Posts filed under ‘Infecciones intraabdominales’

Adenitis mesentérica por Yersinia enterocolítica

Rev Med Urug 2007; 23: 265-268

Dres. Lorena Pardo, María Inés Mota, Gustavo Giachetto, María Parada, Catalina Pirez, Gustavo Varela

Departamento de Bacteriología y Virología, Instituto de Higiene. Instituto de Pediatría, Centro Hospitalario Pereira Rossell. Facultad de Medicina, Universidad de la República. Montevideo, Uruguay

Se presenta por primera vez en nuestro país un caso de adenitis mesentérica en una niña de 3 años asociado a infección por Yersinia enterocolítica. La cepa recuperada del coprocultivo correspondió al bioserotipo patogénico 4/O:3 y presentó además el plásmido de virulencia.
PDF
http://www.rmu.org.uy/revista/2007v4/art7.pdf

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October 9, 2018 at 8:51 am

MANUAL INTEGRAL DE DIAGNÓSTICO MICROBIOLÓGICO DE Yersinia enterocolítica 135 pags

SELENE BERENICE GUERRERO FUENTES – UNIVERSIDAD NACIONAL AUTÓNOMA DE MÉXICO

Yersinia enterocolítica es un cocobacilo gramnegativo con bordes redondeados, aerobios y anaerobios facultativos1, de amplia distribución mundial cuyo reservorio natural se encuentra en una gran variedad de animales.

La transmisión a los humanos se realiza principalmente a través de la vía fecal-oral aunque también se han descrito casos de transmisión a través de transfusiones sanguíneas.

Su aislamiento se realiza habitualmente dentro de un cuadro gastrointestinal y rara vez produce trastornos extraintestinales como bacteriemia, abscesos, manifestaciones cutáneas, etc.

Éstos se han asociado a diferentes enfermedades de base como alteraciones del metabolismo del hierro, diabetes mellitus, alcoholismo, malnutrición, tumores, terapia inmunosupresora y cirrosis. 2
PDF
https://www.zaragoza.unam.mx/portal/wp-content/Portal2015/Licenciaturas/qfb/tesis/tesis_guerrero_fuentes.pdf

October 9, 2018 at 8:50 am

FALSA APENDICITIS – YERSINIA ENTEROCOLÍTICA

Revista Digital Universitaria abril 2005 V.6 N.4

Yersinia enterocolitica pertenece a la familia Enterobacteriaceae, la cual se ha aislado de una gran variedad de animales domésticos y silvestres (Brenner, et al; 1980).

Microorganismo responsables de muchos casos de enteritis infecciosa a nivel mundial; algunos brotes epidémicos se han asociado al consumo de alimentos, en algunos casos probablemente la infección en el hombre sea debida al contacto con animales.

Más de las dos terceras partes de las infecciones se manifiestan por cuadros diarreicos, sobre todo en niños menores de cinco años. Esta diarrea a menudo es acompañada de febrícula y dolor abdominal moderado por 1 a 3 semanas.

En 1976 Brenner y colaboradores encontraron por métodos moleculares cepas parecidas a Yersinia enterocolitica, estos trabajos permitieron a varios autores establecer, por sus características fenotípicas, cuatro especies distintas: Y. enterocolitica, Y. intermedia, Y.frederiksenii y Y. Kristensenii. La especie Yersinia enterocolitica por su heterogeneidad bioquímica se clasifica en biogrupos. Inicialmente eran 5 que posteriormente se extendieron a 8 …

PDF
http://www.revista.unam.mx/vol.6/num4/art31/abr_art31.pdf

October 9, 2018 at 8:49 am

Uracosinus: una causa poco frecuente de onfalitis recurrente en adultos

Anales de Medicina Interna (Madrid) Julio 2006

  1. Ochando Cerdán, D. Vega Menéndez, P. Pacheco Martínez, M. Ramos Fernández, J. A. Blanco Cabellos1,
  2. Hernández Granados, C. Loinaz Segurola, A. Quintans Rodríguez

Servicios de Cirugía General y Aparato Digestivo y 1Radiodiagnóstico. Fundación Hospital Alcorcón. Alcorcón. Madrid

El uracosinus es una anomalía congénita poco frecuente secundaria a la obliteración incompleta del uraco en su porción infraumbilical, que puede aparecer a cualquier edad. Presentamos un paciente de 47 años que acudió al servicio de urgencias por supuración umbilical persistente que no había respondido al tratamiento médico (ATB y curaciones). La TAC confirmó la existencia de un sinus del uraco con cambios de onfalitis. La cirugía consistió en la resección en bloque del mismo con onfalectomía. El postoperatorio transcurrió sin incidencias.

FULL TEXT

http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-71992006000700007

PDF

http://scielo.isciii.es/pdf/ami/v23n7/nota2.pdf

September 1, 2018 at 12:00 pm

JULY 2018 – Risk Factors for Surgical Site Infection After Cholecystectomy

Background.

There are limited data on risk factors for surgical site infection (SSI) after open or laparoscopic cholecystectomy.

Methods.

A retrospective cohort of commercially insured persons aged 18–64 years was assembled using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure or Current Procedural Terminology, 4th edition codes for cholecystectomy from December 31, 2004 to December 31, 2010. Complex procedures and patients (eg, cancer, end-stage renal disease) and procedures with pre-existing infection were excluded. Surgical site infections within 90 days after cholecystectomy were identified by ICD-9-CM diagnosis codes. A Cox proportional hazards model was used to identify independent risk factors for SSI.

Results.

Surgical site infections were identified after 472 of 66566 (0.71%) cholecystectomies; incidence was higher after open (n = 51, 4.93%) versus laparoscopic procedures (n = 421, 0.64%; P < .001). Independent risk factors for SSI included male gender, preoperative chronic anemia, diabetes, drug abuse, malnutrition/weight loss, obesity, smoking-related diseases, previous Staphylococcus aureus infection, laparoscopic approach with acute cholecystitis/obstruction (hazards ratio [HR], 1.58; 95% confidence interval [CI], 1.27–1.96), open approach with (HR, 4.29; 95% CI, 2.45–7.52) or without acute cholecystitis/obstruction (HR, 4.04; 95% CI, 1.96–8.34), conversion to open approach with (HR, 4.71; 95% CI, 2.74–8.10) or without acute cholecystitis/obstruction (HR, 7.11; 95% CI, 3.87–13.08), bile duct exploration, postoperative chronic anemia, and postoperative pneumonia or urinary tract infection.

Conclusions.

Acute cholecystitis or obstruction was associated with significantly increased risk of SSI with laparoscopic but not open cholecystectomy. The risk of SSI was similar for planned open and converted procedures. These findings suggest that stratification by operative factors is important when comparing SSI rates between facilities.

FULL TEXT

https://academic.oup.com/ofid/article/4/2/ofx036/3044173

PDF (CLIC en PDF)

July 15, 2018 at 4:00 pm

Clinical response and mortality in tigecycline complicated intra-abdominal infection and complicated skin and soft-tissue infection trials

Internat J of Antimicrob Agents september 2015 V.46 N.3

Matteo Bassetti, Paul C. McGovern, Christoph Wenisch, R. Daniel Meyer, Jean Li Yan, Michele Wible, Scott T. Rottinghaus, Alvaro Quintana

Highlights

  • These analyses provide valuable insights into clinical response and mortality with tigecycline use.
  • These analyses suggest tigecycline is not a significant factor for clinical failure.
  • The cIAI analyses suggest tigecycline is not a significant factor for death.

An imbalance in all-cause mortality was noted in tigecycline phase 3 and 4 comparative clinical trials across all studied indications. We investigated clinical failure and mortality in phase 3 and 4 complicated skin and soft-tissue infection (cSSTI) and complicated intra-abdominal infection (cIAI) tigecycline trials using descriptive analyses of a blinded adjudication of mortality and multivariate regression analyses. Attributable mortality analyses of cSSTI revealed death due to infection in 0.1% of each treatment group (P = 1.000). In cIAI, there were no significant differences between tigecycline (1.2%) and comparator (0.7%) subjects who died due to infection (P = 0.243). For cIAI clinical failure, treatment interaction with organ dysfunction was observed with no difference observed between clinical cure for tigecycline (85.4%) and comparator (76.7%) treatment groups (odds ratio = 0.58, 95% confidence interval 0.28–1.19). Tigecycline-treated subjects had more adverse events of secondary pneumonias (2.1% vs. 1.2%) and more adverse events of secondary pneumonias with an outcome of death (0.5% vs. 0.1%). These analyses do not suggest that tigecycline is a factor either for failure (cSSTI and cIAI studies) or for death (cIAI studies).

FULL TEXT

https://www.ijaaonline.com/article/S0924-8579(15)00216-2/fulltext

PDF

https://www.ijaaonline.com/article/S0924-8579(15)00216-2/pdf

July 8, 2018 at 5:55 pm

Ceftazidime/Avibactam and Ceftolozane/Tazobactam: Second-generation β-Lactam/βLI Combinations.

Clinical Infectious Diseases July 15, 2016 V.63 N.2 P.234-41.

van Duin D1, Bonomo RA2.

Abstract

Ceftolozane/tazobactam and ceftazidime/avibactam are 2 novel β-lactam/β-lactamase combination antibiotics. The antimicrobial spectrum of activity of these antibiotics includes multidrug-resistant (MDR) gram-negative bacteria (GNB), including Pseudomonas aeruginosa. Ceftazidime/avibactam is also active against carbapenem-resistant Enterobacteriaceae that produce Klebsiella pneumoniae carbapenemases. However, avibactam does not inactivate metallo-β-lactamases such as New Delhi metallo-β-lactamases. Both ceftolozane/tazobactam and ceftazidime/avibactam are only available as intravenous formulations and are dosed 3 times daily in patients with normal renal function. Clinical trials showed noninferiority to comparators of both agents when used in the treatment of complicated urinary tract infections and complicated intra-abdominal infections (when used with metronidazole). Results from pneumonia studies have not yet been reported. In summary, ceftolozane/tazobactam and ceftazidime/avibactam are 2 new second-generation cephalosporin/β-lactamase inhibitor combinations. After appropriate trials are conducted, they may prove useful in the treatment of MDR GNB infections. Antimicrobial stewardship will be essential to preserve the activity of these agents.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928383/pdf/ciw243.pdf

 

June 10, 2018 at 10:52 am

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