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    Item type:Publication,
    Recommendations for the management of candidemia in children in Latin America
    (2013)
    María E. Santolaya
    ;
    Flavio de Queiroz Telles
    ;
    Tito Alvarado Matute
    ;
    Arnaldo Lopes Colombo
    ;
    Jeannete Zurita
      6Scopus© Citations 13
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    Item type:Publication,
    Recommendations for the management of candidemia in neonates in Latin America
    (2013)
    María E. Santolaya
    ;
    Tito Alvarado Matute
    ;
    Flavio de Queiroz Telles
    ;
    Arnaldo Lopes Colombo
    ;
    Jeannete Zurita
      18Scopus© Citations 25
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    Item type:Publication,
    Recommendations for the diagnosis of candidemia in Latin America
    (2013)
    Arnaldo Lopes Colombo
    ;
    Jorge Alberto Cortes
    ;
    Jeannete Zurita
    ;
    Manuel Guzman-Blanco
    ;
    Tito Alvarado Matute
      3Scopus© Citations 17
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    Item type:Publication,
    Recomendaciones para el manejo de la candidemia en adultos en América Latina
    (2013)
    Marcio Nucci
    ;
    ;
    Manuel Guzman-Blanco
    ;
    Iris Nora Tiraboschi
    ;
    Jorge Alberto Cortes
    Scopus© Citations 37  1
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    Item type:Publication,
    Epidemiology of Candidemia in Latin America: A Laboratory-Based Survey
    (2013)
    Marcio Nucci
    ;
    Flavio Queiroz-Telles
    ;
    Tito Alvarado-Matute
    ;
    Iris Nora Tiraboschi
    ;
    Jorge Cortes
    Scopus© Citations 312  2
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    Item type:Publication,
    Antimicrobial stewardship programs in adult intensive care units in Latin America: Implementation, assessments, and impact on outcomes
    (2021)
    Rodolfo E. Quirós
    ;
    Ana C. Bardossy
    ;
    Patricia Angeleri
    ;
    Jeannete Zurita
    ;
    Washington R. Aleman Espinoza
    <jats:title>Abstract</jats:title><jats:sec id="S0899823X21000805_as1"><jats:title>Objective:</jats:title><jats:p>To assess the impact of antimicrobial stewardship programs (ASPs) in adult medical–surgical intensive care units (MS-ICUs) in Latin America.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as2"><jats:title>Design:</jats:title><jats:p>Quasi-experimental prospective with continuous time series.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as3"><jats:title>Setting:</jats:title><jats:p>The study included 77 MS-ICUs in 9 Latin American countries.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as4"><jats:title>Patients:</jats:title><jats:p>Adult patients admitted to an MS-ICU for at least 24 hours were included in the study.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as5"><jats:title>Methods:</jats:title><jats:p>This multicenter study was conducted over 12 months. To evaluate the ASPs, representatives from all MS-ICUs performed a self-assessment survey (0–100 scale) at the beginning and end of the study. The impact of each ASP was evaluated monthly using the following measures: antimicrobial consumption, appropriateness of antimicrobial treatments, crude mortality, and multidrug-resistant microorganisms in healthcare-associated infections (MDRO-HAIs). Using final stewardship program quality self-assessment scores, MS-ICUs were stratified and compared among 3 groups: ≤25th percentile, &gt;25th to &lt;75th percentile, and ≥75th percentile.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as6"><jats:title>Results:</jats:title><jats:p>In total, 77 MS-ICU from 9 Latin American countries completed the study. Twenty MS-ICUs reached at least the 75th percentile at the end of the study in comparison with the same number who remain within the 25th percentile (score, 76.1 ± 7.5 vs 28.0 ± 7.3; <jats:italic>P</jats:italic> &lt; .0001). Several indicators performed better in the MS-ICUs in the 75th versus 25th percentiles: antimicrobial consumption (143.4 vs 159.4 DDD per 100 patient days; <jats:italic>P</jats:italic> &lt; .0001), adherence to clinical guidelines (92.5% vs 59.3%; <jats:italic>P</jats:italic> &lt; .0001), validation of prescription by pharmacist (72.0% vs 58.0%; <jats:italic>P</jats:italic> &lt; .0001), crude mortality (15.9% vs 17.7%; <jats:italic>P</jats:italic> &lt; .0001), and MDRO-HAIs (9.45 vs 10.96 cases per 1,000 patient days; <jats:italic>P</jats:italic> = .004).</jats:p></jats:sec><jats:sec id="S0899823X21000805_as7"><jats:title>Conclusion:</jats:title><jats:p>MS-ICUs with more comprehensive ASPs showed significant improvement in antimicrobial utilization.</jats:p></jats:sec>
    Scopus© Citations 25  1
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    Item type:Publication,
      7  1
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    Item type:Publication,
    Surveillance of Candida spp Bloodstream Infections: Epidemiological Trends and Risk Factors of Death in Two Mexican Tertiary Care Hospitals
    (2014)
    Dora E. Corzo-Leon
    ;
    Tito Alvarado-Matute
    ;
    Arnaldo L. Colombo
    ;
    Patricia Cornejo-Juarez
    ;
    Jorge Cortes
    Scopus© Citations 32  1
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    Item type:Publication,
    A Prospective Cohort Multicenter Study of Molecular Epidemiology and Phylogenonnics of Staphylococcus aureus Bacterennia in Nine Latin American Countries
    (2017)
    Cesar A. Arias
    ;
    Jinnethe Reyes
    ;
    Lina Paola Carvajal
    ;
    Sandra Rincon
    ;
    Lorena Diaz
    <jats:title>ABSTRACT</jats:title> <jats:p> <jats:named-content content-type="genus-species">Staphylococcus aureus</jats:named-content> is an important pathogen causing a spectrum of diseases ranging from mild skin and soft tissue infections to life-threatening conditions. Bloodstream infections are particularly important, and the treatment approach is complicated by the presence of methicillin-resistant <jats:named-content content-type="genus-species">S. aureus</jats:named-content> (MRSA) isolates. The emergence of new genetic lineages of MRSA has occurred in Latin America (LA) with the rise and dissemination of the community-associated USA300 Latin American variant (USA300-LV). Here, we prospectively characterized bloodstream MRSA recovered from selected hospitals in 9 Latin American countries. All isolates were typed by pulsed-field gel electrophoresis (PFGE) and subjected to antibiotic susceptibility testing. Whole-genome sequencing was performed on 96 MRSA representatives. MRSA represented 45% of all (1,185 <jats:named-content content-type="genus-species">S. aureus</jats:named-content> ) isolates. The majority of MRSA isolates belonged to clonal cluster (CC) 5. In Colombia and Ecuador, most isolates (≥72%) belonged to the USA300-LV lineage (CC8). Phylogenetic reconstructions indicated that MRSA isolates from participating hospitals belonged to three major clades. Clade A grouped isolates with sequence type 5 (ST5), ST105, and ST1011 (mostly staphylococcal chromosomal cassette <jats:italic>mec</jats:italic> [SCC <jats:italic>mec</jats:italic> ] I and II). Clade B included ST8, ST88, ST97, and ST72 strains (SCC <jats:italic>mec</jats:italic> IV, subtypes a, b, and c/E), and clade C grouped mostly Argentinian MRSA belonging to ST30. In summary, CC5 MRSA was prevalent in bloodstream infections in LA with the exception of Colombia and Ecuador, where USA300-LV is now the dominant lineage. Clonal replacement appears to be a common phenomenon, and continuous surveillance is crucial to identify changes in the molecular epidemiology of MRSA. </jats:p>
      7  1Scopus© Citations 101