ABSTRACT
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Subject(s)
Humans , Male , Adult , Pulmonary Eosinophilia/drug therapy , Pulmonary Eosinophilia/physiopathology , Pulmonary Eosinophilia , Anti-Bacterial Agents/therapeutic use , Bronchodilator Agents/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Strongyloides stercoralis , Strongyloides stercoralis/isolation & purification , Cough/complications , Cough/etiology , Dyspnea/complications , Respiratory Sounds/diagnosis , Respiratory Sounds/physiopathology , Enzyme-Linked Immunosorbent Assay/methods , Bronchiectasis/complications , Bronchiectasis/drug therapy , Tomography, Emission-Computed/methodsSubject(s)
Eosinophilia/parasitology , Lung Diseases, Parasitic/diagnosis , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/diagnosis , Adult , Animals , Eosinophilia/diagnosis , Humans , Lung Diseases, Parasitic/pathology , Male , Senegal/ethnology , Strongyloidiasis/pathologySubject(s)
Dicrocoeliasis/epidemiology , Dicrocoelium/isolation & purification , Dicrocoelium/pathogenicity , Feces/parasitology , Food Parasitology , Adolescent , Adult , Animals , Antibodies, Helminth/isolation & purification , Antigens, Helminth/isolation & purification , Child , Dicrocoeliasis/transmission , Emigrants and Immigrants , Female , Host-Parasite Interactions , Humans , Immunologic Factors/metabolism , Male , Middle Aged , Parasite Egg Count , Ruminants/parasitology , Spain/epidemiology , Young AdultSubject(s)
Fusarium/isolation & purification , Mycetoma/diagnosis , Mycetoma/microbiology , Humans , Male , Middle Aged , Mycetoma/pathology , Mycetoma/therapySubject(s)
Humans , Male , Adult , Mycetoma/complications , Mycetoma/diagnosis , Magnetic Resonance Imaging/methods , Magnetic Resonance Imaging , Fusarium/cytology , Fusarium/isolation & purification , Biopsy/methods , Itraconazole/therapeutic use , Mycetoma , Fusarium/radiation effects , Isoniazid/therapeutic use , Ethambutol/therapeutic use , Rifampin/therapeutic useABSTRACT
Fundamento. Describir dos casos de neumonía adquirida en la comunidad por Acinetobacter baumannii. Pacientes y métodos. Se trata de dos pacientes, uno con antecedentes de diabetes mellitus tipo 2 y tromboembolismo pulmonar dos años antes, y el segundo sin factores de riesgo conocidos salvo la edad, ingresados por neumonía adquirida en la comunidad por A. baumannii, que desarrollaron cavitación, con evolución final favorable. Conclusión. El A. baumannii es una causa infrecuente de neumonía de la comunidad, aunque debe ser tomado en consideración en pacientes con situaciones de base debilitantes y que no evolucionan de forma favorable en los primeros días del ingreso con tratamiento convencional (AU)
Subject(s)
Middle Aged , Aged , Male , Humans , Radiography, Thoracic , Pneumonia, Bacterial , Treatment Outcome , Community-Acquired Infections , Acinetobacter baumannii , Acinetobacter Infections , Drug Therapy, CombinationABSTRACT
OBJECTIVES: Description of two cases of community-acquired Acinetobacter baumannii pneumonia. PATIENTS AND METHODS: Two patients, one with a history of diabetes mellitus type 2 and pulmonary thromboembolism 2 years earlier and the second without known risk factors except for the age, were admitted to hospital because of community-acquired A. baumannii pneumonia with cavitation and with favorable final evolution. CONCLUSION: A. baumannii is an infrequent cause of community-acquired pneumonia, although it should be suspected in patients with debilitating illness and in patients who do not evolve favorably on the first days of the admission with conventional treatment.
Subject(s)
Acinetobacter Infections/microbiology , Acinetobacter baumannii/isolation & purification , Community-Acquired Infections/microbiology , Pneumonia, Bacterial/microbiology , Acinetobacter Infections/diagnostic imaging , Acinetobacter Infections/drug therapy , Aged , Anti-Bacterial Agents , Community-Acquired Infections/diagnostic imaging , Community-Acquired Infections/drug therapy , Drug Therapy, Combination/therapeutic use , Humans , Male , Middle Aged , Pneumonia, Bacterial/diagnostic imaging , Pneumonia, Bacterial/drug therapy , Radiography, Thoracic , Treatment OutcomeABSTRACT
BACKGROUND: To present the epidemiology of the outbreak and the description of patients with infection or colonization of the respiratory tract caused by A. baumannii in an Internal Medicine ward. METHODS: 20 consecutively patients hospitalized in the Internal Medicine ward were studied during 18 months with isolation of multiresistant A. baumanni in respiratory tract specimens with or without clinical signs of infection. RESULTS: Starting on an index case, that was a patient coming from other hospital with diagnosis of nosocomial Acinetobacter pneumonia, we detected 20 patients. The age of the patients ranged from 48 to 95 years, with a mean of 71.4 years. Eighty percent were males. The clinical features were similar: advanced age, with chronic diseases (35 percent diabetics, 45 percent with chronic lung diseases), and use of broad-spectrum antibiotics agents, fundamentally third generation cephalosporin (70 percent), clarithromycin (55 percent) and quinolones (30 percent). 75 percent of patients were in the same ward. Eight (40 percent) of the patients with chronic lung diseases were subjects with COPD, two with asthma and chronic glucocorticoids treatment, and one with a sleep apnea. In four cases the isolation was considered a colonization. The mean stay was 26.15 days, and the mortality 40 percent. CONCLUSIONS: The nosocomial infection caused by Acinetobacter baumannii is responsible of a high morbi-mortality between the patients hospitalized in an Internal Medicine ward, and produce an increase in length of stay. It is necessary a combination of control measures to prevent the transmission in the hospital and the outbreak of new multiresistant strains.
Subject(s)
Acinetobacter Infections/epidemiology , Acinetobacter baumannii/isolation & purification , Cross Infection/epidemiology , Disease Outbreaks , Respiratory Tract Infections/epidemiology , Acinetobacter Infections/microbiology , Acinetobacter Infections/therapy , Aged , Aged, 80 and over , Cross Infection/microbiology , Cross Infection/therapy , Drug Resistance, Multiple , Female , Hospital Units , Humans , Infection Control , Internal Medicine , Male , Middle Aged , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/therapyABSTRACT
Fundamento: Presentar la epidemiología del brote y la descripción de los pacientes con infección o colonización de las vías respiratorias por Acinetobacter baumannii en el área de hospitalización de Medicina Interna. Métodos: Estudio de 20 pacientes consecutivos ingresados en la planta de hospitalización de Medicina Interna durante 18 meses, en los que se aisló en esputo A. baumannii multirresistente, acompañado o no de signos clínicos de infección. Resultados: A raíz de un caso índice, que fue un paciente trasladado de otro centro hospitalario con el diagnóstico de neumonía nosocomial por A. baumannii, se han detectado 20 pacientes, cuya edad media es de 71.4 años (48-95). El perfil de los pacientes fue similar: edad avanzada, con patología crónica de base (35% diabéticos, 45% con enfermedad respiratoria crónica), con ingresos previos en Medicina Interna (35%), y con antecedente de consumo en el mes previo de antibióticos, fundamentalmente cefalosporinas de tercera generación (70% de los casos), claritromicina (55%) y quinolonas (30%). El 75% de los casos aconteció en el mismo área de hospitalización. De los pacientes con enfermedad pulmonar crónica, 8 (40%) cumplían criterios de EPOC, 2 eran asmáticos corticodependientes y 1 paciente estaba diagnosticado de SAOS. En 4 casos el aislamiento se consideró colonización. La estancia media fue de 26.15 días, con un porcentaje de exitus del 40%. Conclusiones: La infección nosocomial por Acinetobacter baumannii es responsable de una elevada morbimortalidad entre los pacientes ingresados en la planta de Medicina Interna. Es fundamental la adopción de medidas para el control de su transmisión intrahospitalaria y evitar la aparición de nuevas cepas multirresistentes (AU)
Background: To present the epidemiology of the outbreak and the description of patients with infection or colonization of the respiratory tract caused by A. baumannii in an Internal Medicine ward. Methods: 20 consecutively patients hospitalized in the Internal Medicine ward were studied during 18 months with isolation of multiresistant A. baumanni in respiratory tract specimens with or without clinical signs of infection. Results: starting on an index case, that was a patient coming from other hospital with diagnosis of nosocomial Acinetobacter pneumonia, we detected 20 patients. The age of the patients ranged from 48 to 95 years, with a mean of 71.4 years. Eighty percent were males. The clinical features were similar: advanced age, with chronic diseases (35 percent diabetics, 45 percent with chronic lung diseases), and use of broad-spectrum antibiotics agents, fundamentally third generation cephalosporin (70 percent), clarithromycin (55 percent) and quinolones (30 percent). 75 percent of patients were in the same ward. Eight (40 percent) of the patients with chronic lung diseases were subjects with COPD, two with asthma and chronic glucocorticoids treatment, and one with a sleep apnea. In four cases the isolation was considered a colonization. The mean stay was 26.15 days, and the mortality 40 percent. Conclusions: The nosocomial infection caused by Acinetobacter baumannii is responsible of a high morbi-mortality between the patients hospitalized in an Internal Medicine ward, and produce an increase in length of stay. It is necessary a combination of control measures to prevent the transmission in the hospital and the outbreak of new multiresistant strains (AU)
