ABSTRACT
Peripheral venous catheter-associated bloodstream infections (PVC-BSIs) lead to prolonged hospitalization, morbidity and increased costs. The impact of infection-prevention measures on the rate of PVC-BSIs in a university hospital in Spain was assessed. An active surveillance programme was initiated in 2015, which revealed a high PVC-BSI incidence ratio (0.48/1000 patient-days). A bundle aimed at nurses, medical staff and patients was implemented, and a Catheter Infection Team (CIT) was set up. The intervention achieved a decrease in PVC-BSI rate: 0.34 in 2016, 0.29 in 2017, and 0.17 in 2018. The decline was greatest for Gram-negative PVC-BSIs (67.6% in 2015, 35.3% in 2018).
Subject(s)
Catheter-Related Infections/prevention & control , Catheterization, Peripheral/adverse effects , Catheterization, Peripheral/methods , Infection Control/methods , Sepsis/prevention & control , Adolescent , Adult , Aged , Aged, 80 and over , Catheter-Related Infections/epidemiology , Female , Humans , Incidence , Infection Control/organization & administration , Male , Middle Aged , Sepsis/epidemiology , Spain/epidemiology , Young AdultABSTRACT
El riesgo de infección por Mycobacterium tuberculosis se halla aumentado en los pacientes con enfermedades inflamatorias crónicas y en tratamiento inmunosupresor, en particular con terapia antifactor de necrosis tumoral α. La detección de la infección tuberculosa latente y el tratamiento preventivo dirigido a reducir el riesgo de progresión a tuberculosis activa es obligatoria en este grupo de pacientes. Este documento de consenso multidisciplinar actualiza la opinión de expertos y establece recomendaciones para el diagnóstico y tratamiento de la infección tuberculosa latente en estos pacientes, según los conocimientos actuales en terapias biológicas
Patients with chronic inflammatory diseases being treated with immunosuppressive drugs, and with tumor necrosis factor inhibitors in particular, have an increased risk of infection by Mycobacterium tuberculosis. Screening for latent tuberculosis infection and preventive therapy to reduce the risk of progression to active tuberculosis are mandatory in this group of patients. This updated multidisciplinary consensus document presents the latest expert opinions on the treatment and prevention of tuberculosis in candidates for biologic therapy and establishes recommendations based on current knowledge relating to the use of biologic agents
Subject(s)
Humans , Antitubercular Agents/therapeutic use , Tuberculosis/prevention & control , Biological Therapy/adverse effects , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal/therapeutic use , Antitubercular Agents/administration & dosage , Hidradenitis Suppurativa/drug therapy , Patient Selection , Psoriasis/drug therapy , Tuberculosis/drug therapy , Drug Monitoring , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
Patients with chronic inflammatory diseases being treated with immunosuppressive drugs, and with tumor necrosis factor inhibitors in particular, have an increased risk of infection by Mycobacterium tuberculosis. Screening for latent tuberculosis infection and preventive therapy to reduce the risk of progression to active tuberculosis are mandatory in this group of patients. This updated multidisciplinary consensus document presents the latest expert opinions on the treatment and prevention of tuberculosis in candidates for biologic therapy and establishes recommendations based on current knowledge relating to the use of biologic agents.
Subject(s)
Antitubercular Agents/therapeutic use , Biological Therapy/adverse effects , Latent Tuberculosis/drug therapy , Tuberculosis/prevention & control , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal/therapeutic use , Antitubercular Agents/administration & dosage , Drug Monitoring , Hidradenitis Suppurativa/drug therapy , Humans , Immunity, Cellular , Latent Tuberculosis/diagnosis , Patient Selection , Psoriasis/drug therapy , Risk , T-Lymphocyte Subsets/immunology , Tuberculosis/drug therapy , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
Mannose-binding lectin (MBL) is a serum protein that activates the complement and mediates phagocytosis. MBL levels and MBL2 genotype may impact upon host susceptibility to tuberculosis (TB) disease but evidence to date has been conflicting. MBL2 exon 1 and promoter genotyping and serum MBL concentrations were determined in 79 patients with active tuberculosis (58 pulmonary TB and 21 extrapulmonary or miliary TB) and 120 household healthy contacts (HHC) from a Mediterranean area (Majorca Island, Spain). Significantly higher serum MBL levels were found in patients with active tuberculosis than in HHC [median MBL concentrations 3430 ng mL(-1) (10-28 415) and 2600 ng mL(-1) (5-20 000) respectively, P = 0.002]. These higher MBL levels were mainly related to the most prevalent YA/YA wild-type diplotype. There was a strong correlation between MBL2 exon 1 and promoter genotype and MBL levels. The diplotype LYQA/HYPA was present in 12 out of 57 of the pulmonary TB cases but in none of the extrapulmonary TB patients. Diplotype LXPA/HYPA, producer of high levels of MBL, was significantly more frequent in HHC than in patients (16.8% vs. 6.4%, P = 0.031) suggesting a protective role against the development of TB disease that has not been previously found.
Subject(s)
Exons/genetics , Genetic Predisposition to Disease/genetics , Mannose-Binding Lectin/genetics , Polymorphism, Single Nucleotide , Promoter Regions, Genetic/genetics , Tuberculosis/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Female , Gene Frequency , Genotype , Haplotypes , Humans , Male , Mannose-Binding Lectin/blood , Mediterranean Islands , Middle Aged , Spain , Tuberculosis/blood , Tuberculosis, Pulmonary/blood , Tuberculosis, Pulmonary/genetics , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Listeriosis/diagnosis , Listeria monocytogenes/isolation & purificationSubject(s)
Listeria monocytogenes/isolation & purification , Listeriosis/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Listeriosis/drug therapy , Listeriosis/physiopathology , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
Antecedentes y objetivo. La tuberculosis constituye un importante problema sanitario, también en nuestro medio. Este estudio sepropone describir las características clínicas y epidemiológicas de la tuberculosis cutánea en nuestro medio. Pacientes y métodos. Estudio retrospectivo de los casos de tuberculosis cutánea diagnosticados de enero de 2003 a julio de 2011 en un hospital de Mallorca. Se registraron las formas clínicas, la metodología diagnóstica empleada, el tratamiento utilizado y la evolución clínica. Resultados. Se diagnosticaron 28 casos de tuberculosis con afectación cutánea (5,9% del total de tuberculosis), tuberculosis verdadera en 15 casos (14 escrofulodermas, un empiema necessitatis) y tubercúlides en el resto (8 casos de eritema indurado de Bazin y 5 de eritema nodoso). El foco de origen de los escrofulodermas fue ganglionar (10), óseo (4) y pleural (1); 13/28 pacientes eran originarios de otros continentes. La mayoría de los pacientes fueron tratados con 3-4 fármacos tuberculostáticos, evolucionando favorablemente. Conclusión. La tuberculosis cutánea no es infrecuente en nuestro medio. En las tuberculosis cutáneas verdaderas el cultivo es el método diagnóstico más rentable, mientras que en las tubercúlides generalmente la histología es la que proporciona el diagnóstico(AU)
Background and objective. Tuberculosis is an important health care problem, even in our setting. The objective of this study is to describe clinic and epidemiological features of cutaneous tuberculosis in our area. Patients and methods. A retrospective study was performed of all patients diagnosed of cutaneous tuberculosis in a hospital in Mallorca (Spain) from January 2003 to July 2011. The clinical forms, diagnostic methods used, treatment used and clinical course were recorded. Results. Twenty-eight cases of cutaneous tuberculosis were diagnosed (5.9% of the tuberculosis cases diagnosed in this period), 15 with classic cutaneous tuberculosis (14 scrofuloderma, 1 empyema necessitatis) and 13 patients with tuberculids (8 erythema induratum of Bazin disease and 5 erythema nodosum). Scrofulodermas came from lymph nodes in 10 of the patients, infected bone in 4 and pleural in one case; 13/28 patients came from other continents. Most of the patients were treatment with 3-4 tuberculostatic drugs, with favorable course. Conclusions. Cutaneous tuberculosis is not uncommon in our setting. In classic cutaneous tuberculosis culture is the gold standard diagnostic method while tuberculids are most commonly diagnosed by histology(AU)
Subject(s)
Humans , Male , Female , Tuberculosis, Cutaneous/epidemiology , Tuberculosis, Cutaneous/prevention & control , Isoniazid/therapeutic use , Erythema Induratum/complications , Erythema Induratum/diagnosis , Erythema Nodosum/complications , Erythema Nodosum/diagnosis , Mycobacterium Infections, Nontuberculous/complications , Retrospective Studies , Comorbidity , Rifampin/therapeutic useABSTRACT
BACKGROUND AND OBJECTIVE: Tuberculosis is an important health care problem, even in our setting. The objective of this study is to describe clinic and epidemiological features of cutaneous tuberculosis in our area. PATIENTS AND METHODS: A retrospective study was performed of all patients diagnosed of cutaneous tuberculosis in a hospital in Mallorca (Spain) from January 2003 to July 2011. The clinical forms, diagnostic methods used, treatment used and clinical course were recorded. RESULTS: Twenty-eight cases of cutaneous tuberculosis were diagnosed (5.9% of the tuberculosis cases diagnosed in this period), 15 with classic cutaneous tuberculosis (14 scrofuloderma, 1 empyema necessitatis) and 13 patients with tuberculids (8 erythema induratum of Bazin disease and 5 erythema nodosum). Scrofulodermas came from lymph nodes in 10 of the patients, infected bone in 4 and pleural in one case; 13/28 patients came from other continents. Most of the patients were treatment with 3-4 tuberculostatic drugs, with favorable course. CONCLUSIONS: Cutaneous tuberculosis is not uncommon in our setting. In classic cutaneous tuberculosis culture is the gold standard diagnostic method while tuberculids are most commonly diagnosed by histology.
Subject(s)
Tuberculosis, Cutaneous/epidemiology , Adult , Aged , Antitubercular Agents/therapeutic use , Female , Humans , Male , Middle Aged , Retrospective Studies , Spain/epidemiology , Treatment Outcome , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/drug therapyABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Rhodococcus equi/isolation & purification , Pneumonia, Bacterial/microbiology , HIV Infections/complications , AIDS-Related Opportunistic Infections/microbiologySubject(s)
Actinomycetales Infections/etiology , HIV Infections/complications , Rhodococcus equi , Adult , Humans , MaleABSTRACT
We describe two new cases of Peptostreptococcus endocarditis, one case of Peptostreptococcus micros prosthetic valve endocarditis and the other of Peptostreptococcus assaccharolyticus tricuspid native valve endocarditis in an intravenous drug user (IDU) patient and review nine cases previously reported.
Subject(s)
Endocarditis, Bacterial/microbiology , Gram-Positive Bacterial Infections , Peptostreptococcus , Adult , Aged , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Adult , Pneumonia/complications , Pneumonia/diagnosis , Rhodococcus equi/isolation & purification , Rhodococcus equi/pathogenicity , HIV Infections/complications , HIV Infections/diagnosis , Radiography, Thoracic/methods , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Anti-Retroviral Agents/therapeutic use , Microbial Sensitivity Tests/methods , HIV Infections/physiopathology , HIV Infections , Bronchoscopy/methods , Hemoptysis/complications , Hemoptysis/diagnosis , Tomography, Emission-Computed/methods , Mycobacterium tuberculosis/isolation & purification , Mycobacterium tuberculosis/pathogenicity , Retrospective StudiesABSTRACT
Describimos dos nuevos casos de endocarditis por Peptostreptococcus, uno de ellos sobre válvula protésica y causado por P. micros, y otro caso de endocarditis tricuspídea por P. assacharolyticus en un paciente ADVP. Revisamos los 9 casos previamente publicados en la literatura de endocarditis causada por anaerobios del género Peptostreptococcus
We describe two new cases of Peptostreptococcus endocarditis, one case of Peptostreptococcus micros prosthetic valve endocarditis and the other of Peptostreptococcus assaccharolyticus tricuspid native valve endocarditis in an intravenous drug user (IDU) patient and review nine cases previously reported
Subject(s)
Humans , Male , Female , Middle Aged , Adult , Endocarditis/diagnosis , Endocarditis/epidemiology , Peptostreptococcus/isolation & purification , Peptostreptococcus/pathogenicity , Penicillins/therapeutic use , Aneurysm, Infected/complications , Aneurysm, Infected/diagnosis , Endocarditis/pathology , Mitral Valve/abnormalities , Mitral Valve/pathology , Mitral Valve Insufficiency/complications , Esophagus/pathology , Esophagus , Gram-Negative Anaerobic Cocci/isolation & purification , Endocarditis/complications , Endocarditis, Bacterial/complicationsSubject(s)
Actinomycetales Infections/etiology , HIV Infections/complications , Pneumonia, Bacterial/etiology , Rhodococcus equi , Actinomycetales Infections/diagnostic imaging , Actinomycetales Infections/drug therapy , Adult , Anti-Bacterial Agents/adverse effects , Antiviral Agents/adverse effects , Disease Progression , HIV Infections/drug therapy , Humans , Male , Pneumonia, Bacterial/diagnostic imaging , Pneumonia, Bacterial/drug therapy , RadiographySubject(s)
Granuloma, Plasma Cell , Adult , Aged , Female , Granuloma, Plasma Cell/diagnosis , Granuloma, Plasma Cell/therapy , Humans , Male , Middle Aged , Retrospective StudiesSubject(s)
Giant Cell Arteritis/complications , Guillain-Barre Syndrome/complications , Aged , Anti-Inflammatory Agents/therapeutic use , Female , Giant Cell Arteritis/therapy , Guillain-Barre Syndrome/therapy , Humans , Immunoglobulins, Intravenous/therapeutic use , Plasma Exchange , Steroids , Treatment OutcomeABSTRACT
No disponible
