Subject(s)
Humans , Female , Infant , Bacteremia , Kingella kingae , Stomatitis, Herpetic , Inpatients , Physical Examination , Symptom Assessment , Arthritis, Infectious , Microbiology , Communicable Diseases , Child HealthABSTRACT
PURPOSE: To analyze the relationship between intraoperative cultures and the development of surgical site infection (SSI) in women undergoing laparotomy for gynecological surgery. METHODS: Prospective observational cohort study. Over a six-year period, women who underwent elective laparotomy at our hospital were included. Patients' demographics, underlying co-morbidities, surgical variables, type and etiology of postoperative surgical site infections were collected. Skin and subcutaneous samples were taken just prior to skin closure and processed for microbiological analysis. Univariate and multivariate analyses (logistic regression model) were conducted to explore the association of the studied variables with SSIs. RESULTS: 284 patients were included in our study, of which 20 (7%) developed surgical site infection, including 11 (55%) superficial and nine (45%) organ-space. At univariate analysis, length of surgery, colon resection, transfusion and positive intraoperative culture were associated with surgical site infection occurrence. Skin and subcutaneous cultures were positive in 25 (8.8%) and 20 (7%) patients, respectively. SSI occurred in 35% of women with positive subcutaneous culture and in 20% of those with positive skin cultures. Using multivariate analysis, the only independent factor associated with surgical site infection was a positive subcutaneous culture (OR 10.4; 95% CI 3.5-30.4; P<0.001). CONCLUSION: Intraoperative subcutaneous cultures before skin closure may help early prediction of surgical site infection in open gynecological procedures.
Subject(s)
Bacteria/isolation & purification , Intraoperative Care , Laparotomy/adverse effects , Surgical Wound Infection/etiology , Adult , Aged , Bacteria/growth & development , Bacteriological Techniques , Cell Culture Techniques , Female , Humans , Middle Aged , Prognosis , Prospective Studies , Risk Factors , Skin/microbiology , Subcutaneous Fat/microbiology , Surgical Wound Infection/diagnosis , Surgical Wound Infection/microbiologyABSTRACT
Effectiveness of amphotericin B alone or in combination with rifampicin or clarithromycin on the killing of Candida species biofilms was investigated in vitro. Amphotericin B was assayed at 0.005 to 10 mg/ml. Rifampin and clarithromycin were assayed at 10 mg/ml. We studied 7 Candida albicans, 3 Candida parapsilosis, 3 Candida glabrata, 3 Candida krusei and 2 Candida tropicalis strains. Biofilms were developed in 96-well, flat-bottomed microtiter plates for 48 hours. A synergistic effect between amphotericin B and clarithromycin was demonstrated against 66.6% of C. parapsilosis, 66.6% of C. glabrata, and 42.8% of C. albicans biofilms. A synergistic effect between amphotericin B and rifampin was demonstrated against 66.6% of C. parapsilosis, 42.8% of C. albicans, and 33.3% of C. glabrata biofilms. No synergistic effect was observed against C. krusei or C. tropicalis biofilms with any of the combinations. Rifampin or clarithromycin alone did not exert any effect on Candida species biofilms. Rifampin or clarithromycin combinations with amphotericin B might be of interest in the treatment of Candida biofilm-related infections.
Subject(s)
Amphotericin B/pharmacology , Anti-Bacterial Agents/pharmacology , Biofilms/drug effects , Candida/drug effects , Clarithromycin/pharmacology , Rifampin/pharmacology , Biofilms/growth & development , Candida/growth & development , Dose-Response Relationship, Drug , Drug Synergism , Drug Therapy, CombinationABSTRACT
OBJECTIVE: The purpose of this study is to evaluate the efficacy of antibiotic lock therapy to treat port-related enterococci, Gram-negative, or Gram-positive bacilli bloodstream infections. PATIENTS AND METHODS: We conducted a prospective observational study including all patients with port-related bacteremia diagnosed at the Clinica Universitaria de Navarra, Pamplona, Spain. During a 36-month period, 110 patients were diagnosed with port-related bacteremia. Of these patients, 18 met criteria to be enrolled in the study. They were treated with a combination of systemic and antibiotic lock therapy (12-24 h/day during 7-14 days). Treatment effectiveness was assessed by clinical and microbiologic criteria. RESULTS: Treatment was associated with clinical and microbiologic success in 88.8% of our patients (2/2 of the Propionibacterium acnes, 5/5 of the Corynebacterium spp., 6/7 of the Gram-negative bacillus, and 3/4 of the Enterococcus faecium port-related bloodstream infections). Mean increase of port life span for all patients after bacteremia was 288 days (range, 0-1403 days). CONCLUSION: Antibiotic lock therapy combined with systemic antibiotics appears to be a safe and effective treatment of port-related bacteremia caused by enterococci, Gram-negative, or Gram-positive bacilli if the patient is stable and no septic syndrome is associated.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Catheters, Indwelling/adverse effects , Gram-Negative Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/drug therapy , Adolescent , Adult , Aged , Bacteremia/etiology , Bacteremia/microbiology , Catheters, Indwelling/microbiology , Female , Gram-Negative Bacteria/drug effects , Gram-Negative Bacterial Infections/etiology , Gram-Positive Bacteria/drug effects , Gram-Positive Bacterial Infections/etiology , Humans , Male , Middle Aged , Prospective Studies , Treatment Outcome , Vancomycin/therapeutic useABSTRACT
The 1st reported case of breast implant-associated infection due to Granulicatella adiacens, formerly known as nutritionally variant streptococci, Streptococcus adiacens, and Abiotrophia adiacens is presented. Microbiology and previously reported cases of infections by this organism are reviewed.
