Posts filed under ‘Infecciones en transplantados’

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

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

Infectious Complications After Liver Transplantation.

Gastroenterol Hepatol (N Y). 2015 Nov;11(11):741-53.

Hernandez Mdel P1, Martin P1, Simkins J1.

Author information

1Dr Hernandez is an assistant professor of medicine and Dr Martin is a professor of medicine in the Division of Hepatology at the University of Miami Miller School of Medicine in Miami, Florida. Dr Simkins is an assistant professor of medicine in the Division of Infectious Diseases at the University of Miami Miller School of Medicine.

Abstract

Orthotopic liver transplantation (OLT) is the standard of care for patients with decompensated cirrhosis and for patients with hepatocellular carcinoma.

More than 6000 liver transplants are performed annually in the United States. High patient and graft survival rates have been achieved in great part due to the availability of potent immunosuppressive agents.

Systemic immunosuppression has rendered the liver recipient susceptible to de novo infections as well as reactivation of preexisting latent infections. Infections occurring during the first month post-OLT are usually nosocomial, donor-derived, or the result of a perioperative complication.

The development of opportunistic infections (OIs) such as Aspergillus and the reactivation of latent infections such as Mycobacterium tuberculosis are more frequent 1 to 6 months posttransplant, when the net state of immunosuppression is the highest.

Immunosuppressive therapy is tapered 6 to 12 months post-OLT; therefore, infections occurring during that time period and afterward generally resemble those of the general population.

Screening strategies applied to determine the risk of an infection after transplantation and the use of prophylactic antimicrobial therapy have reduced the incidence of OIs after OLT.

This article will review the various causes of infection post-OLT and the therapies used to manage complications.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849501/pdf/GH-11-741.pdf

February 10, 2017 at 8:49 am

Listeria monocytogenes meningitis in an immunocompromised patient.

New Microbiol. 2015 Jan;38(1):113-8.

Barocci S1, Mancini A, Canovari B, Petrelli E, Sbriscia-Fioretti E, Licci A, D’Addesa S, Petrini G, Giacomini M, Renzi A, Migali A, Briscolini S.

Author information

1ASUR Marche AV2, O.U. Clinical Pathology, Senigallia (AN), Italy.

Abstract

This report describes a case of meningitis caused by Listeria monocytogenes in a stem cell transplant recipient on immunosuppressive therapy for cutaneous chronic graft-versus host disease.

A 59-year-old woman had undergone allogeneic stem cell transplantation (from a matched unrelated donor) 13 months previously for chronic lymphocytic leukemia. She was on regular hematologic follow-up.

Though her previous malignancy has been in remission, she was immunosuppressed due to the pharmacological treatment.

We describe a meningitis caused by a typical food-borne pathogen, dangerous in patients with impaired cell-mediated immunity. Moreover the bacterium had a multidrug resistance, a rare characteristic in clinical listeriosis.

Rapid diagnosis and treatment are key factors in these cases. We chose ampicillin and rifampicin that allowed a complete resolution of the clinical manifestations.

PDF

http://www.newmicrobiologica.org/PUB/allegati_pdf/2015/1/113.pdf

December 18, 2016 at 12:22 pm

Steroid-Based Therapy and Risk of Infectious Complications

PLoS Med 2016 May 24; 13:e1002024

Lionel Rostaing, Paolo Malvezzi

Clinique Universitaire de Néphrologie, Unité de Transplantation Rénale, CHU Grenoble, La Tronche, France

Lionel Rostaing

Université Toulouse III Paul Sabatier, Toulouse, France

INSERM U563, IFR–BMT, CHU Purpan, Toulouse, France

Steroid-based therapy is widely used in the treatment of different diseases, across many health care settings. In a study based on the National Health and Nutrition Examination Survey (NHANES), conducted between 1999 and 2005, the prevalence of long-duration glucocorticoid use in the United States general population was 1.2% (95% CI 1.1–1.4) [1].

In a study of the United Kingdom general population, over 20 years, the long-term use of glucocorticoids (>3 months) was 0.75% (95% CI 0.74–0.75) [2].

Over this time period, long-term corticosteroid prescriptions for rheumatoid arthritis, polymyalgia rheumatica/giant cell arteritis, ulcerative colitis, asthma, chronic obstructive pulmonary disease (COPD), and Crohn’s disease were evident.

In addition, among patients with a solid-organ transplant, who number more than 1 million worldwide, at least 50% take 5–10 mg of glucocorticoids per day over the long term.

With this in mind, it is of utmost importance that patients are managed in the best way with regards to side effects, particularly infectious complications…..

FULL TEX

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002025

PDF

http://journals.plos.org/plosmedicine/article/asset?id=10.1371%2Fjournal.pmed.1002025.PDF

June 16, 2016 at 3:23 pm

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

Tratamiento de la infección del tracto urinario en los receptores de trasplantes de órganos sólidos: Declaración de consenso del Grupo de Estudio de Infección en receptores de trasplantes (GESITRA) de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC) y la Red Española de Investigación en Patología Infecciosa (REIPI)

Enf Infecc & Microbiol. Clínica Diciembre 2015 V.33 N.10 e1-e21

CONSENSO

Elisa Vidal, Carlos Cervera, Elisa Cordero, Carlos Armiñanzas, Jordi Carratalá, José Miguel Cisneros, M. Carmen Fariñas, Francisco López-Medrano, Asunción Moreno, Patricia Muñoz, Julia Origüen, Núria Sabé, Maricela Valerio, Julián Torre-Cisneros

a Unidad Clínica de Gestión de Enfermedades Infecciosas, Instituto Maimónides de Investigación en Biomedicina de Córdoba, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain

b Servicio de Enfermedades Infecciosas, Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, Spain

c Unidad Clínica de Gestión de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain

d Unidad de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain

e Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Universidad de Barcelona, Barcelona, Spain

f Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Instituto de Investigación Biomédica 12 de Octubre, Departamento de Medicina, Universidad Complutense, Madrid, Spain

g Departamento de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain

Antecedentes

Las infecciones del tracto urinario (ITU) son muy frecuentes en los receptores de un trasplante de órgano sólido (TOS).

Métodos

Investigadores y clínicos con experiencia en el TOS han desarrollado este documento de consenso para el mejor abordaje de estos pacientes. Hemos realizado una revisión sistemática y se ha especificado el nivel de evidencia para cada recomendación basado en la literatura disponible. Este artículo se ha redactado de acuerdo con las recomendaciones internacionales sobre documentos de consenso y las recomendaciones del Instrumento para Evaluación de Guías de Práctica Clínica II (AGREE II).

Resultados

Se realizan recomendaciones sobre el abordaje de la bacteriuria asintomática y sobre la profilaxis y tratamiento de las ITU en receptores de TOS. Se han revisado el abordaje diagnóstico-terapéutico de las ITU recurrentes y el papel de la ITU en el rechazo o disfunción del injerto renal. Finalmente, se incluyen recomendaciones sobre las interacciones entre antimicrobianos e inmunosupresores.

Conclusiones

Se incorpora a este documento la información científica más actualizada sobre la ITU en el contexto del TOS.

PDF

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90445480&pident_usuario=0&pcontactid=&pident_revista=28&ty=160&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=en&fichero=28v33n10a90445480pdf001.pdf

 

Enferm Infecc Microbiol Clin. 2015;33:680-7

Executive summary.

Abordaje de la infección urinaria en receptores de trasplante de órgano sólido: documento de consenso del Grupo de Estudio de la Infección en Receptores de Trasplante (GESITRA) de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC) y la Red Española para el Estudio de Patología Infecciosa (REIPI)

Elisa Vidal, Carlos Cervera, Elisa Cordero, Carlos Armiñanzas, Jordi Carratalá, José Miguel Cisneros, M. Carmen Fariñas, Francisco López-Medrano, Asunción Moreno, Patricia Muñoz, Julia Origüen, Núria Sabé, Maricela Valerio, Julián Torre-Cisneros

a Unidad Clínica de Gestión de Enfermedades Infecciosas, Instituto Maimónides de Investigación en Biomedicina de Córdoba, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain

b Servicio de Enfermedades Infecciosas, Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, Spain

c Unidad Clínica de Gestión de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain

d Unidad de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain

e Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Universidad de Barcelona, Barcelona, Spain

f Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Instituto de Investigación Biomédica 12 de Octubre, Departamento de Medicina, Universidad Complutense, Madrid, Spain

g Departamento de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain

Las infecciones del tracto urinario (ITU) son muy frecuentes en los receptores de un trasplante de órgano sólido (TOS). Hemos realizado una revisión sistemática para determinar el abordaje de la ITU en receptores de TOS.

 

Se realizan recomendaciones sobre el abordaje de la bacteriuria asintomática y sobre la profilaxis y tratamiento de las ITU en receptores de TOS. Se han revisado el abordaje diagnóstico-terapéutico de las ITU recurrentes y el papel de la ITU en el rechazo o disfunción del injerto renal. Finalmente, se incluyen recomendaciones sobre las interacciones entre antimicrobianos e inmunosupresores.

PDF

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90445481&pident_usuario=0&pcontactid=&pident_revista=28&ty=161&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=en&fichero=28v33n10a90445481pdf001.pdf

 

April 7, 2016 at 8:03 am

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