Posts filed under ‘REPORTS’

Infección por Candida spp. sobre prótesis articulares

Rev Esp Quimioter 2011:24(1):37-41

GARCÍA-OLTRA, S. GARCÍA-RAMIRO, J. C MARTÍNEZ, R. TIBAU, G. BORI, J. BOSCH, J. MENSA, A. SORIANO

Introducción

Las infecciones periprotésicas por Candida spp.constituyen una entidad poco frecuente. El objetivo de este trabajo fue revisar la experiencia en dos centros hospitalarios.

Material y métodos

Se realizó una revisión retrospectiva de los casos de infección protésica de etiología fúngica atendidos en dos hospitales de Barcelona entre febrero de 2002 y octubre de 2010. Se incluyeron todos aquellos pacientes con criterios clínicos de infección y aislamiento de Candida spp. Se recogieron las principales variables demográficas, microbiológicas, terapéuticas y evolutivas.

Resultados

Se identificaron 10 casos, 8 mujeres y 2 varones, cuya edad media fue de 77,7 (rango 66-92) años. Nueve pacientes habían tenido una infección bacteriana previa, por la que recibieron tratamiento antibiótico durante más de 15 días y precisaron desbridamiento en más de una ocasión. La especie más frecuente fue Candida albicans con 6 casos. Todos los pacientes recibieron fluconazol y tratamiento quirúrgico consistente en desbridamiento sin retirada de la prótesis en 3 casos y recambio en 2 tiempos con un espaciador en los 7 restantes. El tratamiento fracasó en los 10 casos y fue necesario practicar un desbridamiento adicional en 1 caso, artroplastia de resección en 8 y tratamiento “supresivo”con fluconazol en uno. Tras un seguimiento medio de 31 meses (rango 2-67) dos pacientes estaban libres de enfermedad.

Conclusión

La infección protésica por Candida spp. se observa en pacientes que han recibido tratamiento antibiótico previo prolongado y han sido intervenidos en más de una ocasión. El tratamiento con fluconazol y desbridamiento o recambio en 2 tiempos con un espaciador se asoció a una elevada tasa de fracaso.

PDF

http://seq.es/seq/0214-3429/24/1/garciaoltra.pdf

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September 3, 2017 at 7:05 pm

Papel de daptomicina en el tratamiento empírico y dirigido de infecciones por cocos grampositivos del paciente crítico

Revista Española de Quimioterapia Marzo 2011 V.24 N.1 P.14-24

GARNACHO-MONTERO, R. AMAYA-VILLAR, M. L. GÓMEZ-GRANDE, V. JEREZ, L. LORENTE-RAMOS, A. LOZA, A. MARTÍNEZ, J. C. POZO, R. SIERRA, J. POMARES, M. V. DE LA TORRE, C. ORTIZ

Las infecciones graves causadas por bacterias grampositivas son un problema grave y que se asocia a una elevada mortalidad. Entre ellas, hay que resaltar las causadas por Staphylococcus aureus resistente a meticilina siendo la bacteriemia primaria o asociada a catéter o a endocarditis las principales presentaciones.

Vancomicina ha sido tradicionalmente el tratamiento de elección para estas infecciones pero su actividad no es satisfactoria especialmente en caso de SARM con concentración mínima inhibitoria (CMI) >1mg/L.

Daptomicina es un antibiótico lipopéptido cuyo espectro de acción son las bacterias grampositivas incluyendo SARM y Enterococcus spp resistente a glucopéptido.

Destacar también que frente a S.aureus sensible a meticilina, daptomicina es rápidamente bactericida y más activo que vancomicina y al menos tan activo como las penicilinas isoxazólicas.

En el presente artículo se discute el papel de este antibiótico en el tratamiento empírico y dirigido de las infecciones por bacterias grampositivas que afectan a los pacientes críticos.

PDF

http://seq.es/seq/0214-3429/24/1/garnacho.pdf

September 3, 2017 at 7:01 pm

Ceftaroline for Severe Methicillin-Resistant Staphylococcus aureus Infections: A Systematic Review

Open Forum Infectious Diseases April  2017 V.4 N.2

Reese A. Cosimi; Nahal Beik; David W. Kubiak; Jennifer A. Johnson

This article reviews and evaluates the existing literature describing clinical outcomes and safety of ceftaroline in severe methicillin-resistant Staphylococcus aureus infections.

Ceftaroline is approved by the Food and Drug Administration for acute bacterial skin and skin-structure infections and community-acquired bacterial pneumonia, including cases with concurrent bacteremia. Use for serious methicillin-resistant Staphylococcus aureus (MRSA) infections has risen for a multitude of reasons.

The aim of this article is to review the literature evaluating clinical outcomes and safety of ceftaroline prescribed for serious MRSA infections. We conducted a literature search in Ovid (Medline) and PubMed for reputable case reports, clinical trials, and reviews focusing on the use of ceftaroline for treatment of MRSA infections.

Twenty-two manuscripts published between 2010 and 2016 met inclusion criteria. Mean clinical cure was 74% across 379 patients treated with ceftaroline for severe MRSA infections. Toxicities were infrequent. Ceftaroline treatment resulted in clinical and microbiologic cure for severe MRSA infections. Close monitoring of hematological parameters is necessary with prolonged courses of ceftaroline.

PDF

https://watermark.silverchair.com/api/watermark?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAdMwggHPBgkqhkiG9w0BBwagggHAMIIBvAIBADCCAbUGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMvnqvVinRP8PvAJRgAgEQgIIBhlKCsxJw2TOe_6entYFWKf2-BkLTzr93n2tNH8boO2PS2YUg-9vu5Q-L-DJpmzM7DybrlX_pwpnbZFdudrBmCQLL7seS64Dye4f4yKrP77NOfRvdjaUZMK-XLaJd8ErFzBbnr1-N-mOL8-kV83A6A4ITJAdm8Jq9jzOeIYCQwN0PLNKB–odW_WZPmol9Ejhni7qBlP3YCDpy1gltUPWl85dzPkEUP5b8SI5YMO4kTIdJ0HFk1nICzg0YUJEaiNJ-mRByK5miWMV3xJ4pKL2dE8qJB76Ah4__m-y0tHUeCCo6PUPBPL8VP96DvLgEwq_ux-IqDFe9PQ-YOno9txJIBaClm1VFTVmntQVKbnVMZUZVLiby8OXf7h336QP126S-9bqm5Zep_P3AUddt2BMeOYVdTXEqYFqH3Ch1bU1BoAWzxP0qErq5CWsrFehfhmyZ6FjysnivJ4s4eOlfVpvraLyxP4DxmWsGWQ3SFytnkwhliMVF1t6jAJO7SyQ0kYSe5ITzz5Fvg

September 3, 2017 at 6:40 pm

Vaginal seeding or vaginal microbial transfer from the mother to the caesarean-born neonate: a commentary regarding clinical management

BJOG: An International Journal of Obstetrics & Gynaecology

Commentary

T Haahr, J Glavind, P Axelsson, M Bistrup Fischer, J Bjurström, G Andrésdóttir, D Teilmann-Jørgensen, U Bonde, N Olsén Sørensen, M Møller, J Fuglsang, PG Ovesen, JP Petersen, J Stokholm, TD Clausen

Recent evidence suggests caesarean delivery (CD) to be a risk factor for inflammatory and metabolic diseases such as asthma, allergies and other chronic immune disorders in the child.[1]

One hypothetical pathogenesis of these associations has been proposed to be a disruption of the neonatal colonization (NC) after CD.[2]

To further support this hypothesis, it has been observed that the effect of CD on NC differed according to the type of CD, i.e. planned or emergency,[3] and that the risk of asthma in children born by CD was mitigated by rupture of membranes, though still increased compared with children delivered vaginally.[4]

Such interruption of NC has been speculated to hamper adequate immune development and set the stage for later disease.[5] Although this hypothesis was recently questioned by Chu et al.,[6] several publications have pointed out the mode of delivery as an important independent factor that impacts NC, especially in the first months of life.[3, 7, 8]

Thus, Dominguez-Bello and colleagues came up with the novel idea to transfer vaginal microbes from the mother to the caesarean-born neonate in an attempt to modulate NC, i.e. vaginal seeding (VS).[9] In their pilot study, it was concluded that the NC of caesarean-born neonates partially could be restored with VS based on data from four neonates.

Since then, several publications have discussed these findings which underscore the need to further investigate the balance between benefits and risks associated with VS and its potential use in the clinic.[10-12]

Nevertheless, many patients have already adopted the concept of this new birth trend; thus, obstetricians, midwives and other healthcare professionals frequently encounter couples who are concerned regarding disrupted NC after CD, and are querying the potential impact of VS….

FULL TEXT

http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.14792/full

PDF

http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.14792/epdf

September 1, 2017 at 8:22 am

Recommendations for prevention of surgical site infection in adult elective arthroplasty.

Medicina (B Aires). 2017;77(2):143-157.

[Article in Spanish]

Chuluyán JC1, Vila A2, Chattás AL3, Montero M3, Pensotti C4, Tosello C5, Sánchez M6, Vera Ocampo C7, Kremer G8, Quirós R8, Benchetrit GA9, Pérez CF10, Terusi AL11, Nacinovich F12.

Author information

1 Grupo de Trabajo Infectología, Hospital General de Agudos Dr. T. álvarez, Argentina. E-mail: jcchulu@gmail.com

2 Servicio de Infectología, Hospital Italiano de Mendoza, Mendoza, Argentina.

3 Hospital General de Agudos Dr. Pirovano, Argentina.

4 Clínica Monte Grande, Buenos Aires, Argentina.

5 Hospital de Clínicas José de San Martín, UBA, Buenos Aires, Argentina.

6 Hospital Italiano de Buenos Aires, Argentina.

7 Sanatorio Dupuytren, Argentina.

8 Hospital Universitario Austral, Argentina.

9 Instituto de Investigaciones Médicas A. Lanari, UBA, Buenos Aires, Argentina.

10 Policlínico del Docente-Centro Médico Huésped, Argentina.

11 Instituto César Milstein, Argentina.

12 Instituto Cardiovascular de Buenos Aires, Centros Médicos Dr. Stamboulian, Argentina.

Abstract

Surgical site infections complicating orthopedic implant surgeries prolong hospital stay and increase risk of readmission, hospitalization costs and mortality. These recommendations are aimed at:

(i) optimizing compliance and incorporating habits in all surgery phases by detecting risk factors for surgical site infections which are potentially correctable or modifiable; and

(ii) optimizing preoperative antibiotic prophylaxis as well as intraoperative and postoperative care.

PDF

http://www.medicinabuenosaires.com/PMID/28463223.pdf

August 31, 2017 at 3:49 pm

Susceptibility of Colistin-Resistant, Gram-Negative Bacteria to Antimicrobial Peptides and Ceragenins

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

Marjan M. Hashemi, John Rovig, Scott Weber, Brian Hilton, Mehdi M. Forouzan, and Paul B. Savage

aDepartment of Chemistry and Biochemistry, Brigham Young University, Provo, Utah, USA

bDepartment of Chemical Engineering, Brigham Young University, Provo, Utah, USA

The susceptibility of colistin-resistant clinical isolates of Klebsiella pneumoniae to ceragenins and antimicrobial peptides (AMPs) suggests that there is little to no cross-resistance between colistin and ceragenins/AMPs and that lipid A modifications are found in bacteria with modest changes in susceptibility to ceragenins and with high levels of resistance to colistin.

These results suggest that there are differences in the resistance mechanisms to colistin and ceragenins/AMPs

PDF

http://aac.asm.org/content/61/8/e00292-17.full.pdf+html

August 30, 2017 at 8:18 am

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

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