Our results support the hypothesis that carriers of the PlA2 allele might have an increased risk for ACS. PlA2 homozygosity was associated with an inadequate response to aspirin therapy. Our data further suggest that patients with PlA2 allele homozygosity might benefit from antiplatelet therapy based on adenosine diphosphate antagonists throughout secondary treatment for prevention of ACS.

No abstract

No abstract

Meropenem administration in EI results in a better clinical outcome for febrile neutropenia episodes, with fewer additional antibiotics needed.

No abstract

Currently, the vast majority of BSI in individuals with onco-haematological diseases with febrile neutropenia have a TTP <24 h, including all episodes caused by MDR-GNB. Our results support reassessing empiric antibiotic treatment in neutropenic patients at 24 h, to apply antibiotic stewardship de-escalation strategies.

Clostridium difficile infection (CDI) is increasingly recognized as an emerging healthcare problem of elevated importance. Prevention and treatment strategies are constantly evolving along with the apperance of new scientific evidence and novel treatment methods, which is well-reflected in the differences among consecutive international guidelines. In this article, we summarize and compare current guidelines of five international medical societies on CDI management, and discuss some of the controversial and currently unresolved aspects which should be addressed by future research.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-016-0122-1) contains supplementary material, which is available to authorized users.

Objectives: To assess risk factors for multidrug-resistant Pseudomonas aeruginosa (MDR-PA) infection in neutropenic patients. Methods: Single-centre retrospective analysis of consecutive bloodstream infection (BSI) episodes (2004 e2017, Barcelona). Two multivariate regression models were used at BSI diagnosis and P. aeruginosa detection. Significant predictors were used to establish rules for stratifying patients according to MDR-PA BSI risk. Results: Of 661 Gram-negative BSI episodes, 190 (28.7%) were caused by P. aeruginosa (70 MDR-PA). Independent factors associated with MDR-PA among Gram-negative organisms were haematological malignancy (OR 3.30; 95% CI 1.15e9.50), pulmonary source of infection (OR 7.85; 95% CI 3.32e18.56), nosocomial-acquired BSI (OR 3.52; 95% CI 1.74e7.09), previous antipseudomonal cephalosporin (OR 13.66; 95% CI 6.64e28.10) and piperacillin/tazobactam (OR 2.42; 95% CI 1.04e5.63), and BSI occurring during ceftriaxone (OR 4.27; 95% CI 1.15e15.83). Once P. aeruginosa was identified as the BSI aetiological pathogen, nosocomial acquisition (OR 7.13; 95% CI 2.87e17.67), haematological malignancy (OR 3.44; 95% CI 1.07e10.98), previous antipseudomonal cephalosporin (OR 3.82; 95% CI 1.42e10.22) and quinolones (OR 3.97; 95% CI 1.37e11.48), corticosteroids (OR 2.92; 95% CI 1.15e7.40), and BSI occurring during quinolone (OR 4.88; 95% CI 1.58e15.05) and b-lactam other than ertapenem (OR 4.51; 95% CI 1.45e14.04) were independently associated with MDR-PA. Per regression coefficients, 1 point was assigned to each parameter, except for nosocomial-acquired BSI (3 points). In the second analysis, a score >3 points identified 60 (86.3%) out of 70 individuals with MDR-PA BSI and discarded 100 (84.2%) out of 120 with non-MDR-PA BSI. Conclusions: A simple score based on demographic and clinical factors allows stratification of individuals with bacteraemia according to their risk of MDR-PA BSI, and may help facilitate the use of rapid MDRdetection tools and improve early antibiotic appropriateness.