[Central venous catheters-related infections in patients with parenteral nutrition]. / Infecciones relacionadas con el catéter venoso central en pacientes con nutrición parenteral total.

INTRODUCTION: Infections related to central venous catheters (CVC) are complications with a high prevalence and possible serious consequences. Administration of total parenteral nutrition (TPN) is a risk factor, although the information available for these patients and conventional inpatient units is scarce. OBJECTIVE: To determine the rate of catheter-related bacteremia (CRB) in patients with TPN and to identify possible relationships with administration route or place of insertion, to determinate the current situation and identify possible preventive measures. METHOD: Prospective-observational study of 13 months. All adult patients who received TPN were included. Infection rate used was the CRB per 1,000 days of CVC. RESULTS: 176 CVC were registered in 159 patients. In 47% of CVC, vein access was jugular vein, despite being a location of greatest risk of infection. In critically ill patients, which followed a zero bacteremia project, there was no cases of infection. In other patients, bacteremia rate was 13.10 per 1,000 days of CVC. The average time elapsed between catheter insertion and infection was 11 days (range: 4-22) and the most frequent species were S. epidermidis (38%) and S. hominis (19%). DISCUSSION: In our environment there is a high rate of BRC in non-critical patients, with a high proportion of CVC in locations with higher risk of infection, despite not having found in the sample a higher rate of infection depending on the access route. Place of insertion, operating room face ward, is related to a lower rate of BRC. Measures to standardize clinical practice may reduce its incidence. The zero bacteremia project is confirmed as a highly effective method.

[Linezolid resistant Staphylococcus epidermidis in a patient with a knee replacement]. / Staphylococcus epidermidis resistente a linezolid en paciente portador de prótesis de rodilla.

Staphylococcus epidermidis is the most prevalent species of coagulase-negative staphylococci (CNS). It accounts for over 65% of all staphylococci isolated from samples. In recent years the increasing relevance of CNS as pathogens is evident, mainly causing bacteraemia and prosthetic device infection. Linezolid, being an effective antibiotic against this pathogen, and due to its ease of use and oral posology, is becoming the treatment of choice in outpatients. However, the continued use of this drug is causing the development of resistant strains. We describe a prosthetic infection due to linezolid resistant S. epidermidis that appeared in a patient who had been previously treated with this drug for 16 days due to the isolation of Bacillus sp. This case was not related to a resistant strain hospital outbreak.

Staphylococcus epidermidis resistente a linezolid en paciente portador de prótesis de rodilla / Linezolid resistant Staphylococcus epidermidis in a patient with a knee replacement

Staphylococcus epidermidis (S. epidermidis) es la especie más prevalente de los estafilococos coagulasa negativos (ECN). Supone más del 65% de todos los estafilococos aislados en las muestras. En los últimos años, el protagonismo como patógenos es manifiesto, fundamentalmente causando bacteriemia e infección de material protésico. El linezolid, por ser un antibiótico eficaz frente a este patógeno y ante su facilidad de uso por vía oral, está siendo de elección en el tratamiento de estas infecciones en el domicilio. Sin embargo, el uso continuado de este fármaco está causando la aparición de resistencias. Presentamos el caso clínico de una infección protésica por S. epidermidis resistente a linezolid en un paciente en el que previamente se había aislado Bacillus sp., motivo por el que había recibido este antibiótico durante 16 días. El caso no estuvo relacionado con un brote intrahospitalario de S. epidermidis resistente a linezolid (AU)

Staphylococcus epidermidis is the most prevalent species of coagulase-negative staphylococci (CNS). It accounts for over 65% of all staphylococci isolated from samples. In recent years the increasing relevance of CNS as pathogens is evident, mainly causing bacteraemia and prosthetic device infection. Linezolid, being an effective antibiotic against this pathogen, and due to its ease of use and oral posology, is becoming the treatment of choice in outpatients. However, the continued use of this drug is causing the development of resistant strains. We describe a prosthetic infection due to linezolid resistant S. epidermidis that appeared in a patient who had been previously treated with this drug for 16 days due to the isolation of Bacillus sp. This case was not related to a resistant strain hospital outbreak (AU)

Síndrome febril en varón de 22 años / Febrile syndrome in a 22-year old male

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