Michele Bartoletti

• University of Bologna

Background Pseudomonas aeruginosa bloodstream infections (Pa-BSIs) are still a major cause of mortality in ICUs, posing many treatment uncertainties. Methods This multicentre, retrospective study analysed data from 14 Italian hospitals, including all consecutive adults developing Pa-BSI in ICU during 2021–22 and treated with antibiotics for at lea...

The treatment of Stenotrophomonas maltophilia bloodstream infections (BSI) remains challenging due to the organism's intrinsic multidrug resistance and the potential side effects of commonly used first-line antibiotics. Here, we describe four cases of S. maltophilia BSI treated with cefiderocol (≥ 72 h) in different Italian hospitals. Additionally,...

Objectives: Large language models (LLMs) show promise in clinical decision-making, but comparative evaluations of their antibiotic prescribing accuracy are limited. This study assesses the performance of various LLMs in recommending antibiotic treatments across diverse clinical scenarios. Methods: Fourteen LLMs, including standard and premium versi...

Acinetobacter baumannii is a significant public health concern due to the emergence of antibiotic-resistant strains. Cefiderocol (FDC), a novel siderophore cephalosporin, has shown promise as a last-line treatment for multidrug-resistant Gram-negative bacteria. However, the emergence of in vivo-acquired FDC-resistant A. baumannii strains highlights...

In recent years, novel antimicrobials have been developed to counter the emergence of antimicrobial resistance and provide effective therapeutic options against multidrug-resistant (MDR) Gram-negative bacilli (GNB). Cefiderocol, a siderophore cephalosporin, represents a novel valuable antimicrobial drug for the treatment of infections caused by MDR...

Introduction Implant-based breast reconstruction (IBR) is the predominant breast reconstruction technique post-mastectomy, with bacterial infections being a significant complication affecting patient recovery and quality of life. The following study aimed to determine the microbiological features of the causative agents responsible for breast impla...

A Delphi consensus-seeking procedure was conducted to validate a list of ICD-9-CM codes that could help identify hospital admissions in which antimicrobials are more likely to be prescribed. The panel agreed to include 2967 codes out of 16229 (18.28%). Such codes could support AMS strategies by large-scale monitoring of drug consumption.

The increasing diffusion of antimicrobial resistance represents one of the major public health problems worldwide. In the last years, novel antimicrobial molecules have been developed to contrast the emergence of antimicrobial resistance and to provide a valuable therapeutic options against multi drug-resistant (MDR) GNB microorganisms. A new sider...

Objectives: To determine the association of adequate empirical combination therapy (AECT) with 30-day all-cause mortality in patients with septic shock due to Pseudomonas aeruginosa bloodstream infections (BSI). Methods: This multicentre, retrospective cohort study analysed data from 14 public hospitals in Italy, including all consecutive adult pa...

Background: HAIs (Healthcare-Acquired-Infections) have been recently the subject of judgment n. 6386 pronounced on 3rd March 2023 by the Italian Supreme Court. This sentence provided three criteria to determine whether a health facility is responsible for the patient contracting a nosocomial infection, i.e. time criterion, topographical criterion a...

Objectives Advancements in Artificial Intelligence(AI) have made platforms like ChatGPT increasingly relevant in medicine. This study assesses ChatGPT’s utility in addressing bacterial infection-related questions and antibiogram-based clinical cases. Methods This study involved a collaborative effort involving infectious disease (ID) specialists a...

Intra-abdominal infections (IAIs) are common surgical emergencies and are an important cause of morbidity and mortality in hospital settings, particularly if poorly managed. The cornerstones of effective IAIs management include early diagnosis, adequate source control, appropriate antimicrobial therapy, and early physiologic stabilization using int...

Background Meropenem-vaborbactam is a recent and promising option for the treatment of KPC-producing Klebsiella pneumoniae (KPC-Kp) infections, including those resistant to ceftazidime-avibactam. Methods We conducted a retrospective analysis of observational data from 19 Italian hospitals on use and outcomes of patients treated with meropenem-vabo...

Background Group A Streptococcus (GAS) causes multiple clinical manifestations, including invasive (iGAS) or even life-threatening (severe-iGAS) infections. After the drop in cases during COVID-19 pandemic, in 2022 a sharp increase of GAS was reported globally. Methods GAS strains collected in 09/2022–03/2023 in two university hospitals in Milan,...

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) is a major issue in healthcare, since it is often associated with endocarditis or deep site foci. Relevant morbidity and mortality associated with MRSA-BSIs forced the development of new antibiotic strategies; in particular, this review will focus the atte...

Background We assessed the laboratory diagnosis and treatment of invasive fungal disease (IFD) in Italy to detect limitations and potential for improvement. Methods The survey was available online at www.clinicalsurveys.net/uc/IFI management capacity/, and collected variables such as (a) institution profile, (b) perceptions of IFD in the respectiv...

Despite global vaccination efforts, immunocompromized patients remain at high risk for COVID-19-associated morbidity. In particular, patients with impaired humoral immunity have shown a high risk of persistent infection. We report a case series of adult patients with B cell malignancies and/or undergoing B cell targeting therapies with persisting S...

Unlabelled: BACKGROUND SOURCES; CONTENT; IMPLICATIONS: Infectious disease pandemics and epidemics pose significant global threats, and the risk of emerging infectious diseases has increased due to factors such as international connections, travel, and population density. Despite investments in global health surveillance, much of the world remains...

A substantial increase in broad-spectrum antibiotics as empirical therapy in patients with community-acquired pneumonia (CAP) has occurred over the last 15 years. One of the driving factors leading to that has been some evidence showing an increased incidence of drug-resistant pathogens (DRP) in patients from a community with pneumonia, including m...

Background Intra-abdominal candidiasis (IAC) is burdened by high mortality rates. However, the correct management of a critically ill patient with suspected IAC is an issue still on debate. The aim of our study was to evaluate the safety of pulse high-dose of liposomal amphotericin B (L-AmB) in patients with suspected IAC managed with a Beta-D-Gluc...

(1) Background: To explore the impact of the degree of inflammation on voriconazole exposure in critically ill patients affected by COVID-associated pulmonary aspergillosis (CAPA); (2) Methods: Critically ill patients receiving TDM-guided voriconazole for the management of proven or probable CAPA between January 2021 and December 2022 were included...

Background: Ceftobiprole is approved in Europe for community-acquired pneumonia (CAP) and non-ventilator associated hospital-acquired pneumonia (HAP) in adults. Real-life data are limited. Methods: This was a multicentre, observational and ambispective investigator-initiated study run in Italy from January 2018 to December 2019 in order evaluate...

Outcome of early treatment of COVID‐19 with antivirals or anti‐spike monoclonal antibodies (MABs) in patients with haematological malignancies (HM) is unknown. A retrospective study of HM patients treated for mild/moderate COVID‐19 between March 2021 and July 2022 was performed. The main composite end‐point was treatment failure (severe COVID‐19 or...

Objectives: Ceftazidime-avibactam (CAZ-AVI)-based treatments have been associated with emergence of resistance in KPC-producing Klebsiella pneumoniae (KPC-Kp) isolates following antimicrobial exposure. Herein, we evaluated the CAZ-AVI-resistance development in KPC-Kp isolated from patients treated with CAZ-AVI-based therapy. Methods: We enrolled...

Background Therapeutic drug monitoring (TDM) may represent an invaluable tool for optimizing antimicrobial therapy in septic patients, but extensive use is burdened by barriers. The aim of this study was to assess the impact of a newly established expert clinical pharmacological advice (ECPA) program in improving the clinical usefulness of an alrea...

The novel coronavirus SARS-CoV-2, responsible for the COVID-19 pandemic, has caused significant life loss and healthcare burden globally. The pathophysiology of severe COVID-19 resembles a cytokine release syndrome (CRS) response. This inflammatory storm may benefit from immunomodulating agents and corticosteroids. In this chapter we will review th...

Main aim of this systematic review is to quantify the risk and identify predictors of clinical evolution of SARS-CoV-2 in hematological patients compared to different control populations. Two independent reviewers screened the literature assessing clinical outcomes of SARS-CoV-2 infection in adult patients with active hematological malignancies pub...

Efficacy of early treatment with anti‐SARS‐CoV‐2 spike protein monoclonal antibodies (mAbs) for nosocomial SARS‐CoV‐2 infection in hematologic patients is unknown. Retrospective, cohort study conducted in four Italian teaching hospitals. We included adult patients with hematologic malignancies and hospital‐acquired SARS‐CoV‐2 infection diagnosed be...

Scope: Despite the large availability of vaccines coronavirus disease 2019 (COVID-19) induced by SARS-CoV-2 continues to be a major threat for healthcare and fragile people. A number of options are now available for outpatients with mild to moderate COVID-19 at risk for disease progression to prevent deaths or hospitalization. Methods: An ESCMID...

Background: Carbapenem-resistant Enterobacterales (CRE) colonisation at liver transplantation (LT) increases the risk of CRE infection after LT, which impacts on recipients' survival. Colonization status usually becomes evident only near LT. Thus, predictive models can be useful to guide antibiotic prophylaxis in endemic centres. Aims: This stud...

Objective of this study was to assess the appropriate treatment duration for enterococcal central line-associated bloodstream infections (CLABSIs). This observational, retrospective, multicenter study conducted between 2011 and 2019 enrolled all hospitalized patients with monomicrobial enterococcal CLABSI. Those with infective endocarditis and non-...

Objective To evaluate the cost-effectiveness of dalbavancin compared with standard of care (SoC) treatment as daptomycin or teicoplanin in patients with sternal wound infections (SWI). Methods Multicentre retrospective study of patients diagnosed with SWI from January 2016 to December 2019 at two cardiac surgery facilities treated with dalbavancin...

Introduction : Conditions favoring persistent enterococcal bacteremia (pEB) have not been fully investigated yet. The aim of our study is to analyze risk factors for pEB and its impact on mortality. Methods : International two-center retrospective study of all hospitalized adults with enterococcal bacteremia managed with follow-up BCs during the p...

Objective The aim of our study was to build a predictive model able to stratify the risk of bacterial co-infection at hospitalization in patients with COVID-19. Methods Multicenter observational study of adult patients hospitalized from February to December 2020 with confirmed COVID-19 diagnosis. Endpoint was microbiologically documented bacterial...

(1) Background: Chest Computed Tomography (CT) has been proposed as a non-invasive method for confirming the diagnosis of SARS-CoV-2 patients using radiomic features (RFs) and baseline clinical data. The performance of Machine Learning (ML) methods using RFs derived from semi-automatically segmented lungs in chest CT images was investigated regardi...

First reports of cases and case series of COVID-19-associated pulmonary aspergillosis (CAPA) emerged during the first months of the pandemic. Prevalence rates varied widely due to the fact that CAPA was, and still remains, challenging to diagnose in patients with COVID-19-associated acute respiratory failure (ARF). The clinical picture and radiolog...

Novel carbapenem-β-lactamase inhibitor combination, imipenem/relebactam (IMI-REL), has been recently approved for treatment of infections with limited or no alternative treatment options. In this study, we described the emergence of the IMI-REL-resistance in a KPC-producing Klebsiella pneumoniae (KPC-Kp) strain collected from a hematological patien...

Objectives The novel carbapenem/β-lactamase inhibitor combination imipenem/cilastatin/relebactam has been developed for the treatment of infections due to carbapenemase-producing Enterobacteriaceae (CPE). Herein, we describe the in vivo evolution of imipenem/cilastatin/relebactam resistance in longitudinal intra-patient Klebsiella pneumoniae carbap...

Infection is a major complication of solid organ transplantation. The occurrence of infection follows a typical timeline related to the intensity of immunosuppression and the time between surgery and symptoms onset. In the early posttransplant period, bacterial and healthcare-related infections are predominant and multidrug-resistant bacteria commo...

Objective In this study we investigated the rate of susceptibility testing discrepancies between semi-automated and reference systems with carbapenem-resistant Enterobacterales (CRE), and the impact of alleged errors by semi-automated systems on guiding targeted therapy for CRE bloodstream infection (BSI). Methods Multicenter, retrospective study...

Objectives The COVID-19 pandemic has intensified interest in how the infection impacts the lung microbiome of critically ill patients and contributes to acute respiratory distress syndrome (ARDS). We aimed to characterize the lower respiratory tract mycobiome of COVID-19 critically ill patients in comparison to COVID-19-negative patients. Methods...

Objectives: To analyse the impact of cefiderocol use on outcome in patients admitted to the ICU for severe COVID-19 and further diagnosed with carbapenem-resistant Acinetobacter baumannii (CR-Ab) infection. Methods: Retrospective multicentre observational study was performed at four Italian hospitals, from January 2020 to April 2021. Adult patie...

Background Hyperglycemia and obesity are associated with a worse prognosis in subjects with COVID-19 independently. Their interaction as well as the potential modulating effects of additional confounding factors is poorly known. Therefore, we aimed to identify and evaluate confounding factors affecting the prognostic value of obesity and hyperglyce...

Scope In January 2021, the ESCMID Executive Committee (EC) decided to launch a new initiative to develop ESCMID guidelines on several COVID19-related issues, including treatment of COVID-19. Methods An ESCMID COVID-19 guidelines task force was established by the ESCMID Executive Committee. A small group was established, half appointed by the chair...

Objectives To explore the relationship between cefiderocol pharmacokinetic/pharmacodynamic (PK/PD) target attainment and microbiological outcome in critically ill patients affected by extensively drug-resistant Acinetobacter baumannii (XDR-AB) bloodstream infection (BSI) and/or ventilator-associated pneumonia (VAP). Methods Patients who received c...

Background The management of non-fermentative gram-negative bloodstream infection (NFGN-BSI) offers numerous challenges. In this study the aim is to analyse a large cohort of patients with NFGN-BSI recruited in the northern Italy to describe epidemiology, etiological and susceptibility pattern, therapeutic management and outcome. Methods Multicent...

Bacterial infections are frequent in cirrhotic patients with acute decompensation or acute-on-chronic liver failure and can complicate the clinical course. Delayed diagnosis and inappropriate empirical treatments are associated with poor prognosis and increased mortality. Fungal infections are much less frequent, usually nosocomial and associated w...

The SARS-CoV-2-associated COVID-19 pandemic has shaken the global healthcare system. Although the best-known symptoms are dry cough and pneumonia, viral RNA has been detected in the stool and about half of COVID-19 patients exhibit gastrointestinal upset. In this scenario, special attention is being paid to the possible role of the gut microbiota (...

Background: COVID assessment can be performed using the recently developed individual risk score (prediction of severe respiratory failure in hospitalized patients with SARS-COV2 infection, PREDI-CO score) based on High Resolution Computed Tomography. In this study, we evaluated the possibility of automatizing this estimation using semi-supervised...

COVID-19 infection may predispose to secondary bacterial infection which is associated with poor clinical outcome especially among critically ill patients. We aimed to characterize the lower respiratory tract bacterial microbiome of COVID-19 critically ill patients in comparison to COVID-19-negative patients. We performed a 16S rRNA profiling on br...

Meropenem/Vaborbactam (MEM-VAB) is a novel carbapenem- β-lactamase inhibitor active against KPC-producing Enterobacteria. Herein, we evaluate the incidence of meropenem/vaborbactam-resistance among KPC-producing K. pneumoniae (KPC-Kp) bloodstream infection in a large Italian hospital. Meropenem/vaborbactam-resistance was found in 8% (n = 5) KPC-Kp,...

Objectives To assess the incidence of colonization and infection with carbapenemase producing Enterobacteriaceae (CPE) and carbapenem resistant Acinetobacter baumannii (CR-Ab) in the ICUs of our city hospitals before and during COVID-19 pandemic. Methods Multicentre before-after cross sectional study to compare the rates of colonization and infect...

Background: Few small studies have described hospital-acquired infections (HAIs) during COVID-19. Research question: What patient characteristics in critically ill patients with COVID-19 are associated with HAIs and how do HAIs associate with outcomes in these patients? Study design and methods: Multicenter retrospective analysis of prospectiv...

Objective To investigate the rate of and the risk factors for breakthrough‐IFI (b‐IFI) after orthotopic liver transplantation (OLT) according to the new definition proposed by Mycoses‐Study‐Group‐Education‐and‐Research‐Consortium (MSG‐ERC) and the European‐Confederation‐of‐Medical‐Mycology (ECMM). Methods Multicenter prospective study of adult pat...

Procalcitonin (PCT) is widely considered as a highly sensitive biomarker of bacterial infection, offering general and emergency surgeons a key tool in the management of surgical infections. A multidisciplinary task force of experts met in Bologna, Italy, on April 4, 2019, to clarify the key issues in the use of PCT across the surgical pathway. The...

Background & aims: Circulating albumin in cirrhosis can be dysfunctional due to accumulating structural damages, leading to the concept of effective albumin concentration (eAlb) referring to the albumin portion presenting structural and functional integrity. We aimed to estimate eAlb in patients with decompensated cirrhosis and analyze its relatio...

Background: Limited and wide-ranging data are available on the recurrent Clostridioides difficile infection (rCDI) incidence rate. Methods: We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-...

Objective : The impact on outcome of five interventions was reviewed in order to investigate the state-of-art for management of Enterobacteriaceae bloodstream infection (E-BSI). Methods : We searched for randomized controlled trials (RCTs) and observational studies, published from January 2008 to March 2019 on PUBMED, EMBASE and COCHRANE library....

Background The aim of this secondary analysis of the TESEO cohort is to identify, early in the course of treatment with tocilizumab, factors associated with the risk of progressing to mechanical ventilation and death and develop a risk score to estimate the risk of this outcome according to patients’ profile. Methods Patients with COVID-19 severe...

We aimed to investigate the incidence of meropenem/vaborbactam-resistance among KPC-producing Klebsiella pneumoniae (KPC-Kp) bloodstream infection in a large Italian hospital. Meropenem/vaborbactam-resistance was found in 8% (n = 5) KPC-Kp, while 5% (n = 3) strains exhibited cross-resistance to ceftazidime/avibactam. Genomic analysis revealed that...

Pneumonia caused by severe acute respiratory syndrome coronavirus 2 emerged in China at the end of 2019. Because of the severe immunomodulation and lymphocyte depletion caused by this virus and the subsequent administration of drugs directed at the immune system, we anticipated that patients might experience fungal superinfection. We collected data...

The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 C...

Carbapenemase-producing Enterobacteriaceae (CPE) are a serious public health concern and represent a major threat to immunocompromised hosts, including solid organ (SOT) and stem cell transplant (HSCT) recipients. Transplant patients are at particular risk of developing CPE colonization and/or infection due to their frequent exposure to prolonged c...

Background A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary. Results In order to evaluate the impact of Covid-19 on the ICU capacity to manage critic...

Background Enterococcal bacteraemia (EB) is common, particularly in the nosocomial setting, and its management poses a challenge for clinicians and microbiologists. Objectives The aim was to summarize the more relevant features of EB and to provide a practical state-of-the-art on the topics that more directly affect its management. Sources Pubmed...

Background Bacterial and fungal infections (BFI) are frequent in patients with cirrhosis and often trigger acute-on-chronic liver failure (ACLF). This prospective observational study aims to describe the interactions between BFI and ACLF in terms of mortality and related risk factors. Methods We performed a two centers prospective observational st...

Objectives: To assess the efficacy of corticosteroids in patients with coronavirus disease 2019 (COVID-19) METHODS: Multicenter observational study from February 22 through June 30, 2020. We included consecutive adult patients with severe COVID-19 defined as respiratory rate ≥30 breath per minute, oxygen saturation ≤93% on ambient air or arterial...

Background: Human cytomegalovirus (CMV) modulates both innate and adaptive immune responses. However, limited data are available on the role of receptors of innate immunity, such as toll-like receptors (TLRs) in contributing to antiviral responses and inflammation. Objectives: The aim of this translational study was to characterize TLR responses in...

Background Heparin administration in COVID-19 patients is recommended by expert consensus, although evidence about dosage, duration and efficacy are limited. We aim to investigate the association between different dosages of low molecular weight heparin (LMWH) and mortality among COVID-19 hospitalized patients. Methods and Results Retrospective st...

Background: The management of non-fermentative gram-negative bloodstream infection (NFGN-BSI) offers numerous challenges. In this study the aim is to analyse a large cohort of patients with NFGN-BSI recruited in the northern Italy to describe epidemiology, etiological and susceptibility pattern, therapeutic management and outcome. Methods: Multicen...

Objectives We aimed to develop and validate a risk score to predict severe respiratory failure (SRF) among patients hospitalized with coronavirus disease-2019 (COVID-19). Methods We performed a multicentre cohort study among hospitalized (>24 hours) patients diagnosed with COVID-19 from February 22 to April 3 2020, at 11 Italian hospitals. Patient...

Background and aims Bacterial infections can trigger the development of organ failure/s and acute-on-chronic liver failure (ACLF). Different geographic variations in their bacteriology and clinical practices could lead to different epidemiology, phenotypes and outcomes of ACLF around the world. The aim of the study was to evaluate regional differen...

Background: In this study we evaluated the incidence of invasive pulmonary aspergillosis among intubated patients with critical coronavirus disease 2019 (COVID-19) and evaluated different case definitions of invasive aspergillosis. Methods: Prospective, multicentre study on adult patients with microbiologically confirmed COVID-19 receiving mecha...

Coronavirus disease 2019 (COVID‐19) may be associated with worse outcome in solid organ transplant (SOT) recipients. We performed a prospective cohort study of hospitalized patients with confirmed diagnosis of COVID‐19, from March 15 to April 30 2020, at two tertiary hospitals in Emilia‐Romagna Region. SOT recipients were compared with non‐SOT pati...

Objective Specific comorbidities and old age create a greater vulnerability to severe Coronavirus Disease 19 (COVID-19). While obesity seems to aggravate the course of disease, the actual impact of the body mass index (BMI) and the cutoff which increases illness severity are still under investigation. The aim of the study was to analyze whether the...

Infections of cardiac implantable electrical device (CIEDI) are an emerging medical issue. They can be distinguished as infections limited to the pocket (more common) or systemic CIEDI (endocarditis or bacteremia). A correct and early microbiological diagnosis is essential for proper management of these patients. In this chapter we will present the...

Background Candida species are among the most frequent causative agents of healthcare-associated bloodstream infections, with mortality higher than 40% in critically ill patients. Specific populations of critically ill patients may present peculiar risk factors related to their reason for intensive care unit admission. The primary objective of the...

A 71-year old gentleman with history of arterial hypertension treated with valsartan presented on was hospitalized at the Infectious Diseases Unit, University of Bologna (Italy) for severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2) and received treatment with hydroxychloroquine 200mg bid (400 mg bid the first day), azithromycin 400 mg q...

Background No therapy is approved for COVID-19 pneumonia. The aim of this study was to assess the role of tocilizumab in reducing the risk of invasive mechanical ventilation and death in patients with severe COVID-19 pneumonia who received standard of care treatment. Methods This retrospective, observational cohort study included adults (≥18 years...

Background Serum bactericidal titres (SBTs) were widely used in the 1970s and 1980s to monitor antimicrobial therapy but are now seldom recommended. It is the only laboratory test that integrates drug pharmacodynamics, host pharmacokinetics, and synergistic or antagonistic interactions of antimicrobial combinations into a single index of antimicrob...

Objectives The aim of this study was to evaluate the risk factors for candidemia in patients with liver cirrhosis. Methods This was a case-control-control (1:2:2) study performed in four Italian tertiary centres from 2006 to 2015. Cases were patients with liver cirrhosis developing candidemia. For every case of candidemia we enrolled two additiona...

Objectives: We examined factors associated with follow-up blood cultures (FU-BCs) in patients with monomicrobial gram-negative bloodstream infection (GN-BSI), and investigated impact of FU-BCs on therapeutic management and patient outcome. Methods: Retrospective cohort analysis of adult patients diagnosed with GN-BSI at tertiary-care university...

Background To compare the prognostic utility of the new definition of difficult to treat resistance (DTR) versus established definitions in a cohort of patients with Gram-negative Bloodstream Infections (GNBSIs). Methods Retrospective single-center study of adult patients with monomicrobial GNBSI, hospitalized from 2013 to 2016. DTR was defined as...

BACKGROUND In this study we evaluated the effectiveness of a management bundle for Enterococcus spp BSI (E-BSI). METHODS This was a single-center quasi-experimental (pre/post) study. In the “pre” phase (January 2014 to December 2015) patients with monomicrobial E-BSI were retrospectively enrolled. During the “post” or “intervention” phase (January...