Browsing by Author "Zubieta, Marcela"

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    Consenso sobre riesgo de complicaciones infecciosas en pacientes usuarios de medicamentos biológicos seleccionados. Parte II: Guía clínica chilena de Prevención de Infecciones Asociadas al Uso de Terapias Biológicas (PREVITEB)
    (2019) Cerón Araya, Inés María; Vizcaya Altamirano, María Cecilia; Gambra, Pilar; Ferres Garrido, Marcela Viviana; Bidart, Teresa; Lépez Quizhpi,Tania Lorena; Acuña, María Paz; Álvarez, Ana María; Zubieta, Marcela; Durán, Luisa; Rabagliati Borie, Ricardo Miguel
    The use of biological therapies has meant a great improvement in the management of several conditions like autoimmune, neoplastic or others diseases. Although its use has implied significant improvements in the prognosis of these diseases, it is not exempt from complications: infectious diseases as one of them. The objective of this consensus was to evaluate, from an infectious viewpoint, the safeness of the most frequently used biological therapies and give recommendations for the prevention of infections in patients treated with these drugs. These recommendations were based on the highest quality evidence available for the selected biologics. The consensus counts of 2 manuscripts. This second part is a guideline that details these recommendations through screening strategies, prophylactic therapies and vaccines indications for bacterial, mycobacterial, viral, fungal and parasitic infections, both for adults and children.
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    Consenso sobre riesgo de complicaciones infecciosas en pacientes usuarios de medicamentos biológicos seleccionados. Primera parte
    (2019) Cerón Araya, Inés María; Gambra, Pilar; Vizcaya Altamirano, María Cecilia; Ferrés Garrido, Marcela Viviana; Bidart, Teresa; López Quizhpi, Tania Lorena; Acuña, M. Paz; Álvarez, Ana M.; Zubieta, Marcela; Rabello, Marcela; Iruretagoyena Bruce, Mirentxu Inés; Rabagliati Borie, Ricardo Miguel
    The use of biological therapies has meant a great improvement in the management of several conditions like autoimmune, neoplastic or others diseases. Although its use has implied significant improvements in the prognosis of these diseases, it is not exempt from complications: infectious diseases as one of them. The objective of this consensus was to evaluate, from an infectious viewpoint, the safeness of the most frequently used biological therapies and give recommendations for the prevention of infections in patients treated with these drugs. These recommendations were based on the highest quality evidence available for the selected biologics. The consensus counts of two manuscripts. This first part details the risks of developing infectious complications depending on the type of biological used for a certain pathology. This evaluation included a broad search in MEDLINE and Epistemonikos of systematic reviews and meta-analyzes of controlled clinical trials and case- control examining post-treatment infections with anti-TNF alpha, anti-CD20, anti-CD52, CTLA4-Ig and anti-integrins. The research was complemented by a review of: multicentre cohorts of biological users, the MMWR of the CDC, Atlanta, U.S.A., and national registers and scientific societies in which infectious complications derived from the use of biological therapies were mentioned.
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    Consensus 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, Marcela
    The 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.
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    Epidemiological changes of invasive fungal disease in children with cancer: Prospective study of the National Child Program of Antineoplastic Drugs network, Chile
    (2024) Barraza, Marlon; Valenzuela, Romina; Villarroel, Milena; de la Maza, Veronica; Contardo, Veronica; Alvarez, Ana Maria; Gutierrez, Valentina; Zubieta, Marcela; Martinez, Daniela; Santolaya, Maria E.
    Background: Invasive fungal diseases (IFD) are high morbidity and mortality infections in children with cancer suffering episodes of high-risk febrile neutropenia (HRFN). IFD epidemiology has changed in the last two decades, with an increasing incidence in recent years due to the growing number of immunocompromised children at risk for IFD. The aim of this study was to evaluate the incidence of IFD in children with cancer in the period 2016-2020 compared to 2004-2006 in six hospitals in Chile. Methods: Prospective, multicentre study, carried out between 2016 and 2020 in six hospitals in Chile. The defined cohort corresponds to a dynamic group of HRFN episodes in patients <18 years old with cancer, who at the fourth day of evolution still presented fever and neutropenia (persistent HRFN). Each episode was followed until resolution of FN. The incidence of IFD was calculated between 2016 and 2020 and compared with data obtained in the period 2004-2006. The incidence rate was estimated. Results: A total of 777 episodes of HRFN were analysed; 257 (33.1%) were considered as persistent-HRFN occurring in 174 patients. The median age was 7 years (IQR: 3-12 years) and 52.3% (N = 91) were male. Fifty-three episodes of IFD were detected: 21 proven, 14 probable and 18 possible. Possible IFD were excluded, leaving 239 episodes of persistent-HRFN with an IFD incidence of 14.6% (95% CI 10.5-19.9) and an incidence rate of 13.6 IFD cases per 1000 days of neutropenia (95% CI 9.5-20.0). Compared to 2004-2006 cohort (incidence: 8.5% (95% CI 5.2-13.5)), a significant increase in incidence of 6.1% (95% CI 0.2-12.1, p = .047) was detected in cohorts between 2016 and 2020. Conclusion: We observed a significant increase in IFD in 2016-2020, compared to 2004-2006 period.
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    Invasive fungal infections in children with cancer and severe aplastic anemia in nine hospitals from PINDA Network, Chile. 2016-2020
    (2023) Gutierrez, Valentina; Contardo, Veronica; de la Maza, Veronica; Claverie, Ximena; Salgado, Carmen; Zubieta, Marcela; Silva, Beatriz; Torres, Juan P.; Greppi, Claudia; Venegas, Marcela; Martinez, Daniela; Alvarez, Ana M.; Labrana, Yenis; Diaz, Paulina; Ducasse, Karen; Inostroza, Tamara; Cordova, Marcela; Santolaya, Maria E.
    Background: Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in pediatric oncology patients and severe aplastic anemia (SAA). Aim: To describe the epidemiology of IFI from 2016 to 2020 in children with cancer and SAA to assess the indication of antifungal prophylaxis. Methods: Multicenter, retrospective study of IFIs in pediatric oncology patients and SAA. Probable and proven IFIs were included. Results: Over the 5-year period, 57 IFIs were found, median age 9 years, 70% were proven and 30% were probable. Yeast infections were 42% and mold infections 56%. The most frequent infection sites were lung 38%, blood 36% and rhinosinusal 21%. The total IFI frequency was 5.4%, 21% in SAA, 10% in acute myeloid leukemia (AML), 6.9% in relapsed AML, 5.4% in relapsed acute lymphoblastic leukemia (ALL), 3.8% in ALL. Mold infections were predominant in AML, relapsed AML, and SAA. IFIs mortality was 11%. Conclusion: Frequency of IFI was consistent with the literature. We strongly recommend antifungal prophylaxis against mold infections in patients with SAA, AML, and relapsed AML. Would consider in high risk ALL relapse in induction chemotherapy.
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    Risk Factors Associated With Invasive Fungal Disease in Children With Cancer and Febrile Neutropenia A Prospective Multicenter Evaluation
    (LIPPINCOTT WILLIAMS & WILKINS, 2010) Villarroel, Milena; Aviles, Carmen L.; Silva, Pamela; Guzman, Ana M.; Poggi, Helena; Alvarez, Ana M.; Becker, Ana; O'Ryan, Miguel; Salgado, Carmen; Topelberg, Santiago; Tordecilla, Juan; Varas, Monica; Viviani, Tamara; Zubieta, Marcela; Santolaya, Maria E.
    Background: Empiric antifungal treatment has become standard of care in children with cancer and prolonged fever and febrile neutropenia (FN), with the downside that it leads to significant over treatment. We characterized epidemiologic, clinical, and laboratory features of invasive fungal disease (IFD) in children with cancer and FN with the aim to identify risk factors for IFD that can aid in better selecting children who require antifungal treatment.