelga; Garcia, PatriciaBackground Febrile neutropenia is a life-threatening condition commonly observed in patients with hematologic malignancies. The aim of this article is to provide updated knowledge about bloodstream infections in febrile neutropenia episodes within the Andean region of Latin America.Method This retrospective study was based in 6 hospitals in Chile, Ecuador, and Peru and included adult patients with acute leukemia or lymphoma and febrile neutropenia between January 2019 and December 2020.Results Of the 416 febrile neutropenia episodes, 38.7% had a bloodstream infection, 86% of which were caused by gram-negative rods, with Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa being the most frequently identified bacteria. K pneumoniae isolates were more frequently resistant than E coli to cefotaxime (65% vs 39.6%), piperacillin-tazobactam (56.7% vs 27.1%), and imipenem (35% vs 2.1%) and were more frequently multidrug resistant (61.7% vs 12.5%). Among P aeruginosa, 26.7% were resistant to ceftazidime, piperacillin-tazobactam, and imipenem, and 23.3% were multidrug resistant. Overall 30-day mortality was 19.8%, being higher with vs without a bloodstream infection (26.7% vs 15.3%, P = .005). Fever duration was also significantly longer, as well as periods of neutropenia and length of hospital stay for patients with bloodstream infection. Additionally, the 30-day mortality rate was higher for episodes with inappropriate vs appropriate empirical antibiotic therapy (41.2% vs 26.6%, P = .139).Conclusions Considering the high rates of bacteria-resistant infection and 30-day mortality, it is imperative to establish strategies that reduce the frequency of bloodstream infections, increasing early identification of patients at higher risks of multidrug bacteria resistance, and updating existing empirical antibiotic recommendations.
- ItemCambios clínicos y epidemiológicos de candidemias en pacientes adultos desde 2000 a 2013(2017) Siri, L.; Legarraga Raddatz, Paulette; García Cañete, Patricia; González, T.; Rabagliati, Ricardo
- ItemCaracterísticas clínicas, diagnósticas y pronósticas de pacientes con neumonía por Pneumocystis jiroveci en individuos infectados por virus de inmunodeficiencia humana e individuos inmunocomprometidos por otra etiología(2014) Cerón Araya, Inés María; Rabagliati, Ricardo; Langhaus, Javiera; Silva, Felipe; Guzmán Durán, Ana María; Lagos Lucero, Sonia Marcela
- ItemClinical and epidemiological changes of candidemia among adult patients from 2000 to 2013(SOC CHILENA INFECTOLOGIA, 2017) Siri, Leonardo; Legarraga, Paulette; Garcia, Patricia; Gonzalez, Tamara; Rabagliati, RicardoBackground: Invasive Candida spp. infections have been described more frequently. Aim: To characterize the epidemiological data of candidemia in recent years. Methods: A retrospective study of adult patients in a University Hospital in Santiago, Chile, with 1 or more documented episodes of candidemia, from January 2000 to December 2013. Results: One hundred and twenty episodes of candidemia were identified in 120 patients, annual incidence of 0.4 cases per 1000 discharges, 53.3% were male patients, 58.3%> 60 years, 77,5% had at least one co-morbidity. Candida albicans was the species most frequently identified 55%, followed by C. glabrata 18.3%, C. tropicalis 11.7% and C. parapsilosis 9.2%. Comparing 2000-2006 vs 2007-2013, increased the frequency of C. parapsilosis among non-albicans and echinocandins prescription. Patients with C. albicans showed higher APACHE-II, more requirement for invasive mechanical ventilation, greater association with CVC, and shorter incubation time compared with non-albicans species. The 30-day mortality was 31.7%. Conclusions: During this 14-years period we observed that C. albicans was the predominant specie and more recently a change among C. non-albicans increasing C. parapsilosis and decreasing C. glabrata 30-days and attributable mortality decreased together with more echinocandins prescription.
- ItemConsensus of the Chilean Society of Infectious Diseases for the management of episodes of febrile neutropenia in adults and children with cancer(2023) Alvarez, Ana Maria; Morales, Ricardo; Raijmakers, Mariella; Barraza, Marlon; Lafourcade, Monica; Duran, Luisa; Contardo, Veronica; Amador, Roberto; Bidart, Teresa; Santolaya, Maria Elena; Flores, Ivonne; Gambra, Pilar; Gonzalez, Claudio; Lopez, Tania; Rabagliati, Ricardo; Vizcaya, Cecilia; Zubieta, MarcelaThe Committee of Infections in Immunocompromised Patients of the Chilean Society of Infectious Diseases presents an update in the Management of febrile neutropenia in adults and children with cancer. It comes from the significant changes that occurred in recent years in the confrontation of these patients. For which a multidisciplinary task force group developed recommendations in relation to their initial handling, laboratory exams required, the initial empirical antimicrobial treatment and in front of known infectious focus, invasive fungal infections and antimicrobial prophylaxis.
- ItemCOVID-19-Associated Mold Infection in Critically Ill Patients, Chile(2021) Rabagliati, Ricardo; Rodriguez, Nicolas; Nunez, Carolina; Huete, Alvaro; Bravo, Sebastian; Garcia, PatriciaPatients with severe coronavirus disease (COVID-19) may have COVID-19-associated invasive mold infection (CAIMI) develop. We report 16 cases of CAIMI among 146 nonimmunocompromised patients with severe COVID-19 at an academic hospital in Santiago, Chile. These rates correspond to a CAIMI incidence of 11%; the mortality rate for these patients was 31.2%.
- ItemCurrent situation of endemic mycosis in the Americas and the Caribbean: Proceedings of the first international meeting on endemic mycoses of the Americas (IMEMA)(2022) Caceres, Diego H.; Echeverri Tirado, Laura C.; Bonifaz, Alexandro; Adenis, Antoine; Gomez, Beatriz L.; Flores, Claudia Lizette Banda; Canteros, Cristina E.; Santos, Daniel Wagner; Arathoon, Eduardo; Soto, Elia Ramirez; Queiroz-Telles, Flavio; Schwartz, Ilan S.; Zurita, Jeannete; Damasceno, Lisandra Serra; Garcia, Nataly; Fernandez, Norma B.; Chincha, Omayra; Araujo, Patricia; Rabagliati, Ricardo; Chiller, Tom; Giusiano, GustavoBackground The Americas are home to biologically and clinically diverse endemic fungi, including Blastomyces, Coccidioides, Emergomyces, Histoplasma, Paracoccidioides and Sporothrix. In endemic areas with high risk of infection, these fungal pathogens represent an important public health problem. Objectives This report aims to summarise the main findings of the regional analysis carried out on the status of the endemic mycoses of the Americas, done at the first International Meeting on Endemic Mycoses of the Americas (IMEMA). Methods A regional analysis for the Americas was done, the 27 territories were grouped into nine regions. A SWOT analysis was done. Results All territories reported availability of microscopy. Seventy percent of territories reported antibody testing, 67% of territories reported availability of Histoplasma antigen testing. None of the territories reported the use of (1-3)-beta-d-glucan. Fifty two percent of territories reported the availability of PCR testing in reference centres (mostly for histoplasmosis). Most of the territories reported access to medications such as trimethoprim-sulfamethoxazole, itraconazole, voriconazole and amphotericin B (AMB) deoxycholate. Many countries had limited access to liposomal formulation of AMB and newer azoles, such as posaconazole and isavuconazole. Surveillance of these fungal diseases was minimal. Conclusions A consensus emerged among meeting participants, this group concluded that endemic mycoses are neglected diseases, and due to their severity and lack of resources, the improvement of diagnosis, treatment and surveillance is needed.
- ItemDo high MICs predict the outcome in invasive fusariosis?(2021) Nucci, Marcio; Jenks, Jeffrey; Thompson, George R., III; Hoenigl, Martin; dos Santos, Marielle Camargo; Forghieri, Fabio; Rico, Juan Carlos; Bonuomo, Valentina; Lopez-Soria, Leyre; Lass-Florl, Cornelia; Candoni, Anna; Garcia-Vidal, Carolina; Cattaneo, Chiara; Buil, Jochem; Rabagliati, Ricardo; Pia Roiz, Maria; Gudiol, Carlota; Fracchiolla, Nicola; Isolina Campos-Herrero, Maria; Delia, Mario; Farina, Francesca; Fortun, Jesus; Nadali, Gianpaolo; Sastre, Enric; Colombo, Arnaldo L.; Perez Nadales, Elena; Alastruey-Izquierdo, Ana; Pagano, LivioBackground: Invasive fusariosis (IF) affects mostly severely immunocompromised hosts and is associated with poor outcome. Since Fusarium species exhibit high MICs for most antifungal agents, this could explain the poor prognosis. However, a clear-cut correlation between MIC and outcome has not been established.
- ItemEpidemiología de neutropenia febril en pacientes adultos con leucemia aguda y linfoma. Estudio de cohorte en hospitales público y privado de Santiago, Chile(2014) Rabagliati, Ricardo; Bertín Cortes Monroy, Pablo; Cerón Araya, Inés María; Rojas Romero, Hernán Humberto; Domínguez, Isabel; Vera, Álvaro; Sir, Leonardo; Flores, Jimena; Fernández, Paulina; Pérez, Marco; Cruz Mesía, Rolando J. de la
- ItemEvaluación del aspergillus lateral flow device para el diagnóstico de aspergilosis invasora, experiencia en un hospital universitario(2018) Delama, Ignacio; Legarraga Raddatz, Paulette; González, Tamara; García Cañete, Patricia; Rabagliati, Ricardo
- ItemEvaluación del rendimiento de 1,3-β-d-glucano como apoyo diagnóstico de infecciones invasoras por Candida spp. en pacientes críticos adultos(2017) Donato, Liliana; González, Tamara; Canales, Marilena; Legarraga Raddatz, Paulette; García Cañete, Patricia; Rabagliati, Ricardo
- ItemH1N1 pandemic influenza impact on hand hygiene and specific precautions compliance among healthcare workers(W B SAUNDERS CO LTD, 2011) Labarca L., Jaime; Zambrano González, Alejandra; Niklitschek, Sergio; Ferrés, Marcela; Pérez, Carlos; Rabagliati, Ricardo; Ajenjo Henríquez, María Cristina
- ItemInfección respiratoria aguda por coronavirus Sars-CoV-2 en personal de salud. Implementación de un programa de detección precoz y seguimiento de casos en un hospital universitario(2020) Poblete Umanzor, Rodrigo Eduardo; Saldías Peñafiel, Fernando; Ugarte, N. S.; Valverde, A. V.; Ceriani Bravo, Alejandro Andrés; Pernas, S. S.; Letelier Saavedra, Luz María; Scheuch, J. I. G.; Rabagliati, Ricardo
- ItemOlder age does not influence CD4 cell recovery in HIV-1 infected patients receiving Highly Active Anti Retroviral Therapy(2004) Tumbarello, Mario.; Rabagliati, Ricardo; de Gaetano Donati, Katleen.; Bertagnolio, Silvia.; Montuori, Eva.; Tamburrini, Enrica.; Tacconelli, Evelina.; Cauda, Roberto.Abstract Background Diagnosis of HIV infection is recently occurring with increasing frequency in middle-aged and in older individuals. As HAART became available, a minimal beneficial effect on immunological outcome in older in respect of younger subjects has been reported. In fact, both the intensity and the rapidity of the immunological response appeared to be reduced in elderly subjects. On the contrary, only few reports have indicated a similar immunological outcome both in older and younger HIV-positive subjects. Interestingly, older age did not seem to significantly affect the long-term virological outcome of HAART treated subjects. Methods To characterise epidemiological and clinical features of older HIV+ subjects, a prospective case-control study was performed: 120 subjects ≥ 50 and 476 between 20 and 35 years were initially compared. Subsequently, to better define the impact of HAART on their viro-immunological response, 81 older were compared with 162 younger subjects. Results At baseline cases presented significantly lower TCD4+ cell number and were more frequently affected by comorbid conditions. Under HAART a statistically significant increase in TCD4+ cell number was observed in cases and controls. At multivariate analysis, there was no statistically significant difference between cases and controls regarding viro-immunological response. Conclusions Although older subjects present a more severe HIV infection, they can achieve, under HAART, the same viro-immunological success as the younger individuals.
- ItemPandemic influenza A (H1N1) in HIV-1-infected patients(LIPPINCOTT WILLIAMS & WILKINS, 2010) Perez, Carlos M.; Dominguez, Maria I.; Ceballos, Maria E.; Moreno, Cristina; Labarca, Jaime A.; Rabagliati, Ricardo; Vasquez, Patricia; Lasso, Martin; Serri, MichelObjective: To characterize the clinical presentation, course and mortality of pandemic influenza in HIV-1-infected patients in Santiago, Chile.
- ItemPerfil clínico-epidemiológico de las infecciones por virus respiratorios en adultos hospitalizados durante la estación de influenza 2004(2006) Rabagliati, Ricardo; Serri, Michel; Perret Perez, Cecilia; Guzmán Durán, Ana María; Azócar, Teresa; Habash, Leila; Espinoza, Claudia; Ferrés Garrido, Marcela VivianaBackground: During yearly influenza (FLU) season, FLU viruses are well represented among hospitalized patients as in the community. Also, other respiratory viruses could be represented among adult in-patients. Aim: to describe the presence and clinical- epidemiological characteristics of non-FLU respiratory virus infections (respiratory syncytial-RSV, parainfluenza and adenovirus-ADV) among hospitalized adults during FLU season and to compare with FLU-A (IA) or -B (IB) cases. Patients and Methods: Adult patients hospitalized at Hospital Clínico Universidad Católica between May to July 2004 with a respiratory virus infections confirmed by rapid antigen test or direct immunofluorescence of IA, IB (Flu group) or RSV, parainfluenza (1-2-3) and ADV (non-Flu group) were included. Results: 86 cases were identified: 73.5% FLU (48.2% IA, 25.3% IB) and 26.5% non-FLU (15.7% parainfluenza-2; 8.4% RSV; 1.2% parainfluenza-3; 1.2% ADV). No differences were observed in general characteristics and evolution of patients. In FLU-group were more frequently observed myalgia, cough, hospitalization due to febrile syndrome, higher values of C-reactive protein and band leukocytes count (p < 0.05). Conclusions: During 2004 FLU season a 26.5 % of respiratory viral infection were due to non-FLU viruses among adult hospitalized in our centre. The difficulty to difference FLU vs. non-FLU infections, suggest that it is necessary to include other respiratory virus in the viral etiological diagnosis, even in FLU season.
- ItemProphylaxis against fungal infections in solid organ and hematopoietic stem cells transplantation(SOC CHILENA INFECTOLOGIA, 2012) Rabagliati, Ricardo; Elena Santolaya, M.Invasive fungal infections are an important cause of morbidity and mortality in SOT and HSCT recipients. The main species involved are Candida spp. and Aspergillus spp, less frequently Cryptococcus spp., causal agents of mucormycosis and Fusarium spp. Usually occur within the first six months post-transplant, but they do it later, especially during episodes of rejection, which maintains the state of immune system involvement. Prophylaxis recommendations are specific to each type of transplant. In liver transplantation use of fluconazole is recommended only in selected cases by high risk factor for invasive fungal infections (A1). If the patient has a high risk of aspergillosis, there are some suggestions for adults population to use amphotericin B-deoxycholate, liposomal amphotericin B or caspofungin (C2) without being validated none of these recommendations in pediatric population. In adult lung transplant patients where the risk of aspergillosis is higher than in other locations, we recommend universal prophylaxis with itraconazole 200 mg/day, nebulised liposomal amphotericin B or voriconazole (C2), no validated recommendations for pediatrics. In HSCT, universal prophylaxis is recommended only in allogeneic and autologous selected cases. The most accepted indication is fluconazole (A1), and posaconazole (A1) or micafungin (A1) in selected cases with high risk of aspergillosis.
- ItemTuberculosis Recommendations for Solid Organ Transplant Recipients and Donors(2018) Santoro-Lopes, Guilherme; Subramanian, Aruna K.; Molina, Israel; Maria Aguado, Jose; Rabagliati, Ricardo; Len, Oscar