Juan Frasquet Artés
@gva.es
Generalitat Valencian
Scopus Publications
- Blood transcriptomic for the diagnosis of nosocomial infections in critically ill patients: an observational proof-of-concept study
Ruben Martín-Latorre, Kaya Haener, Hugo Arrando, Juan Frasquet, Mónica Gordón, Amparo Martinez, Carlos Folgado, Álvaro Castellanos-Ortega, Paula Ramirez
Infection, 2025 - Nosocomial bloodstream infection in critically ill patients: is extracorporeal membrane oxygenation a relevant factor?
A. Martínez, M. Martín-Cerezuela, C. Carrasco, J. Frasquet, R. Gimeno, F. Perez-Esteban, F. Álvarez, J. Pemán, Á. Castellanos, P. Ramirez
Journal of Hospital Infection, 2025 - Cefiderocol pharmacokinetics in critically ill patients undergoing ECMO support
María Marín-Cerezuela, Ruben Martín-Latorre, Juan Frasquet, Jesus Ruiz-Ramos, Sandra Garcia-Contreras, Mónica Gordón, María Jesús Broch, Álvaro Castellanos-Ortega, Paula Ramirez
Critical Care, 2024
To the Editor,Extracorporeal membrane oxygenation (ECMO) is increasingly being used as a rescue therapy for severe acute respiratory distress syndrome or severe circulatory failure.Nosocomial infections are common in ECMO patients; therefore, antibiotics are frequently used [1].However, preliminary evidence suggests that ECMO support could alter antibiotic serum concentrations.Both subtherapeutic and elevated serum concentrations of commonly used antimicrobial agents have been reported [2].New antimicrobials, especially novel -Lactams and -Lactam/-Lactamase inhibitors, have been commercialized after a thorough pharmacokinetic (PK) assessment.However, new molecule PK changes have again been reported in critically ill patients, especially in those on ECMO support [3]. Circuit adsorption and sequestration are added to critical illness PK derangements, yet the specific weight of each of these factors is not clear [2,3].Cefiderocol is a siderophore cephalosporin active against gram-negative bacteria, including carbapenemase-producing strains, with promising positioning for difficult-to-treat infections. - Epidemiological and clinical characterization of community, healthcare-associated and nosocomial colonization and infection due to carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Spain
Elena Salamanca-Rivera, Zaira R. Palacios-Baena, Javier E. Cañada, Zaira Moure, María Pérez-Vázquez, Jorge Calvo-Montes, Luis Martínez-Martínez, Rafael Cantón, Guillermo Ruiz Carrascoso, Cristina Pitart, Ferran Navarro, Germán Bou, Xavier Mulet, Juan José González-López, Fran Sivianes, Mercedes Delgado-Valverde, Álvaro Pascual, Jesús Oteo-Iglesias, Jesús Rodríguez-Baño, , Mariela Martínez Ramírez, M. Pilar Ortega Lafont, Emilia Cercenado, Cristobal del Rosario, Jose Luis Perez Arellano, María Lecuona, Luis López-Urrutia Lorente, José Leiva, José Luis del Pozo, Salvador Giner, Juan Frasquet, Lidia Garcia Agudo, Soledad Illescas, Pedro de la Iglesia, Rosario Sánchez Benito, Eugenio Garduño, Ma Isabel Fernández Natal, Marta Arias, Mar Olga Pérez Moreno, Ana Isabel López-Calleja, José Manuel Azcona, Alba Belles, Mercè García González, Miriam Valverde Troya, Begoña Palop, Fernando García Garrote, Jose Luis Barrios Andrés, Leyre López Soria, Adelina Gimeno, Ester Clapés Sanchez, Jennifer Villa, Nuria Iglesias Nuñez, Rafael Sánchez Arroyo, Susana Hernando, Eva Riquelme Bravo, Caridad Sainz de Baranda, Oscar Esparcia Rodríguez, Jorge Gaitán, María Huertas, M. José Rodríguez Escudero, Carmen Aldea, Nerea Sanchez, Antonio Casabella Pernas, Ma Dolores Quesada, Carmina Martí Sala, Laura Mora, Encarnación Clavijo, Natalia Chueca, Federico Juan Manuel GarcíaSánchez, Fátima Galán Sánchez, Carmen Liébana, Carolina Roldán, Ma Isabel Cabeza, Ma Teresa Cabezas Fernández, Lucía Martínez Lamas, Sonia Rey Cao, Ma Isabel Paz Vidal, Raquel Elisa Rodríguez Tarazona y N Andrés, Amparo Coira Nieto, Ma Luisa Pérez del Molino Bernal, María Gomáriz Díaz, Matxalen Vidal-García, Jose Luis de Tuesta Díaz, Moises García Bravo, Almudena Tinajas, Fe Tubau Quintano, Borja Suberviola Cañas y Maria Elie García, Irene Gracia-Ahufinger, Mónica González Bardanca, Belén Viñado, Xavier Nuvials, Ignasi Roca, Patricia Ruiz-Garbajosa, Desireé Gijon, Vicente Pintado, Alba Rivera, David Gutiérrez Campos, Aurora Alemán, Ignacio Ayestarán, Andrés Canut Blasco y Jorge Arribas García
Infection, 2024
Background Community-acquired (CA) and healthcare-associated (HCA) infections caused by carbapenemase-producing Enterobacterales (CPE) are not well characterized. The objective was to provide detailed information about the clinical and molecular epidemiological features of nosocomial, HCA and CA infections caused by carbapenemase-producing Klebsiella pneumoniae (CP-Kp) and Escherichia coli (CP-Ec). Methods A prospective cohort study was performed in 59 Spanish hospitals from February to March 2019, including the first 10 consecutive patients from whom CP-Kp or CP-Ec were isolated. Patients were stratified according to acquisition type. A multivariate analysis was performed to identify the impact of acquisition type in 30-day mortality. Results Overall, 386 patients were included (363 [94%] with CP-Kp and 23 [6%] CP-Ec); in 296 patients (76.3%), the CPE was causing an infection. Acquisition was CA in 31 (8.0%) patients, HCA in 183 (47.4%) and nosocomial in 172 (48.3%). Among patients with a HCA acquisition, 100 (54.6%) had been previously admitted to hospital and 71 (38.8%) were nursing home residents. Urinary tract infections accounted for 19/23 (82.6%), 89/130 (68.5%) and 42/143 (29.4%) of CA, HCA and nosocomial infections, respectively. Overall, 68 infections (23%) were bacteremia (8.7%, 17.7% and 30.1% of CA, HCA and nosocomial, respectively). Mortality in infections was 28% (13%, 14.6% and 42.7% of CA, HCA and nosocomial, respectively). Nosocomial bloodstream infections were associated with increased odds for mortality (adjusted OR, 4.00; 95%CI 1.21–13.19). Conclusions HCA and CA infections caused by CPE are frequent and clinically significant. This information may be useful for a better understanding of the epidemiology of CPE. - Four cases of unexpected severe community-acquired pneumonia aetiology: Group A Streptococcus pyogenes disruption
Mónica Talavera, Almudena Martínez, Carlos Vicent, Juan Frasquet, Ángel Orera, Paula Ramírez
Medicina Intensiva, 2023 - Acute respiratory distress syndrome due to COVID-19. Clinical and prognostic features from a medical Critical Care Unit in Valencia, Spain
P. Ramírez, M. Gordón, M. Martín-Cerezuela, E. Villarreal, E. Sancho, M. Padrós, J. Frasquet, G. Leyva, I. Molina, M. Barrios, S. Gimeno, Á. Castellanos
Medicina Intensiva, 2021
OBJECTIVE Information from critically ill coronavirus disease 2019 (COVID-19) patients is limited and in many cases coming from health systems approaches different from the national public systems existing in most countries in Europe. Besides, patient follow-up remains incomplete in many publications. Our aim is to characterize acute respiratory distress syndrome (ARDS) patients admitted to a medical critical care unit (MCCU) in a referral hospital in Spain. DESIGN Retrospective case series of consecutive ARDS COVID-19 patients admitted and treated in our MCCU. SETTING 36-bed MCCU in referral tertiary hospital. PATIENTS AND PARTICIPANTS SARS-CoV-2 infection confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasal/pharyngeal swabs. INTERVENTIONS None MAIN VARIABLES OF INTEREST: Demographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality. RESULTS Forty-four ARDS COVID-19 patients were included in the study. Median age was 61.50 (53.25 - 67) years and most of the patients were male (72.7%). Hypertension and dyslipidemia were the most frequent co-morbidities (52.3 and 36.4% respectively). Steroids (1mg/Kg/day) and tocilizumab were administered in almost all patients (95.5%). 77.3% of the patients needed invasive mechanical ventilation for a median of 16 days [11-28]. Prone position ventilation was performed in 33 patients (97%) for a median of 3 sessions [2-5] per patient. Nosocomial infection was diagnosed in 13 patients (29.5%). Tracheostomy was performed in ten patients (29.4%). At study closing all patients had been discharged from the CCU and only two (4.5%) remained in hospital ward. MCCU length of stay was 18 days [10-27]. Mortality at study closing was 20.5% (n 9); 26.5% among ventilated patients. CONCLUSIONS The seven-week period in which our MCCU was exclusively dedicated to COVID-19 patients has been challenging. Despite the severity of the patients and the high need for invasive mechanical ventilation, mortality was 20.5%. - Detection and treatment of Candida auris in an outbreak situation: risk factors for developing colonization and candidemia by this new species in critically ill patients
Alba Ruiz-Gaitán, Héctor Martínez, Ana María Moret, Eva Calabuig, María Tasias, Ana Alastruey-Izquierdo, Óscar Zaragoza, Joan Mollar, Juan Frasquet, Miguel Salavert-Lletí, Paula Ramírez, José Luis López-Hontangas, Javier Pemán
Expert Review of Anti Infective Therapy, 2019
Background: Candida auris is an emerging, multidrug-resistant yeast causing hospital outbreaks. This study describes the first 24 months of the ongoing C. auris outbreak in our hospital and analyzes predisposing factors to C. auris candidemia/colonization. Research design and methods: A 12-month prospective, case-controlled study was performed including a total of 228 patients (114 colonized/candidemia and 114 controls). Data from the first 79 candidemia episodes and 738 environmental samples were also analyzed. Definitive C. auris identification was performed by ITS sequencing. Antifungal susceptibility was carried out by EUCAST methodology. Results: Polytrauma (32%), cardiovascular disease (25%), and cancer (17%) were the most common underlying condition in colonized/candidemia patients. Indwelling CVC (odds ratio {OR}, 13.48), parenteral nutrition (OR, 3.49), and mechanical ventilation (OR, 2.43) remained significant predictors of C. auris colonization/candidemia. C. auris was most often isolated on sphygmomanometer cuffs (25%) patient tables (10.2%), keyboards (10.2%), and infusion pumps (8.2%). All isolates were fully resistant to fluconazole (MICs >64 mg/L) and had significantly reduced susceptibility to voriconazole (GM, 1.8 mg/L). Conclusions: Predictor conditions to C. auris colonization/candidemia are similar to other Candida species. C. auris colonizes multiple patient’s environment surfaces. All isolates are resistant to fluconazole and had significant reduced susceptibility to voriconazole. - Influence of antibiotic pressure on multi-drug resistant Klebsiella pneumoniae colonisation in critically ill patients
Jesus Ruiz, Monica Gordon, Esther Villarreal, Juan Frasquet, María Ángeles Sánchez, María Martín, Álvaro Castellanos, Paula Ramirez
Antimicrobial Resistance and Infection Control, 2019
BackgroundThe aim of this study is to evaluate the risk factors for colonisation by multidrug resistant (MDR) K. pneumoniae in a critical care unit and the relationship between colonisation and the antibiotic pressure exerted by the antimicrobial treatments received by patients.MethodsA prospective observational was designed. Patients admitted for more than 48 h to an intensive care unit were included. Samples for surveillance cultures were obtained from all the patients upon admission and once a week. The association between risk factors and colonisation by MDR K. pneumoniae was determined by logistic regression. A Cox regression model was used to evaluate the effect of the use of antimicrobials on the colonisation rate. An ARMIA model was used to investigate the association between the incidence of colonisation by MDR strains and the global consumption of antimicrobials in the unit.ResultsOne thousand seven hundred twenty-five patients were included, from which 308 (17.9%) were positive for MDR K. pneumoniae. In the multivariate analysis, hospitalisation for longer than 7 days together with respiratory infection and administration of any antibiotic was associated with increased MR K. pneumoniae colonisation. Patients who received antibiotics for more than 48 h were colonised earlier than patients who did not receive antibiotic treatment [HR: 2.16 (95%CI:1.55–3.03)]. The ARIMA model found a significant association between the monthly colonisation rate for MR K. pneumoniae and the consumption of cephalosporins and carbapenems in the previous month.ConclusionIndividual antibiotic administration and the global antibiotic pressure of cephalosporins and carbapenems are associated to an increased colonisation by MDR K. pneumoniae strains. - Vancomycin and daptomycin minimum inhibitory concentrations as a predictor of outcome of methicillin-resistant Staphylococcus aureus bacteraemia
Jesus Ruiz, Paula Ramirez, Pablo Concha, Miguel Salavert-Lletí, Esther Villarreal, Monica Gordon, Juan Frasquet, Álvaro Castellanos-Ortega
Journal of Global Antimicrobial Resistance, 2018
OBJECTIVES The aim of this study was to determine the persistence of the adverse prognostic effect of elevated vancomycin minimum inhibitory concentration (MIC) in methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in a setting with low vancomycin use. METHODS A retrospective study focusing on episodes of bacteraemia due to MRSA diagnosed from January 2010 through December 2015 was designed. The main outcome measures were 30-day mortality and treatment failure. Multivariate logistic regression analysis was used to identify variables associated with patient mortality and treatment outcome. RESULTS In total, 79 MRSA bacteraemia episodes were included. The vancomycin MIC was >1.0μg/mL in 53 episodes (67.1%). The presence of high vancomycin MIC was not associated with a higher mortality rate or treatment success. A daptomycin MIC≥0.5μg/mL was present in 16 (26.2%) of 61 episodes for which the daptomycin MIC was obtained and was associated with 30-day mortality in the multivariate analysis (odds ratio=4.72, 95% confidence interval 1.19-18.71). None of the antimicrobials used were associated with a lower risk of treatment failure or mortality. CONCLUSIONS The pernicious effect of high vancomycin MIC disappears in the absence of a predominant use of this antibiotic. However, a high daptomycin MIC in MRSA bacteraemia is associated with higher mortality in patients with bacteraemia, irrespective of antimicrobial treatment choice. - Antimicrobial stewardship programme in critical care medicine: A prospective interventional study
J. Ruiz, P. Ramirez, M. Gordon, E. Villarreal, J. Frasquet, J.L. Poveda-Andres, M. Salavert-Lletí, A. Catellanos
Medicina Intensiva, 2018
OBJECTIVE Hospital antimicrobial stewardship programmes have achieved savings and a more rational use of antimicrobial treatments in general wards. The purpose of this report is to evaluate the experience of an antimicrobial stewardship programme in an intensive care unit (ICU). DESIGN Prospective interventional, before-and-after study. SCOPE 24-bed medical ICU in a tertiary hospital. INTERVENTION Prospective audit and feedback antimicrobial stewardship programme. ENDPOINTS Antimicrobial consumption, antimicrobial related costs, multi-drug resistant microorganisms (MDRM) prevalence, nosocomial infections incidence, ICU length of stay, and ICU mortality rates were compared before and after one-year intervention. RESULTS A total of 218 antimicrobial episodes of 182 patients were evaluated in 61 team meetings. Antimicrobial stewardship suggestions were accepted in 91.5% of the cases. Total antimicrobial DDD/100 patient-days consumption was reduced from 380.6 to 295.2 (-22.4%; p=0.037). Antimicrobial stewardship programme was associated with a significant decrease in the prescription of penicillins plus b-lactamase inhibitors, linezolid, cephalosporins, and aminoglycosides. Overall antimicrobial spending was reduced by €119,636. MDRM isolation and nosocomial infections per 100 patient-days did not change after the intervention period. No changes in length of stay or mortality rate were observed. CONCLUSIONS An ICU antimicrobial stewardship programme significantly reduced antimicrobial use without affecting inpatient mortality and length of stay. Our results further support the implementation of an antimicrobial stewardship programme in critical care units. - Impact of amikacin pharmacokinetic/pharmacodynamic index on treatment response in critically ill patients
Jesus Ruiz, Paula Ramirez, María José Company, Mónica Gordon, Esther Villarreal, Pablo Concha, María Aroca, Juan Frasquet, María Remedios-Marqués, Álvaro Castellanos-Ortega
Journal of Global Antimicrobial Resistance, 2018 - Silver-embedded screens in the intensive care unit. A new tool to control multi-drug resistant bacterial cross-transmission
J. Ruiz, P. Ramirez, E. Villarreal, M. Gordon, S. Cuesta, M. Piñol, J. Frasquet, Á. Castellanos
European Journal of Clinical Microbiology and Infectious Diseases, 2017 - Impact of an antimicrobial stewardship program on critical haematological patients
J. Ruíz-Ramos, J. Frasquet, J. L. Poveda-Andrés, E. Romá, M. Salavert-Lletí, Á. Castellanos, P. Ramírez
Farmacia Hospitalaria, 2017 - Cost-effectiveness analysis of implementing an antimicrobial stewardship program in critical care units
Jesus Ruiz-Ramos, Juan Frasquet, Eva Romá, Jose Luis Poveda-Andres, Miguel Salavert-Leti, Alvaro Castellanos, Paula Ramirez
Journal of Medical Economics, 2017 - From MIC creep to MIC decline: Staphylococcus aureus antibiotic susceptibility evolution over the last 4 years
J. Ruiz, E. Villarreal, M. Gordon, J. Frasquet, A. Castellanos, P. Ramirez
Clinical Microbiology and Infection, 2016 - Cerebral phaeohyphomycosis: Description of a case and review of the literature
Juan S. Frasquet-Artés, Javier Pemán, Marino Blanes, Miriam Hernández-Porto, Josep Cano, Enrique Jiménez-Herrero, José Luis López-Hontangas
Revista Iberoamericana De Micologia, 2014 - Acute bacterial meningitis caused by Streptococcus pyogenes
A.G. Núñez Ramiro, A. Adell Sales, R.J. Calderón Fernández, J. Frasquet, A. Pérez Tamarit
Anales De Pediatria, 2013 - Unexpected postmortem diagnosis of Acanthamoeba meningoencephalitis following allogeneic peripheral blood stem cell transplantation
J. Pemán, I. Jarque, J. Frasquet, C. Alberola, M. Salavert, J. Sanz, B. Gomila, G. Esteban
American Journal of Transplantation, 2008 - Native valve Aspergillus fumigatus endocarditis with blood culture positive and negative for galactomannan antigen. Case report and literature review
Javier Pemán, Rebeca Ortiz, Faisa Osseyran, Carmen Pérez-Bellés, Marisa Crespo, Melitina Chirivella, Juan Frasquet, Anastasio Quesada, Emilia Cantón, Miguel Gobernado
Revista Iberoamericana De Micologia, 2007 - Epidemiology of candidemia in Spain - Multicenter study
Revista Iberoamericana De Micologia, 2002
