Browsing by Author "Silva, Francisco"

Now showing 1 - 11 of 11
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    A Multicenter Study To Evaluate Ceftaroline Breakpoints : Performance in an Area with High Prevalence of Methicillin-Resistant Staphylococcus aureus Sequence Type 5 Lineage
    (2019) Khan, Ayesha; Rivas, Lina M.; Spencer, María; Martínez, Rodrigo; Lam, Marusella; Rojas, Pamela; Porte, Lorena; Silva, Francisco; Braun, Stephanie; García Cañete, Patricia; Valdivieso, Francisca; Mvlhauser, Margareta; Lafourcade, Mónica; Miller, William R.; Arias, César A.; Munita, José M.
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    A New Kind of Quinonic-Antibiotic Useful Against Multidrug-Resistant S. aureus and E. faecium Infections
    (2018) Campanini Salinas, Javier; Andrades Lagos, Juan; González Rocha, Gerardo; Choquesillo Lazarte, Duane; Bollo Dragnic, Soledad; Faúndez Cáceres, Mario; Alarcón, Pedro; Silva, Francisco; Vidal, Roberto; Salas Huenuleo, Edison; Kogan Alterman, Marcelo; Mella, Jaime; Recabarren Gajardo, Gonzalo; Vásquez Velásquez, David
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    Compromiso renal en vasculitis asociadas a anticuerpos anticitoplasma de neutrófilos. Recomendaciones de consenso de las Sociedades Chilenas de Nefrología y Reumatología
    (2018) Aguirre, Verónica; Alvo, Miriam; Ardiles, Leopoldo; Fierro, Alberto; Goecke, Annelise; Iruretagoyena B., Mirentxu; Jalil Milad, Roberto; Massardo Vega, Loreto; Méndez Olivieri, Gonzalo Patricio; Palma, Sergio; Roessler, Emilio; Silva, Francisco; Wurgaft, Andrés
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    Creation of the first national biorepository of multi-resistant bacteria available for the study of bacterial resistance in Chile
    (2022) Garcia, Patricia; Rivas, Lina; Peters, Anne; Henriquez, Paola; Castillo, Loriana; Illesca, Vijna; Maripani, Andrea; Moreno, Juan; Muhlhauser, Margareta; Porte, Lorena; Rioseco, Maria Luisa; Rojas, Pamela; Silva, Francisco; Suazo, Patricio; Munita, Jose M.
    The availability of bacterial strains for the study of bacterial resis-tance is key to advances in basic and clinical research. There are few biobanks of bacteria with known resistance mechanisms, isolated from clinically significant infections. A review of the literature reveals that only in the United States of America is there a biobank of resistant isolates. This publication shows the creation of the first biorepository of resistant bacteria Chile associated with the MICROB-R Laboratory Network, with the participation of 11 centers distributed throughout the country, which to date has more than 3,500 bacterial isolates studied phenotypically and genotypically, available to the Chilean scientific community.
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    First isolation of kpc in Chile: from Italy to a public hospital in Santiago
    (SOC CHILENA INFECTOLOGIA, 2012) Cifuentes, Marcela; Garcia, Patricia; San Martin, Paola; Silva, Francisco; Zuniga, Jennifer; Reyes, Sergio; Rojas, Rodrigo; Ponce, Rodrigo; Quintanilla, Raul; Delpiano, Luis; Wolff, Marcelo
    Carbapenem resistance in Enterobacteriaceae is an emerging problem worldwide. Among the mechanisms involved are the production of ESBLs or AmpC associated with porins loss or the presence of carbapenemases. Among these, the KPC betalactamase has become especially relevant given its rapid spread.In this article we present the first case of isolation of a strain of KPC producer Klebsiella pneumoniae at a hospital in Santiago, in a patient coming from Italy, with a history of multiple hospitalizations for treatment of non-Hodgkin lymphoma and subjected to several cycles of chemotherapy and hemodialysis. The strain was isolated from a urine culture on the seventh day of the patient's arrival to Chile. The isolate was resistant to quinolones, aminoglycosides, cephalosporins and carbapenems, retaining only susceptibility to tigecycline and colistin. In phenotypic test it was found to have positive Hodge test and positive synergy with carbapenems/boronic acid. Polymerase chain reaction demonstrated the presence of beta-lactamases TEM, SHV and KPC-2. None other Class A serine-carbapenemase or metallo-bectalactamases were present.
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    Grupo Colaborativo de Resistencia Bacteriana, Chile : recomendaciones 2014 para el control de la resistencia bacteriana
    (2015) Cifuentes, Marcela; Silva, Francisco; Arancibia, J. Miguel; Rosales, Ruth; Ajenjo Henríquez, María Cristina; Riedel, Gisela; Camponovo, Rossana; Labarca L., Jaime
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    Incidencia de bacterias multi-resistentes en unidades de cuidados intensivos de hospitales chilenos
    (2017) Paz Acuna, M.; Cifuentes, Marcela; Silva, Francisco; Rojas, Alvaro; Cerda, Jaime; Labarca, Jaime; Grp Colaborativo Resistencia
    Introduction: Incidence of multi-resistant bacteria is an indicator that permits better estimation of the magnitude of bacterial resistance in hospitals. Aim: To evaluate the incidence of relevant multi-drug resistant bacteria in intensive care units (ICUs) of Chile. Methods: Participating hospitals submitted information about the number of isolates from infected or colonized patients with 7 epidemiologically relevant multi-resistant bacteria in adult and pediatric ICUs between January 1, 2014 and October 31, 2015 and the number of bed days occupied in these units in the same period was requested. With these data incidence was calculated per 1,000 patient days for each unit. Results: Information from 20 adults and 9 pediatric ICUs was reviewed. In adult ICUs the bacteria with the highest incidence were K. pneumoniae ESBL [4.72 x 1,000 patient day (1.21-13.89)] and oxacillin-resistant S. aureus [3.85 (0.71-12.66)]. In the pediatric units the incidence was lower, highlighting K. pneumoniae ESBL [2.71 (0-7.11)] and carbapenem-resistant P aeruginosa [1.61 (0.31-9.25)]. Conclusion: Important differences between hospitals in the incidence of these bacteria were observed. Incidence of multi-resistant bacteria in adult ICU was significantly higher than in pediatric ICU for most of the studied bacterias.
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    Solid Malignancies Among Etanercept-Treated Patients With Granulomatosis With Polyangiitis (Wegener's) Long-Term Followup of a Multicenter Longitudinal Cohort
    (WILEY, 2011) Silva, Francisco; Seo, Philip; Schroeder, Darrell R.; Stone, John H.; Merkel, Peter A.; Hoffman, Gary S.; Spiera, Robert; Sebastian, Jodi K.; Davis, John C., Jr.; St Clair, E. William; Allen, Nancy B.; McCune, W. Joseph; Ytterberg, Steven R.; Specks, Ulrich; Wegener's Granulomatosis
    Objective. An association between therapeutic inhibition of tumor necrosis factor (TNF) and solid malignancies was observed during the Wegener's Granulomatosis Etanercept Trial (WGET), which included 180 patients with granulomatosis with polyangiitis (Wegener's) (GPA). The present study was conducted to determine the malignancy risk beyond the time of exposure to study therapy.
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    Susceptibilidad antimicrobiana en Chile 2012
    (2014) Cifuentes D., Marcela; Silva, Francisco; García Cañete, Patricia; Bello, Helia; Briceño, Isabel; Calvo A., Mario; Labarca L., Jaime
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    TNF-alpha Blocker Therapy and Solid Malignancy Risk in ANCA-Associated Vasculitis
    (SPRINGER, 2012) Silva, Francisco; Cisternas, Marcela; Specks, Ulrich
    ANCA-associated vasculitides (AAV) are small vessel systemic vasculitis syndromes associated with the potential for high morbidity and mortality. This group includes granulomatosis with polyangiitis (Wegener's, GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA). The standard treatment consists of a combination of glucocorticoids and potent immunosuppressant drugs. These have broad mechanisms of action as well as important adverse effects. Efforts have been made to investigate novel agents with better-defined and narrower mechanisms of action, such as biologics, including TNF-alpha blockers. Etanercept, a well-known TNF-alpha blocker evaluated for GPA in the Wegener's Granulomatosis Etanercept Trial (WGET), was associated with an increase in the development of solid malignancies in comparison to placebo during that trial period. A 5-year follow-up after the WGET trial showed a sustained increase in incidence of solid malignancies, but this could no longer be solely attributed to etanercept exposure. These studies raised concerns about the use of the family of TNF-alpha blockers in AAV. Here, we review the evidence about the association between therapeutic inhibition of tumor necrosis factor (TNF-alpha) by etanercept and other TNF-alpha blockers with the development of solid malignancies in GPA and other AAV.
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    Trends and socioeconomic, demographic, and environmental factors associated with antimicrobial resistance: a longitudinal analysis in 39 hospitals in Chile 2008-2017
    (2023) Allel, Kasim; Labarca, Jaime; Carvajal, Camila; Garcia, Patricia; Cifuentes, Marcela; Silva, Francisco; Munita, Jose M.; Undurraga, Eduardo A.
    Background Antimicrobial resistance (AMR) is among the most critical global health threats of the 21st century. AMR is primarily driven by the use and misuse of antibiotics but can be affected by socioeconomic and environmental factors. Reliable and comparable estimates of AMR over time are essential to making public health decisions, defining research priorities, and evaluating interventions. However, estimates for developing regions are scant. We describe the evolution of AMR for critical priority antibiotic-bacterium pairs in Chile and examine their association with hospital and community-level characteristics using multivariate rate-adjusted regressions. Methods Drawing on multiple data sources, we assembled a longitudinal national dataset to analyse AMR levels for critical priority antibiotic-bacterium combinations in 39 private and public hospitals (2008-2017) throughout the country and characterize the population at the municipality level. We first described trends of AMR in Chile. Second, we used multivariate regressions to examine the association of AMR with hospital characteristics and community-level socioeconomic, demographic, and environmental factors. Last, we estimated the expected distribution of AMR by region in Chile. Findings Our results show that AMR for priority antibiotic-bacterium pairs steadily increased between 2008 and 2017 in Chile, driven primarily by Klebsiella pneumoniae resistant to third-generation cephalosporins and carbapenems, and vancomycin-resistant Enterococcus faecium. Higher hospital complexity, a proxy for antibiotic use, and poorer local community infrastructure were significantly associated with greater AMR.Interpretation Consistent with research in other countries in the region, our results show a worrisome increase in clinically relevant AMR in Chile and suggest that hospital complexity and living conditions in the community may affect the emergence and spread of AMR. Our results highlight the importance of understanding AMR in hospitals and their interaction with the community and the environment to curtail this ongoing public health crisis.