Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study

BACKGROUND: The objective of this study is to analyze the factors that are associated with the adequacy of empirical antibiotic therapy and its impact in mortality in a large cohort of patients with extended-spectrum β-lactamase (ESBL)--producing Escherichia coli and Klebsiella spp. bacteremia. METHODS: Cases of ESBL producing Enterobacteriaceae (ESBL-E) bacteremia collected from 2003 through 2008 in 19 hospitals in Spain. Statistical analysis was performed using multivariate logistic regression. RESULTS: We analyzed 387 cases ESBL-E bloodstream infections. The main sources of bacteremia were urinary tract (55.3%), biliary tract (12.7%), intra-abdominal (8.8%) and unknown origin (9.6%). Among all the 387 episodes, E. coli was isolated from blood cultures in 343 and in 45.71% the ESBL-E was multidrug resistant. Empirical antibiotic treatment was adequate in 48.8% of the cases and the in hospital mortality was 20.9%. In a multivariate analysis adequacy was a risk factor for death [adjusted OR (95% CI): 0.39 (0.31-0.97); P = 0.04], but not in patients without severe sepsis or shock. The class of antibiotic used empirically was not associated with prognosis in adequately treated patients. CONCLUSION: ESBL-E bacteremia has a relatively high mortality that is partly related with a low adequacy of empirical antibiotic treatment. In selected subgroups the relevance of the adequacy of empirical therapy is limited

Prioritizing patient safety: analysis of the procurement process of infusion pumps in Spain

To understand whether patient safety and human factors are considered in healthcare technology procurement, we analyzed the case of infusion pumps as their use critically affects patient safety. We reviewed infusion pump procurements in the Spanish Public Sector Procurement Database. Sixty-three batches in 29 tenders for supplying 12.224 volumetric and syringe infusion pumps and consumables for an overall budget of EUR 30.4 M were identified and reviewed. Concepts related to "ease of use" were identified in the selection requirements of 35 (55.6%) batches, as part of the criteria for the selection of pumps in 23 (36.5%) batches, related to "intuitiveness" in the selection requirements of 35 (55.6%) batches, and in the criteria in 10 (15.9%) batches. No method to evaluate the ease of use, intuitiveness, or usability was mentioned. A review of the procurement teams responsible for the evaluation of the tenders showed no reported human factors or patient safety expertise. We conclude that infusion pump procurement considers usability as a relevant criterion for selection. However, no human factor experts nor specific methods for evaluation of the technology in this field are usually defined. Potential room for refining the selection of healthcare technology to improve patient safety is detected.This research was funded by Instituto de Salud Carlos III, grant number PT20/00055. The authors would like to express their gratitude to the IDIVAL support team for their encouragement and to the friends of MedStar for inspiring and teaching us

Podcast e pillole sonore: ricette didattiche innovative per l'uguaglianza

El proyecto de innovación número 375, titulado Podcasts y píldoras sonoras: recetas docentes innovadoras para la igualdad promueve el uso de la voz como herramienta igualitaria para crear píldoras sonoras o podcasts de auto-aprendizaje, que disminuyan la brecha tecnológica en el alumnado: no necesitan infraestructura y motivan el conocimiento con ejemplos reales.Innovation project number 375, entitled Podcasts and sound pills: innovative teaching recipes for equality, promotes the use of voice as an egalitarian tool to create sound pills or self-learning podcasts that reduce the technological gap among students: they do not require infrastructure and motivate knowledge with real examples.Projecto de inovação número 375, intitulado Podcasts e comprimidos de som: receitas de ensino inovadoras para a igualdade, promove a utilização da voz como ferramenta igualitária para criar comprimidos de som ou podcasts de auto-aprendizagem, que reduzem o fosso tecnológico entre os estudantes: não exigem infra-estruturas e motivam o conhecimento com exemplos reais.Le projet d'innovation numéro 375, intitulé Podcasts et pilules sonores : des recettes pédagogiques innovantes pour l'égalité, promeut l'utilisation de la voix comme outil égalitaire pour créer des pilules sonores ou des podcasts d'auto-apprentissage, qui réduisent le fossé technologique entre les élèves : ils ne nécessitent pas d'infrastructure et motivent les connaissances par des exemples réels.Vicerrectorado de Calidad UCMDepto. de Periodismo y Nuevos MediosFac. de Ciencias de la InformaciónFALSEsubmitte

Sound Pills: Voice as a classroom innovation for equality and inclusion (podcasting, Discord, Twitter, Clubhouse)

El proyecto de innovación docente 2022-2023, titulado Píldoras sonoras: la voz como innovación en el aula para la igualdad y la inclusión (podcasting, Discord, Twitter, Clubhouse), aúna un equipo interdisciplinar de profesorado UCM y profesorado externo (de España y del extranjero), PAS, alumnado de Grado, Máster y Doctorado, una becaria de colaboración, dos becarios FPI UCM-Banco Santander y un becario FPU (doctorado). Todos sus integrantes son expertos docentes y/o investigadores en nuevas tecnologías, innovación docente y auto-aprendizaje, redes sociales, voz y podcasting. Durante la crisis de la COVID-19, se adaptaron perfectamente a la docencia virtual online y gran parte de ellos cuenta con experiencia en docencia online completa, en programas oficiales a distancia, previos al confinamiento. En este nuevo entorno, que se erige como el futuro inmediato, se ha detectado el crecimiento del uso de las redes sociales y repositorios de voz y de podcasting, frente a las redes sociales de fotografía y vídeo, que requieren de mejores dispositivos, mejor acceso Internet y en ocasiones, conocimientos avanzados de edición de vídeo y sonido. Sin embargo, la voz humana es una herramienta primordial, gratuita y accesible para todos y todas. No requiere de infraestructura, ni de logística previa y gracias a ello, elimina la brecha tecnológica por motivos de desigualdad económica, de edad, de formación y de género.Oficina para la Calidad, Vicerrectorado de Calidad, Universidad Complutense de MadridDepto. de Periodismo y Nuevos MediosFac. de Ciencias de la InformaciónFALSEsubmitte