0000000001250754

AUTHOR

Massimo Girardis

showing 13 related works from this author

Impact of Pre-Analytical Time on the Recovery of Pathogens from Blood Cultures: Results from a Large Retrospective Survey.

2017

Background Prompt identification of bloodstream pathogens is essential for optimal management of patients. Significant changes in analytical methods have improved the turnaround time for laboratory diagnosis. Less attention has been paid to the time elapsing from blood collection to incubation and to its potential effect on recovery of pathogens. We evaluated the performance of blood cultures collected under typical hospital conditions in relation to the length of their pre-analytical time. Methods We carried out a large retrospective study including 50,955 blood cultures collected, over a 30-month period, from 7,035 adult septic patients. Cultures were accepted by the laboratory only durin…

0301 basic medicineMaleTime FactorsResearch FacilitiesPhysiologylcsh:MedicineBacteremiaYeast and Fungal ModelsMedicine (all); Biochemistry Genetics and Molecular Biology (all); Agricultural and Biological Sciences (all)Pathology and Laboratory MedicineTurnaround timeSurveys and QuestionnairesMedicine and Health SciencesMedicineBlood culturelcsh:ScienceIncubationCandidaFungal PathogensMultidisciplinarymedicine.diagnostic_testPre analyticalHematologyMiddle AgedHospitalsClinical Laboratory SciencesBody FluidsClinical LaboratoriesBloodItalyExperimental Organism SystemsMedical MicrobiologyFemaleAnatomyPathogensResearch LaboratoriesResearch ArticleBiotechnologymedicine.medical_specialtyCatheters030106 microbiologyMycologyResearch and Analysis MethodsMicrobiologySpecimen HandlingSepsis03 medical and health sciencesSigns and SymptomsRetrospective surveyDiagnostic MedicineInternal medicineSepsisHumansCandida AlbicansMicrobial PathogensAgedRetrospective StudiesBacteriological TechniquesBacteriabusiness.industryClinical Laboratory Techniqueslcsh:ROrganismsFungiBiology and Life SciencesRetrospective cohort studymedicine.diseaseYeastSurgeryBlood CultureBacteremialcsh:QMedical Devices and EquipmentbusinessGovernment LaboratoriesPloS one
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Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

2019

Contains fulltext : 206779.pdf (Publisher’s version ) (Open Access) BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candide…

MaleOutcome Assessmentlnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]MULTICENTERCritical Care and Intensive Care Medicinelaw.invention610 Medical sciences Medicine0302 clinical medicineRetrospective StudieRisk FactorslawOutcome Assessment Health CareEPIDEMIOLOGYMedicineCumulative incidencePREDICTORSCandidaMedicine(all)Cross InfectionIncidenceIncidence (epidemiology)lcsh:Medical emergencies. Critical care. Intensive care. First aidCandidiasisMiddle AgedIntensive care unitEuropeIntensive Care UnitsAbdominal candidiasis; Candida; Candidemia; Candidiasis; ICU; Incidence; Aged; Candidiasis Invasive; Cross Infection; Europe; Female; Humans; Incidence; Intensive Care Units; Male; Middle Aged; Outcome Assessment Health Care; Retrospective Studies; Risk FactorsCandidiasiFemaleSOFA scoreLife Sciences & BiomedicineHumanAbdominal candidiasismedicine.medical_specialtyInvasiveIntensive Care Unit610Abdominal candidiasis Candida Candidemia Candidiasis ICU Incidence03 medical and health sciencesCritical Care MedicineGeneral & Internal MedicineIntensive careSettore MED/41 - ANESTESIOLOGIAMANAGEMENTHumansCandidiasis InvasiveAgedRetrospective StudiesScience & TechnologyAbdominal candidiasis; Candida; Candidemia; Candidiasis; ICU; Incidencebusiness.industrySeptic shockINTRAABDOMINAL CANDIDIASISResearchCandidemia030208 emergency & critical care medicineRetrospective cohort studylcsh:RC86-88.9Odds ratiomedicine.diseaseHealth Carelnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]ICUEmergency medicineAbdominal candidiasibusinessCritical Care
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Nasal pressure swings as the measure of inspiratory effort in spontaneously breathing patients with de novo acute respiratory failure.

2022

Abstract Background Excessive inspiratory effort could translate into self-inflicted lung injury, thus worsening clinical outcomes of spontaneously breathing patients with acute respiratory failure (ARF). Although esophageal manometry is a reliable method to estimate the magnitude of inspiratory effort, procedural issues significantly limit its use in daily clinical practice. The aim of this study is to describe the correlation between esophageal pressure swings (ΔPes) and nasal (ΔPnos) as a potential measure of inspiratory effort in spontaneously breathing patients with de novo ARF. Methods From January 1, 2021, to September 1, 2021, 61 consecutive patients with ARF (83.6% related to COVID…

Self-inflicted lung injuryCritical Care and Intensive Care MedicineAcute respiratory failureself-inflicted lung injuryNon-invasive Mechanical ventilationesophageal pressure swingsacute respiratory failure non-invasive mechanical ventilation esophageal pressure swings nasal pressure swings endotracheal intubation COVID-19 respiratory monitoring inspiratory effort self-inflicted lung injuryHumansInspiratory effortendotracheal intubationEsophageal pressure swingsAcute respiratory failure Non-invasive Mechanical ventilation Esophageal pressure swings Nasal pressure swings Endotracheal intubation COVID-19 Respiratory monitoring Inspiratory effort Self-inflicted lung injuryRespiratory Distress Syndromeacute respiratory failurenon-invasive mechanical ventilationNoninvasive VentilationRespiratory monitoringCOVID-19Endotracheal intubationRespiration ArtificialAcute respiratory failure; COVID-19; Endotracheal intubation; Esophageal pressure swings; Inspiratory effort; Nasal pressure swings; Non-invasive Mechanical ventilation; Respiratory monitoring; Self-inflicted lung injuryNasal pressure swingsnasal pressure swingsrespiratory monitoringRespiratory Insufficiencyinspiratory effortCritical care (London, England)
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Empiric treatment of patients with sepsis and septic shock and place in therapy of cefiderocol: a systematic review and expert opinion statement

2022

AbstractCarbapenem-resistant Gram-negative bacteria are frequent causes of sepsis and septic shock in intensive care unit (ICU) and thus considered a public health threat. Until now, the best available therapies consist of combinations of preexisting or new antibiotics with β-lactamase inhibitors (either new or preexisting). Several mechanisms of resistance, especially those mediated by metallo-β-lactamases (MBL), are responsible for the inefficacy of these treatments, leaving an unmet medical need. Intravenous cefiderocol has been recently approved by the American Food and Drug Administration (FDA) and European Medicines Agency (EMA) for the treatment of complicated urinary tract infection…

cefiderocolJournal of Anesthesia, Analgesia and Critical Care
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Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

2022

INTRODUCTION: Intra-abdominal infections represent the second most frequently acquired infection in the intensive care unit (ICU), with mortality rates ranging from 20% to 50%. Candida spp. may be responsible for up to 10-30% of cases. This study assesses risk factors for development of intra-abdominal candidiasis (IAC) among patients admitted to ICU. METHODS: We performed a case-control study in 26 European ICUs during the period January 2015-December 2016. Patients at least 18 years old who developed an episode of microbiologically documented IAC during their stay in the ICU (at least 48 h after admission) served as the case cohort. The control group consisted of adult patients who did no…

Microbiology (medical)MORTALITYInvasive candidiasiCandida; Intra-abdominal infection; Invasive candidiasis; Risk factorsCONTROLLED-TRIALCASPOFUNGINCANDIDEMIAInvasive candidiasisInfectious Diseaseslnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]Intra-abdominal infectionRisk factorsINFECTIONSMANAGEMENTEPIDEMIOLOGYPREDICTORSCONSENSUSCRITICALLY III PATIENTSCandida
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Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure : the DIANA study

2020

© 2020 The Author(s).

OriginalDELPHI METHODCritical Care and Intensive Care MedicineGUIDELINESlaw.invention0302 clinical medicineAnti-Infective Agents[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseaseslawEpidemiologyMedicine and Health SciencesAntimicrobial de-escalationEPIDEMIOLOGYComputingMilieux_MISCELLANEOUS[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseasesVentilator-associated pneumoniaIntensive care unitAnti-Bacterial Agents3. Good healthIntensive Care UnitsSTEWARDSHIP PROGRAM[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/VirologyCohortAntimicrobial de-escalation; Bacterial infection; Clinical cure; Empirical therapy; Intensive care unit;Clinical cureAntimicrobial de-escalation; Bacterial infection; Clinical cure; Empirical therapy; Intensive care unitAdultmedicine.medical_specialtyCombination therapyCritical IllnessANTIBIOTIC-THERAPYNO03 medical and health sciences[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular systemBETA-LACTAMInternal medicineSettore MED/41 - ANESTESIOLOGIAmedicineHumans[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/ParasitologyIntensive care unitVENTILATOR-ASSOCIATED PNEUMONIAbusiness.industrySEPTIC SHOCKR-PACKAGEbacterial infectionIntensive care unit.030208 emergency & critical care medicinemedicine.disease[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/BacteriologyEmpirical therapyDiscontinuationSEVERE SEPSISlnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]Carbapenems030228 respiratory systemRelative riskBacterial infectionbusinessDe-escalation
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Rationale and clinical application of antimicrobial stewardship principles in the intensive care unit: a multidisciplinary statement

2023

Abstract Background Antimicrobial resistance represents a major critical issue for the management of the critically ill patients hospitalized in the intensive care unit (ICU), since infections by multidrug-resistant bacteria are characterized by high morbidity and mortality, high rates of treatment failure, and increased healthcare costs worldwide. It is also well known that antimicrobial resistance can emerge as a result of inadequate antimicrobial therapy, in terms of drug selection and/or treatment duration. The application of antimicrobial stewardship principles in ICUs improves the quality of antimicrobial therapy management. However, it needs specific considerations related to the cri…

Sepsis
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Good clinical practice for the use of vasopressor and inotropic drugs in critically ill patients: state-of-the-science and expert consensus

2021

Vasopressors and inotropic agents are widely used in critical care. However, strong evidence supporting their use in critically ill patients is lacking in many clinical scenarios. Thus, the Italian Society of Anesthesia and Intensive Care (SIAARTI) promoted a project aimed to provide indications for good clinical practice on the use of vasopressors and inotropes, and on the management of critically ill patients with shock. A panel of 16 experts in the field of intensive care medicine and hemodynamics has been established. Systematic review of the available literature was performed based on PICO questions. Basing on available evidence, the panel prepared a summary of evidences and then wrote…

Inotropemedicine.medical_specialtyConsensusCritical CareCritical IllnessMEDLINEshockCardiotonic AgentsCardiotonic agentsVasoconstrictor agentsCardiogenic shock; Cardiotonic agents; Septic shock; Vasoconstrictor agents03 medical and health sciences0302 clinical medicineVasoconstrictor agents030202 anesthesiologySeptic shockIntensive caremedicineHumansVasoconstrictor AgentsIntensive care medicineCardiogenic shockbusiness.industrySeptic shockCardiogenic shock030208 emergency & critical care medicinemedicine.diseaseAnesthesiology and Pain MedicinePharmaceutical PreparationsShock (circulatory)Good clinical practicemedicine.symptombusinessCardiotonic agents
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Epidemiology of intensive care unit-acquired sepsis in Italy: Results of the SPIN-UTI network

2018

Background. Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Study design. Prospective multicenter study. Methods. The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. Results. During the five editions of the SPIN-UTI project, from 2008 to…

Sleep Initiation and Maintenance DisorderMaleTime FactorsHealthcare-associated infections; Mortality; Sepsis; Surveillance; Public Health Environmental and Occupational Health; Infectious DiseasesDiet MediterraneanCoffeeHealth StatuHealthcare-associated infections; Mortality Parole chiave: Infezioni correlate all'assistenza; Mortalità; Sepsi; Sepsis; Sorveglianza; Surveillance; Public Health Environmental and Occupational Health; Infectious DiseasesAcademic PerformancePrevalenceSurveys and QuestionnaireHospital MortalityProspective StudiesCross InfectionSurveillanceIncidenceSmokingTryptophanShockMiddle AgedShock SepticMortalitàIntensive Care UnitsInfectious DiseasesItalyPopulation SurveillanceFemalePublic HealthHumanAdultEmploymentAlcohol DrinkingSepsiIntensive Care UnitHealthcare-associated infectionsRegression AnalysiYoung AdultAge DistributionSepsisLearningHumansHealthcare-associated infectionMortalityExerciseLife StyleSettore MED/42 - IGIENE GENERALE E APPLICATAAgedCross-Sectional StudieHealthcare-associated infections; Mortality; Sepsis; SurveillanceSepticEnvironmental and Occupational HealthBody WeightLength of StayBody HeightProspective StudieSorveglianzaQuality of LifeStudents NursingMortality Parole chiave: Infezioni correlate all'assistenza
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Poor timing and failure of source control are risk factors for mortality in critically ill patients with secondary peritonitis

2022

PURPOSE: To describe data on epidemiology, microbiology, clinical characteristics and outcome of adult patients admitted in the intensive care unit (ICU) with secondary peritonitis, with special emphasis on antimicrobial therapy and source control. METHODS: Post hoc analysis of a multicenter observational study (Abdominal Sepsis Study, AbSeS) including 2621 adult ICU patients with intra-abdominal infection in 306 ICUs from 42 countries. Time-till-source control intervention was calculated as from time of diagnosis and classified into 'emergency' ( 6 h). Relationships were assessed by logistic regression analysis and reported as odds ratios (OR) and 95% confidence interval (CI). RESULTS: The…

AdultSecondary peritonitiCritical IllnessPeritonitisCritical Care and Intensive Care MedicineAnti-Bacterial AgentsAntimicrobial therapyIntensive Care UnitsSecondary peritonitisIntra-abdominal infectionAnti-Infective AgentsRisk FactorsSource controlSepsisMedicine and Health SciencesHumansIntraabdominal InfectionsMortalityRetrospective StudiesAntimicrobial therapy; Intra-abdominal infection; Mortality; Secondary peritonitis; Source controlIntensive Care Medicine
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Quality of Life in COVID-Related ARDS Patients One Year after Intensive Care Discharge (Odissea Study): A Multicenter Observational Study

2023

Background: Investigating the health-related quality of life (HRQoL) after intensive care unit (ICU) discharge is necessary to identify possible modifiable risk factors. The primary aim of this study was to investigate the HRQoL in COVID-19 critically ill patients one year after ICU discharge. Methods: In this multicenter prospective observational study, COVID-19 patients admitted to nine ICUs from 1 March 2020 to 28 February 2021 in Italy were enrolled. One year after ICU discharge, patients were required to fill in short-form health survey 36 (SF-36) and impact of event-revised (IES-R) questionnaire. A multivariate linear or logistic regression analysis to search for factors associated wi…

SF-36ARDS; COVID-19; ICU; SF-36; health related quality of life; impact of event scale-revised; post-traumatic stress disorderICUhealth related quality of lifeimpact of event scale-revisedCOVID-19post-traumatic stress disorderARDSARDS; COVID-19; health related quality of life; ICU; impact of event scale-revised; post-traumatic stress disorder; SF-36General MedicineJournal of Clinical Medicine
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Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units

2021

Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. I…

Drug Resistancemedicine.disease_causeSeverity of Illness Indexlaw.invention0302 clinical medicineENTEROBACTERIACEAElawDrug Resistance Multiple BacterialMedicine and Health SciencesPharmacology (medical)Cross InfectionbiologyBacterialAntimicrobialIntensive care unitAnti-Bacterial AgentsCommunity-Acquired InfectionsEuropeIntensive Care UnitsAnti-Bacterial Agents; Community-Acquired Infections; Critical Illness; Cross Infection; Europe; Humans; Intensive Care Units; Intraabdominal Infections; Microbial Sensitivity Tests; Peritonitis; Sepsis; Severity of Illness Index; Drug Resistance Multiple BacterialESCHERICHIA-COLI030220 oncology & carcinogenesisKLEBSIELLA-PNEUMONIAEBLOOD-STREAM INFECTIONSPYELONEPHRITISMultiplemedicine.medical_specialtyCritical IllnessMicrobial Sensitivity TestsPeritonitisEnterococcus faecalisNO03 medical and health sciencesIntra‑abdominal InfectionsAntibiotic resistanceFOODSepsisIntensive careInternal medicinemedicineHumansFLUOROQUINOLONE RESISTANCEPseudomonas aeruginosabusiness.industrySeptic shockMORTALITYbiology.organism_classificationmedicine.diseaseRISK-FACTORSIntraabdominal Infectionsbusiness030217 neurology & neurosurgeryEnterococcus faecium
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Additional file 1 of Nasal pressure swings as the measure of inspiratory effort in spontaneously breathing patients with de novo acute respiratory fa…

2022

Additional file 1: eTable 1. Esophageal and nasal pressure swings according to acute respiratory failure etiology. Data are presented as median and interquartile ranges (IQR). eFigure 1. Pearson���s R showing correlations between ��Pes and ��Pnos at 24 hours after splitting the study population according to the NRS received. eFigure 2. Bland-Altman analysis assessing the agreement between ��Pes measured with esophageal manometry and estimated based on ��Pnos (��Pes, estimated) and computed as k����Pnos, where k is the average ratio of ��Pes to ��Pnos measured at baseline. At T2 Bland-Altman methods showed a bias of 0.1 cmH2O and 95% limits of agreement, LoA, from ���2.0 to 2.1 cmH2O (95.1% …

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