Posts filed under ‘Infecciones en neutropenicos’

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/

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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

Infective endocarditis in patients with cancer: a consequence of invasive procedures or a harbinger of neoplasm? –  A prospective, multicenter cohort

Medicine: September 2017 – Volume 96 – Issue 38 – p e7913

Fernández-Cruz, Ana MD, PhDa,b,*; Muñoz, Patricia MD, PhDa,b,c,d; Sandoval, Carmen MDb,e; Fariñas, Carmen MD, PhDf; Gutiérrez-Cuadra, Manuel MD, PhDf; Pericás Pulido, Juan M. MD, PhDg; Miró, José M. MD, PhDg; Goenaga-Sánchez, Miguel Á. MDh; de Alarcón, Arístides MDi; Bonache-Bernal, Francisco MDj; Rodríguez, MªÁngeles MD, PhDk; Noureddine, Mariam MD, PhDl; Bouza Santiago, Emilio MD, PhDa,b,c,d; on behalf of the Spanish Collaboration on Endocarditis (GAMES)

Abstract

The aim of the study was to draw a comparison between the characteristics of infective endocarditis (IE) in patients with cancer and those of IE in noncancer patients.

Patients with IE, according to the modified Duke criteria, were prospectively included in the GAMES registry between January 2008 and February 2014 in 30 hospitals. Patients with active cancer were compared with noncancer patients.

During the study period, 161 episodes of IE fulfilled the inclusion criteria. We studied 2 populations: patients whose cancer was diagnosed before IE (73.9%) and those whose cancer and IE were diagnosed simultaneously (26.1%). The latter more frequently had community-acquired IE (67.5% vs 26.4%, P < .01), severe sepsis (28.6% vs 11.1%, P = .013), and IE caused by gastrointestinal streptococci (42.9% vs 16.8%, P < .01). However, catheter source (7.1% vs 29.4%, P = .003), invasive procedures (26.2% vs 44.5%, P = .044), and immunosuppressants (9.5% vs 35.6%, P = .002) were less frequent.

When compared with noncancer patients, patients with cancer were more often male (75.2% vs 67.7%, P = .049), with a higher comorbidity index (7 vs 4). In addition, IE was more often nosocomial (48.7% vs 29%) and originated in catheters (23.6% vs 6.2%) (all P < .01). Prosthetic endocarditis (21.7% vs 30.3%, P = .022) and surgery when indicated (24.2% vs 46.5%, P < .01) were less common. In-hospital mortality (34.8% vs 25.8%, P = .012) and 1-year mortality (47.8% vs 30.9%, P < .01) were higher in cancer patients, although 30-day mortality was not (24.8% vs 19.3%, P = .087).

A significant proportion of cases of IE (5.6%) were recorded in cancer patients, mainly as a consequence of medical interventions. IE may be a harbinger of occult cancer, particularly that of gastrointestinal or urinary origin.

FULL TEXT

http://journals.lww.com/md-journal/Fulltext/2017/09220/Infective_endocarditis_in_patients_with_cancer___a.11.aspx

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September 22, 2017 at 4:19 pm

Efficacy of β-Lactam/β-Lactamase Inhibitor Combinations for the Treatment of Bloodstream Infection Due to Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in Hematological Patients with Neutropenia

Antimicrobial Agents and Chemotherapy Sept 2017 V.61 N.9

Carlota Gudiol, Cristina Royo-Cebrecos, Edson Abdala, Murat Akova, Rocío Álvarez, Guillermo Maestro-de la Calle, Angela Cano, Carlos Cervera, Wanessa T. Clemente, Pilar Martín-Dávila, Alison Freifeld, Lucía Gómez, Thomas Gottlieb, Mercè Gurguí, Fabián Herrera, Adriana Manzur, Georg Maschmeyer, Yolanda Meije, Miguel Montejo, Maddalena Peghin, Jesús Rodríguez-Baño, Isabel Ruiz-Camps, Teresa C. Sukiennik, Cristian Tebe, and Jordi Carratalà

aInfectious Diseases Department, Bellvitge University Hospital, IDIBELL, University of Barcelona, Spain

bDuran i Reynals Hospital, ICO, Barcelona, Spain

cInstituto do Câncer do Estado de São Paulo, Faculty of Medicine, University of São Paulo, São Paulo, Brazil

dHacettepe University School of Medicine, Ankara, Turkey

eClinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/University Hospitals Virgen del Rocio and Virgen Macarena, Seville, Spain

fInfectious Diseases Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), 12 de Octubre University Hospital, School of Medicine, Universidad Complutense, Madrid, Spain

gReina Sofía University Hospital-IMIBIC-UCO, Córdoba, Spain

hUniversity Hospital of Alberta, Alberta, Canada

iDigestive Transplant Service, Hospital das Clínicas, Universidade Federal Minas Gerais, Belo Horizonte, Brazil

jInfectious Diseases Department, Ramon y Cajal Hospital, Madrid, Spain

kInternal Medicine, Infectious Diseases Section, University of Nebraska Medical Center, Omaha, Nebraska, USA

lInternal Medicine, University Hospital Mútua de Terrassa, Barcelona, Spain

mDepartment of Microbiology & Infectious Diseases, Concord Hospital, Concord, NSW, Australia

nInfectious Diseases Unit, Hospital de la Santa Creu i Sant Pau and Instituto de Investigación Biomédica Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

oInfectious Diseases Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina

pInfectious Diseases, Hospital Rawson, San Juan, Argentina

qDepartment of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Academic Teaching Hospital of Charité University Medical School, Berlin, Germany

rInfectious Disease Unit, Internal Medicine Department, Barcelona Hospital, SCIAS, Barcelona, Spain

sInfectious Diseases Unit, Cruces University Hospital, Bilbao, Spain

tInfectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy

uClinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, University Hospitals Virgen Macarena and Virgen del Rocío—IBiS, Department of Medicine, University of Seville, Seville, Spain

vInfectious Diseases Department, Vall d’Hebron University Hospital, Barcelona, Spain

wHospital Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil

xStatistics Advisory Service, Institute of Biomedical Research of Bellvitge, Rovira i Virgili University, Tarragona, Spain

yREIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, Madrid, Spain

β-Lactam/β-lactamase inhibitors (BLBLIs) were compared to carbapenems in two cohorts of hematological neutropenic patients with extended-spectrum-β-lactamase (ESBL) bloodstream infection (BSI): the empirical therapy cohort (174 patients) and the definitive therapy cohort (251 patients).

The 30-day case fatality rates and other secondary outcomes were similar in the two therapy groups of the two cohorts and also in the propensity-matched cohorts. BLBLIs might be carbapenem-sparing alternatives for the treatment of BSI due to ESBLs in these patients.

PDF

http://aac.asm.org/content/61/8/e00164-17.full.pdf+html

 

Antimicrobial Agents and Chemotherapy August 2017 V.61 N.8

COMMENTARY

Use of β-Lactam/β-Lactamase Inhibitors for Extended-Spectrum-β-Lactamase Infections: Defining the Right Patient Population

Pranita D. Tamma and Maria Virginia Villegas

aJohns Hopkins University School of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, Baltimore, Maryland, USA

bMolecular Genetics and Antimicrobial Resistance Unit—International Center for Microbial Genomics Universidad El Bosque, Bogotá, Colombia

In a multicenter, multinational observational study that included neutropenic patients with bloodstream infections by extended-spectrum-β-lactamase-producing species, Gudiol et al. (Antimicrob. Agents Chemother. 61:e00164-17, 2017, https://doi.org/10.1128/AAC.00164-17) demonstrated that β-lactam/β-lactamase inhibitors are effective treatment options.

A review of this work, however, reminds us that some lingering questions remain for specific high-risk subgroups.

PDF

http://aac.asm.org/content/61/8/e01094-17.full.pdf+html

August 30, 2017 at 8:17 am

Aspergilosis. Formas clínicas y tratamiento

Enf Infecciosas & Microbiologia Clínica Abril 2012 V.30 N.4

Jesús Fortún, Yolanda Meije, Gema Fresco, Santiago Moreno.

Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España

Resumen

La aspergilosis invasiva junto con la aspergilosis crónica pulmonar y la aspergilosis broncopulmonar alérgica, constituyen las formas clínicas de aspergilosis.

Aunque el número de especies de Aspergillus spp. es muy numeroso, Aspergillus fumigatus-complex es el agente etiológico más frecuente, independientemente de la forma clínica y la afección de base del paciente.

El incremento de los diferentes tratamientos inmunosupresores y el mayor uso de corticoides en pacientes con enfermedad obstructiva crónica han condicionado un mayor protagonismo de la aspergilosis en los últimos años.

El uso de galactomanano y las pruebas de imagen complementan las limitaciones microbiológicas en el diagnóstico de estos pacientes. Voriconazol y anfotericina liposomal constituyen la base del tratamiento en todas las formas de aspergilosis, y posaconazol, itraconazol, caspofungina y otras equinocandinas son alternativas eficaces.

El pronóstico depende de la forma clínica y las características del huésped, pero es sombrío fundamentalmente en las formas invasivas diseminadas.

abstract

http://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-aspergilosis-formas-clinicas-tratamiento-S0213005X12000316

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July 17, 2017 at 8:11 am

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

Infectious complications in chronic lymphocytic leukemia.

Mediterr J Hematol Infect Dis. 2012;4(1):e2012070. doi: 10.4084/MJHID.2012.070. Epub 2012 Nov 5.

Nosari A1.

Author information

1Divisione di Ematologia, Niguarda Ca’ Granda Hospital, Piazza Ospedale Maggiore 3 – 20162 Milano, Italy. Tel: 39-02-64442668.

Abstract

Infectious complications have been known to be a major cause of morbidity and mortality in Chronic Lymphocytic Leukemia (CLL) patients who are prone to infections because of both the humoral immunodepression inherent to the hematologic disease and to the immunosuppression related to the therapy.

The majority of infections in CLL patients treated with alkilating agents is of bacterial origin. The immunodeficiency and natural infectious history of alkylator-resistant, corticosteroid-treated patients appears to have changed with the administration of purine analogs, which has been complicated by very severe and unusual infections and also more viral infections due to sustained reduction of CD4-positive T lymphocytes.

The subsequent introduction of monoclonal antibodies in therapies, in particular alemtuzumab, further increased the immunodepression, increasing also infections which appeared more often in patients with recurrent neutropenia due to chemotherapy cycles.

Epidemiological data regarding fungal infections in lymphoproliferative disorders are scarce.

Italian SEIFEM group in a retrospective multicentre study regarding CLL patients reported an incidence of mycoses 0.5%; however, chronic lymphoproliferative disorders emerged as second haematological underlying disease after acute leukemia in a French study on aspergillosis; in particular CLL with aspergillosis accounted for a third of these chronic lymphoproliferative diseases presenting mould infection.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507529/pdf/mjhid-4-1-e2012070.pdf

February 23, 2017 at 7:49 am

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