Posts filed under ‘Infecciones asociadas a catater IV’

Gordonia species: emerging pathogens in pediatric patients that are identified by 16S ribosomal RNA gene sequencing.

Clin Infect Dis. 2007 Aug 15;45(4):483-6. Epub 2007 Jul 5.

BRIEF REPORT

Blaschke AJ1, Bender J, Byington CL, Korgenski K, Daly J, Petti CA, Pavia AT, Ampofo K.

Author information

1Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Utah, Salt Lake City, UT, USA. anne.blaschke@hsc.utah.edu

Abstract

Gordonia species are emerging pathogens that are often misidentified as Rhodococcus or Nocardia species but are reliably distinguished by 16S ribosomal RNA gene sequencing.

We present a case series of 6 episodes of catheter-associated infection caused by Gordonia species in 5 patients seen at a tertiary care pediatric hospital and describe the management and outcomes of this infection in adults and children.

PDF

http://cid.oxfordjournals.org/content/45/4/483.full.pdf+html

January 20, 2017 at 8:12 am

REVISION – Bacteriemia en el paciente crıtico

Med Intensiva. 2009;33(7):336–345

Sabatier, R. Peredo y J. Valles

Centro de Críticos, Hospital de Sabadell, Institut Universitari Parc Taul´ı, UAB, CIBER de Enfermedades Respiratorias, España

La bacteriemia es, junto con la neumoníıa asociada a la ventilación mecánica, la infeccion nosocomial mas frecuente en los pacientes crıticos y se asocia a una importante morbimortalidad. La principal causa de bacteriemia en estos pacientes son los cateteres intravasculares y,  por consiguiente, los microorganismos grampositivos se equiparan en frecuencia a los microorganismos gramnegativos como causantes de estas infecciones. Ademas, y con una frecuencia cada vez mas elevada, en muchas ocasiones estos microorganismos son multirresistentes, lo que dificulta la eleccion del tratamiento antibiotico empırico.

Tambien las infecciones graves adquiridas en la comunidad representan una parte importante de los pacientes que por inestabilidad hemodinamica o disfuncion organica requieren ingreso en la unidad de cuidados intensivos. Una parte importante presenta tambien bacteriemia, y representa aproximadamente un 30% del global de las bacteriemias de los pacientes crıticos. En estos casos mas de un 70% se manifiesta como sepsis grave o shock septico, y se acompañan tambien de una significativa mortalidad.

Ademas, recientemente se ha diferenciado a una poblacion de pacientes con infecciones adquiridas en la comunidad, pero que tienen algun contacto reciente o intermitente con algun tipo de asistencia sanitaria que presentan unas caracterısticas especıficas y equiparables en muchas ocasiones a las infecciones nosocomiales que deberıan tenerse en cuenta en el momento de la eleccion del tratamiento antibiotico empırico.

El objetivo de esta revision es conocer las caracterısticas, los orıgenes, las etiologıas y las complicaciones mas frecuentes de los pacientes crıticos con bacteriemia nosocomial, bacteriemia comunitaria o bacteriemia asociada a cuidados sanitarios con el fin de reconocerlas precozmente e iniciar un tratamiento de soporte y antibiotico empırico eficaz que pueda mejorar el pronostico de estos pacientes.

PDF

http://scielo.isciii.es/pdf/medinte/v33n7/revision.pdf

December 7, 2016 at 7:03 pm

Combination Therapy for Treatment of Infections with Gram-Negative Bacteria

Clin. Microbiol. Rev. July 2012 25(3): 450-470

Pranita D. Tamma, Sara E. Cosgrove, and Lisa L. Maragakis

aThe Johns Hopkins Medical Institutions, Department of Medicine, Division of Pediatric Infectious Diseases, Baltimore, Maryland, USA

bThe Johns Hopkins Medical Institutions, Department of Medicine, Division of Infectious Diseases, Baltimore, Maryland, USA

Combination antibiotic therapy for invasive infections with Gram-negative bacteria is employed in many health care facilities, especially for certain subgroups of patients, including those with neutropenia, those with infections caused by Pseudomonas aeruginosa, those with ventilator-associated pneumonia, and the severely ill. An argument can be made for empiric combination therapy, as we are witnessing a rise in infections caused by multidrug-resistant Gram-negative organisms. The wisdom of continued combination therapy after an organism is isolated and antimicrobial susceptibility data are known, however, is more controversial. The available evidence suggests that the greatest benefit of combination antibiotic therapy stems from the increased likelihood of choosing an effective agent during empiric therapy, rather than exploitation of in vitro synergy or the prevention of resistance during definitive treatment. In this review, we summarize the available data comparing monotherapy versus combination antimicrobial therapy for the treatment of infections with Gram-negative bacteria.

PDF

http://cmr.asm.org/content/25/3/450.full.pdf+html

July 25, 2016 at 6:19 pm

Evaluation of Ceftaroline Alone and in Combination against Biofilm-Producing Methicillin-Resistant Staphylococcus aureus with Reduced Susceptibility to Daptomycin and Vancomycin in an In Vitro Pharmacokinetic/Pharmacodynamic Model.

Antimicrob Agents Chemother. 2015 Aug;59(8):4497-503.

Barber KE1, Smith JR1, Ireland CE1, Boles BR2, Rose WE3, Rybak MJ4.

Author information

1Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA.

2Department of Microbiology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.

3University of Wisconsin School of Pharmacy, Madison, Wisconsin, USA.

4Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA School of Medicine, Wayne State University, Detroit, Michigan, USA m.rybak@wayne.edu

Abstract

Annually, medical device infections are associated with >250,000 catheter-associated bloodstream infections (CLABSI), with up to 25% mortality. Staphylococcus aureus, a primary pathogen in these infections, is capable of biofilm production, allowing organism persistence in harsh environments, offering antimicrobial protection. With increases in S. aureus isolates with reduced susceptibility to current agents, ceftaroline (CPT) offers a therapeutic alternative. Therefore, we evaluated whether CPT would have a role against biofilm-producing methicillin-resistant S. aureus (MRSA), including those with decreased susceptibilities to alternative agents. In this study, we investigated CPT activity alone or combined with daptomycin (DAP) or rifampin (RIF) against 3 clinical biofilm-producing MRSA strains in an in vitro biofilm pharmacokinetic/pharmacodynamic (PK/PD) model. Simulated antimicrobial regimens were as follows: 600 mg of CPT every 8 h (q8h) (free maximum concentration of drug [fCmax], 17.04 mg/liter; elimination half-life [t1/2], 2.66 h), 12 mg/kg of body weight/day of DAP (fCmax, 14.7 mg/liter; t1/2, 8 h), and 450 mg of RIF q12h (fCmax, 3.5 mg/liter; t1/2, 3.4 h), CPT plus DAP, and CPT plus RIF. Samples were obtained and plated to determine colony counts. Differences in log10 CFU/cm(2) were evaluated by analysis of variance with Tukey’s post hoc test. The strains were CPT and vancomycin susceptible and DAP nonsusceptible (DNS). CPT displayed activity throughout the experiment. DAP demonstrated initial activity with regrowth at 24 h in all strains. RIF was comparable to the drug-free control, and little benefit was observed when combined with CPT. CPT plus DAP displayed potent activity, with an average log10 CFU/cm(2) reduction of 3.33 ± 1.01 from baseline. CPT demonstrated activity against biofilm-producing DNS MRSA. CPT plus DAP displayed therapeutic enhancement over monotherapy, providing a potential option for difficult-to-treat medical device infections

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4505217/pdf/zac4497.pdf

July 8, 2016 at 9:52 am

High MICs for Vancomycin and Daptomycin and Complicated Catheter-Related Bloodstream Infections with Methicillin-Sensitive Staphylococcus aureus

Emerging Infectious Diseases June 2016 V.22 N.6

Rafael San-Juan, Esther Viedma, Fernando Chaves, Antonio Lalueza, Jesús Fortún, Elena Loza, Miquel Pujol, Carmen Ardanuy, Isabel Morales, Marina de Cueto, Elena Resino-Foz, Alejandra Morales-Cartagena, Alicia Rico, María P. Romero, María Ángeles Orellana, Francisco López-Medrano, Mario Fernández-Ruiz, and José María Aguado

University Hospital–Research Institute 12 de Octubre, Madrid, Spain (R. San-Juan, E. Viedma, F. Chaves, A. Lalueza, E. Resino-Foz, A. Morales-Cartagena, M.Á. Orellana, F. López-Medrano, M. Fernández-Ruiz, J. María Aguado); Hospital Universitario Ramón y Cajal, Madrid (J. Fortún, E. Loza); University Hospital–Bellvitge Institute for Biomedical Research, Barcelona, Spain (M. Pujol, C. Ardanuy); Hospital Universitario Virgen de la Macarena, Seville, Spain (I. Morales, M. de Cueto); Hospital Universitario La Paz, Madrid (A. Rico, M.P. Romero)

We investigated the prognostic role of high MICs for antistaphylococcal agents in patients with methicillin-sensitive Staphylococcus aureus catheter-related bloodstream infection (MSSA CRBSI). We prospectively reviewed 83 episodes from 5 centers in Spain during April 2011–June 2014 that had optimized clinical management and analyzed the relationship between E-test MICs for vancomycin, daptomycin, oxacillin, and linezolid and development of complicated bacteremia by using multivariate analysis. Complicated MSSA CRBSI occurred in 26 (31.3%) patients; MICs for vancomycin and daptomycin were higher in these patients (optimal cutoff values for predictive accuracy = 1.5 μg/mL and 0.5 μg/mL). High MICs for vancomycin (hazard ratio 2.4, 95% CI 1.2–5.5) and daptomycin (hazard ratio 2.4, 95% CI 1.1–5.9) were independent risk factors for development of complicated MSSA CRBSI. Our data suggest that patients with MSSA CRBSI caused by strains that have high MICs for vancomycin or daptomycin are at increased risk for complications.

PDF

http://wwwnc.cdc.gov/eid/article/22/6/pdfs/15-1709.pdf

May 20, 2016 at 3:39 pm

Diagnóstico y el tratamiento de la bacteriemia y endocarditis por Staphylococcus aureus. Una guía de práctica clínica de la Sociedad Española de Microbiología Clínica y Enfermedades Infecciosas (SEIMC)

Enf Infecc & Microbiol. Clínica Noviembre 2015 V.33 N.9 e1-e23

CONSENSO

Francesc Gudiol, José María Aguado, Benito Almirante, Emilio Bouza, Emilia Cercenado, M. Ángeles Domínguez, Oriol Gasch, Jaime Lora-Tamayo, José M. Miró, Mercedes Palomar, Alvaro Pascual, Juan M. Pericas, Miquel Pujol, Jesús Rodríguez-Baño, Evelyn Shaw, Alex Soriano, Jordi Vallés

a Servicio de Enfermedades Infecciosas, IDIBELL, Hospital Universitario de Bellvitge, Barcelona, Spain

b Unidad de Enfermedades Infecciosas, Instituto de Investigación i + 12, Hospital Universitario 12 de Octubre, Madrid, Spain

c Servicio de Enfermedades Infecciosas, Hospital Universitario Valle de Hebrón, Barcelona, Spain

d Servicio de Microbiología y Enfermedades Infecciosas, Hospital Universitario Gregorio Marañón, Madrid, Spain

e Servicio de Microbiología, IDIBELL, Hospital Universitario de Bellvitge, Barcelona, Departamento de patologia y terapeutica experimental, Universidad de Barcelona, Spain

f Servicio de Enfermedades Infecciosas, Hospital Universitari Parc Taulí, Sabadell, Spain

g Servicio de Enfermedades Infecciosas, Hospital Clinic – IDIBAPS, Universidad de Barcelona, Barcelona, Spain

h Servicio de Medicina Intensiva, Hospital Arnau de Vilanova, Lleida, Spain

i Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Sevilla, Departamento de Microbiología, Universidad de Sevilla, Spain

j Servicio de Enfermedades Infecciosas, Hospital Clinic IDIBAPS, Barcelona, Spain

k Servicio de Cuidados Intensivos, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain

PDF

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90443317&pident_usuario=0&pcontactid=&pident_revista=28&ty=49&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=en&fichero=28v33n09a90443317pdf001.pdf

 

April 9, 2016 at 10:08 am

Utilidad de las Guías de Práctica Clínica para el manejo de las infecciones graves producidas por Staphylococcus aureus

Enf Infecc & Microbiol. Clínica Noviembre 2015 V.33 N.9 P.577-8

Editorial

Winfried V. Kern

PDF

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90443308&pident_usuario=0&pcontactid=&pident_revista=28&ty=40&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=en&fichero=28v33n09a90443308pdf001.pdf

April 9, 2016 at 10:02 am

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