Posts filed under ‘Infecciones en diabeticos’

Comparison of Clinical Presentation and Risk Factors in Diabetic and Non-Diabetic Females with Urinary Tract Infection Assessed as Per the European Association of Urology Classification.

J Clin Diagn Res. 2015 Jun;9(6):PC12-4.          

Garg V1, Bose A2, Jindal J3, Goyal A4.

Author information

1Assistant Professor, Department of Medicine, Dayanand Medical College & Hospital , Ludhiana, Punjab, India .

2Senior Resident, Department of Urology & Renal Transplant, Dayanand Medical College & Hospital , Ludhiana, Punjab, India .

3Resident, Department of Medicine, Dayanand Medical College & Hospital , Ludhiana, Punjab, India .

4Associate Professor, Department of Urology & Renal Transplant, Dayanand Medical College & Hospital , Ludhiana, Punjab, India .

Abstract

INTRODUCTION:

Diabetes has been known to cause severe complicated UTI as a result of its various changes in the genitourinary system. This study of UTI in diabetic females enables us to know the pattern of infections, their causative organisms and severity, particularly with reference to European Association of Urology (EUA) guidelines for UTI 2015.

MATERIALS AND METHODS:

This is a prospective single centre study done over a period of one year at Dayanand Medical College and Hospital on a total of 151 diabetic (Group A) and non-diabetic (Group B) female patients with diagnosis of UTI. A thorough history of the patients was taken which included looking for the anatomical level of infections, host risk factors; extra urogenital risk factors and nephropathy disease were assessed. All patients were adequately investigated. The UTI was classified according to the EAU classification for UTI, and an effort was made to find out the frequent class of UTI in this study group.

RESULTS:

A total of 151 females which included 70 diabetic (Group A) and 81 non diabetic (Group B) females were studied. The most common symptom was fever in both the groups. UTI was classified as per the EAU grades of UTI. In group A, the number of patients having severity grade from 1 to 6 were 47, 9, 4, 2, 4, and 4 respectively. The most common clinical presentation in both the groups was cystitis followed by pyelonephritis and urosepsis. In group B, the number of patients having severity grade from 1 to 6 were 66, 4, 5, 5, 0 and 1 respectively. Most common organism was E-coli, which was susceptible to most of the antibiotics.

CONCLUSION:

UTI in diabetic and non-diabetic female patients have different patterns. Uncontrolled diabetes was more commonly associated with severe UTI like pyelonephritis and emphysematous pyelonephritis. E. coli was most common isolate in either group, followed by klebsiella and Pseudomonas. Candida was isolated only from the diabetic population. Therefore, the most common type of UTI as per the EAU classification in both diabetic and non diabetic female was CY-1R: E. coli(a): ‘simple cystitis but recurrent with susceptibility to standard antibiotics’, in our study.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525549/pdf/jcdr-9-PC12.pdf

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December 2, 2017 at 7:54 am

Septic arthritis in a native knee due to Corynebacterium striatum.

Reumatol Clin. 2017 Mar 7. 

Septic arthritis in a native knee due to Corynebacterium striatum.

[Article in English, Spanish]

Molina Collada J1, Rico Nieto A2, Díaz de Bustamante Ussia M3, Balsa Criado A4.

Author information

1 Servicio de Reumatología, Hospital Universitario La Paz, Madrid, España. Electronic address: molinacolladajuan@gmail.com.

2 Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario La Paz, Madrid, España.

3 Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España.

4 Servicio de Reumatología, Hospital Universitario La Paz, Madrid, España.

Abstract

We describe a case of septic arthritis in a native knee due to Corynebacterium striatum, gram-positive bacilli that are usually commensal organisms of skin and mucosal membranes, but are seldom implicated in native septic arthritis. An 84-year-old man with Corynebacterium striatum septic arthritis of his native left knee and no response to conventional antibiotic therapy. Thus, the patient was allowed to take dalbavancin for compassionate use, with an excellent clinical outcome. This case emphasizes de role of Corynebacterium striatum in native joint infections and highlights the importance of early detection and appropriate treatment in improving the clinical outcome.

PDF (CLIC en PDF)

http://www.reumatologiaclinica.org/es/linkresolver/artritis-septica-rodilla-nativa-por/S1699258X17300335/

October 22, 2017 at 12:43 pm

Septic arthritis of a native knee joint due to Corynebacterium striatum.

J Clin Microbiol. 2014 May;52(5):1786-8.

Westblade LF1, Shams F, Duong S, Tariq O, Bulbin A, Klirsfeld D, Zhen W, Sakaria S, Ford BA, Burnham CA, Ginocchio CC.

Author information

1 Department of Pathology and Laboratory Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA.

Abstract

We report a case of septic arthritis of a native knee joint due to Corynebacterium striatum, a rare and unusual cause of septic arthritis of native joints. The isolate was identified by a combination of phenotypic, mass spectrometric, and nucleic acid-based assays and exhibited high-level resistance to most antimicrobials.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3993712/pdf/zjm1786.pdf

October 22, 2017 at 12:41 pm

Risk Factors for 30-Day Mortality in Patients with Methicillin-Resistant Staphylococcus aureus Bloodstream Infections

International Journal of Infectious Diseases August 2017 V.60 N.8 P.3-6

Pedro Ayau, Ana C. Bardossy, Guillermo Sanchez, Ricardo Ortiz, Daniela Moreno, Pamela Hartman, Khulood Rizvi, Tyler C. Prentiss, Mary B. Perri, Meredith Mahan, Vanthida Huang, Katherine Reyes, Marcus J. Zervos

Highlights

  • The aim of this study was to identify risk factors associated with 30-day mortality in patients with MRSA BSI.
  • 1,168 patients with confirmed MRSA BSI were identified over a 9-year period in which 30-day all-cause mortality was 16%.
  • There was no significant variability in 30-day mortality over our 9-year study period.
  • Our study showed that age, cancer, heart disease, neurologic disease, nursing home residence and Charlson score >3 are risk factors for 30-day mortality in patients with MRSA BSI.
  • Diabetes, PVD and readmission because of infection have statistically significant protective effects on 30-day mortality

Objectives

Methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections (BSI) are a major health care problem accounting for a large percentage of nosocomial infections. The aim of this study was to identify risk factors associated with 30-day mortality in patients with MRSA BSI.

Methods

This was a retrospective study performed in Southeast Michigan. Over a 9- year period, a total of 1,168 patients were identified with MRSA BSI. Patient demographics and clinical data were retrieved and evaluated using electronic medical health records.

Results

30-day mortality during the 9-year study period was 16%. Significant risk factors for 30-day mortality were age, cancer, heart disease, neurologic disease, nursing home residence and Charlson score >3 with Odds Ratio (OR) of 1.03 (CI 1.02–1.04), 2.29 (CI 1.40–3.75), 1.78 (CI 1.20–2.63), 1.65 (CI 1.08–2.25), 1.66 (CI 1.02 − 2.70) and 1.86 (CI 1.18 − 2.95) correspondingly. Diabetes mellitus, peripheral vascular disease (PVD), and readmission were protective factors for 30-day mortality with OR of 0.53 (CI 0.36–0.78), 0.46 (CI 0.26–0.84) and 0.13 (CI0.05 − 0.32) respectively.

Conclusions

Our study identified significant risk factors for 30-day mortality in patients with MRSA BSI. Interestingly, diabetes mellitus, PVD and readmission were protective effects on 30-day mortality. There was no statistically significant variability in 30-day mortality over the 9-year study period.

PDF

http://www.ijidonline.com/article/S1201-9712(17)30146-7/pdf

July 30, 2017 at 12:57 pm

Estimating the burden of invasive and serious fungal disease in the United Kingdom

Journal of Infection January 2017 V.74 N.1

Matthew Pegorie a, David W. Denning b,c,d, *, William Welfare a,d

a Public Health England North West Health Protection Team (Greater Manchester), UK

bNational Aspergillosis Centre, University Hospital of South Manchester, Manchester, UK

c The University of Manchester, Manchester, UK

d Manchester Academic Health Sciences Centre, University of Manchester, UK

Background: The burden of fungal disease in the UK is unknown. Only limited data are systematically collected. We have estimated the annual burden of invasive and serious fungal disease.

Methods: We used several estimation approaches. We searched and assessed published estimates of incidence, prevalence or burden of specific conditions in various high risk groups. Studies with adequate internal and external validity allowed extrapolation to estimate current UK burden. For conditions without adequate published estimates, we sought expert advice.

Results: The UK population in 2011 was 63,182,000 with 18% aged under 15 and 16% over 65. The following annual burden estimates were calculated: invasive candidiasis 5142; Candida peritonitis complicating chronic ambulatory peritoneal dialysis 88; Pneumocystis pneumonia 207e587 cases, invasive aspergillosis (IA), excluding critical care patients 2901e2912, and IA in critical care patients 387e1345 patients, <100 cryptococcal meningitis cases. We estimated 178,000 (50,000e250,000) allergic bronchopulmonary aspergillosis cases in people with asthma, and 873 adults and 278 children with cystic fibrosis. Chronic pulmonary aspergillosis is estimated to affect 3600 patients, based on burden estimates post tuberculosis and in sarcoidosis.

Conclusions: Uncertainty is intrinsic to most burden estimates due to diagnostic limitations, lack of national surveillance systems, few published studies and methodological limitations. The largest uncertainty surrounds IA in critical care patients. Further research is needed to produce a more robust estimate of total burden

PDF

http://www.journalofinfection.com/article/S0163-4453(16)30273-0/pdf

March 25, 2017 at 5:40 pm

Aeromonas hydrophila ecthyma gangrenosum without bacteraemia in a diabetic man: the first case report in Italy.

Infez Med. 2009 Sep;17(3):184-7.

Avolio M1, La Spisa C, Moscariello F, De Rosa R, Camporese A.

Author information

1Microbiologia e Virologia, Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy.

Abstract

Ecthyma gangrenosum is a well recognized cutaneous manifestation of severe, invasive infection by Pseudomonas aeruginosa usually in immunocompromised and critically ill patients. This type of infection is usually fatal. Aeromonas infection is infrequently reported as the cause of ecthyma gangrenosum. Here we show the first case described in Italy of Aeromonas hydrophila ecthyma gangrenosum in the lower extremities in an immunocompetent diabetic without bacteraemia. A 63-year-old obese diabetic male was admitted with an ulcer on his left leg, oedema, pain and fever. Throughout his hospitalization blood cultures remained sterile, but a culture of A. hydrophila was isolated following punctures from typical leg pseudomonal-ecthyma gangrenosum lesions developed after admission. The patient, questioned again, stated that a few days before he had worked in a well near his house without taking precautions. We conclude that early diagnosis and suitable antibiotic therapy are important for the management of ecthyma gangrenosum. The typical presentation of soft tissue infection of A. hydrophila should mimic a Gram-positive infection, which may result in a delay in administration of appropriate antibiotics. Moreover, A. hydrophila should be considered a possible agent for non-pseudomonal ecthyma gangrenosum in a diabetic man with negative blood cultures, in presence of anamnestical risk factors

PDF

http://www.infezmed.it/media/journal/Vol_17_3_2009_9.pdf

February 22, 2017 at 1:23 pm

Pre-existing medical conditions associated with Vibrio vulnificus septicaemia.

Epidemiol Infect. 2014 Apr;142(4):878-81.

Menon MP1, Yu PA1, Iwamoto M1, Painter J1.

Author information

1Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Abstract

Vibrio vulnificus (Vv) can result in severe disease. Although pre-existing liver disease is a recognized risk factor for serious infection, the relative importance of other comorbidities has not been fully assessed.

We analysed reports of Vv infections submitted to CDC from January 1988 to September 2006 in order to assess the role of pre-existing conditions contributing to severe outcomes.

A total of 1212 patients with Vv infection were reported. Only patients with liver disease [adjusted odds ratio (aOR) 5.1)] were more likely to become septic when exposure was due to contaminated food.

Patients with liver disease (aOR 4.1), a haematological disease (aOR 3.2), or malignancy (aOR 3.2) were more likely to become septic when infection was acquired via a non-foodborne exposure.

As such, patients with these pre-existing medical conditions should be advised of the risk of life-threatening illness after eating undercooked contaminated seafood or exposing broken skin to warm seawater

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598054/pdf/nihms727972.pdf

February 17, 2017 at 4:39 pm

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