Asunto(s)
Antifúngicos/uso terapéutico , Candida glabrata/efectos de los fármacos , Candidiasis/tratamiento farmacológico , Equinocandinas/uso terapéutico , Fungemia/tratamiento farmacológico , Huésped Inmunocomprometido , Leucemia/inmunología , Adulto , Anidulafungina , Candida glabrata/aislamiento & purificación , Candidiasis/inmunología , Candidiasis/microbiología , Candidiasis/prevención & control , Farmacorresistencia Fúngica , Femenino , Fungemia/inmunología , Fungemia/microbiología , Fungemia/prevención & control , Humanos , Leucemia/complicaciones , Masculino , Persona de Mediana Edad , Eslovaquia , Resultado del Tratamiento , Triazoles/uso terapéuticoAsunto(s)
Anticoagulantes/administración & dosificación , Endocarditis Bacteriana/epidemiología , Heparina/administración & dosificación , Diálisis Renal/efectos adversos , Anciano , Anciano de 80 o más Años , Embolia/prevención & control , Humanos , Persona de Mediana Edad , Eslovaquia/epidemiología , Trombosis/prevención & controlAsunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Terapia Antirretroviral Altamente Activa , Farmacorresistencia Bacteriana/inmunología , Infecciones por Enterobacteriaceae/epidemiología , Infecciones por Klebsiella/complicaciones , Infecciones Oportunistas/complicaciones , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/inmunología , Antibacterianos/farmacología , Cambodia , Cefotaxima/farmacología , Niño , Enterobacter , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/inmunología , Humanos , Klebsiella , Infecciones por Klebsiella/epidemiología , Infecciones por Klebsiella/inmunología , Infecciones Oportunistas/inmunologíaRESUMEN
Etiology, risk factors, treatment and outcome of 21 cases of bacterial meningitis diagnosed in excessive alcohol consumers within 5 years of national community acquired meningitis survey in Slovakia is reported.
Asunto(s)
Alcoholismo/complicaciones , Alcoholismo/epidemiología , Meningitis Bacterianas/complicaciones , Meningitis Bacterianas/epidemiología , Adulto , Infecciones Comunitarias Adquiridas/epidemiología , Encuestas Epidemiológicas , Humanos , Masculino , Meningitis Neumocócica/complicaciones , Meningitis Neumocócica/epidemiología , Factores de Riesgo , Eslovaquia/epidemiología , Resultado del TratamientoRESUMEN
Data on both positive (protective) and negative effect of wine on cardiovascular, neurologic and immune system are briefly reviewed.
Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Enfermedades Cardiovasculares/epidemiología , Infecciones/epidemiología , Enfermedades del Sistema Nervioso/epidemiología , Vino , Humanos , Sistema Inmunológico/efectos de los fármacos , Salud Mental , Vino/efectos adversosRESUMEN
There was a significant difference in occurrence of coronary hearth disease and arterial hypertension occurrence in the sample of 16,345 patients living in northeast part of Slovak republic near Polish frontier versus to the viticulture regions of Nove Zamky, Sturovo in favour of villages in Bardejov region. Another difference was that 80 years and older respondents live significantly more frequently in south Slovakian viticulture villages.
Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Bebidas Alcohólicas , Enfermedad Coronaria/epidemiología , Hipertensión/epidemiología , Vino , Anciano , Anciano de 80 o más Años , Bases de Datos Factuales , Humanos , Longevidad/efectos de los fármacos , Eslovaquia/epidemiología , Encuestas y CuestionariosRESUMEN
The aim of this study was to assess mortality and sequellae within cases from Nationwide survey of community acquired meningitis and identify risk factors for inferior outcome. Risk factors such as underlying disease (diabetes mellitus, cancer, trauma, neonatal age, splenectomy, alcoholism, sepsis, other infections), etiology, clinical symptoms and outcome (death, improvement and cured after modifications of ATB therapy, cured without change of therapy, cured with neurologic sequellae) were recorded and analysed with univariate analysis (chi2 or t test for trends, CDC Atlanta 2004). Analysing risk factors for inferior outcome (death or cured with neurologic sequellae), we compared patients who died or survived with neurologic sequellae to all patients with community acquired bacterial meningitis. Univariate analysis showed that trauma (p<0.05), alcohol abuse (p<0.05), diabetes, S. aureus (p<0.05) and gram-negative etiology (A. baumannii, Ps. aeruginosa or Enterobacteriaceae) (36% vs. 11,9%, p<0.05) were predicting inferior outcome. Analysing risk factors for treatment failure (death or failed but cured after change of antibiotic treatment) prior sepsis (34.1% vs. 13.9%, p<0.01) and gram-negative etiology (25% vs. 11.9%, p<0.02) were statistically significant predictors of treatment failure. Neisseria meningitis had less failures (p<0.05). Concerning infection associated mortality again diabetes mellitus (p<0.05), alcoholism (p<0.05) staphylococcal and gram-negative etiology (p<0.05) were significant predictors of death. N. meningitis had surprisingly less treatment failures (appropriate and rapid initial therapy). Neurologic sequellae were more common in patients with alcohol abuse (p<0.05), craniocerbral trauma (p<0.05) and less common in meningitis with pneumococcal etiology (p<0.05).
Asunto(s)
Alcoholismo/complicaciones , Daño Encefálico Crónico/etiología , Lesiones Encefálicas/complicaciones , Infecciones por Bacterias Gramnegativas/complicaciones , Meningitis Bacterianas/terapia , Alcoholismo/mortalidad , Lesiones Encefálicas/mortalidad , Distribución de Chi-Cuadrado , Infecciones Comunitarias Adquiridas/complicaciones , Infecciones Comunitarias Adquiridas/mortalidad , Infecciones Comunitarias Adquiridas/terapia , Diabetes Mellitus , Infecciones por Bacterias Gramnegativas/mortalidad , Infecciones por Bacterias Gramnegativas/terapia , Humanos , Meningitis Bacterianas/complicaciones , Meningitis Bacterianas/mortalidad , Factores de Riesgo , Eslovaquia , Insuficiencia del TratamientoRESUMEN
The aim of this study was to assess if differences in etiology and risk factors among 372 cases of bacterial meningitis acquired after surgery (PM) or in community (CBM) have impact on outcome of infected patients. Among 372 cases of bacterial meningitis within last 17 years from 10 major Slovak hospitals, 171 were PM and 201 CBM. Etiology, risk factors such as underlying disease, cancer, diabetes alcoholism, surgery, VLBW, ENT infections, trauma, sepsis were recorded and mortality, survival with sequellae, therapy failure were compared in both groups. Significant differences in etiology and risk factors between both groups were reported. Those after neurosurgery had more frequently Coagulase negative staphylococci (p<0.001), Enterobacteriaceae (p=0.01) and Acinetobacter baumannii (p=0.0008) isolated from CSF and vice versa Streptococcus pneumoniae (p<0.001), Neisseria meningitis (p<0.001) and Haemophillus influenza (p=0.0009) were more commonly isolated from CSF in CBM. Neurosurgery (p<0.001), sepsis (p=0.006), VLBW neonates (p=0.00002) and cancer (p=0.0007) were more common in PM and alcohol abuse (p<0.001) as well as otitis/sinusitis (p<0.001) and Roma ethnic group (p=0.001) in CAM. Initial treatment success was significantly more frequently observed among CAM (p<0.001) but cure after modification was more common in PM (p=0.002). Therefore outcome in both groups was similar (14.6% vs. 12.4%, p=NS).
Asunto(s)
Infección Hospitalaria/mortalidad , Meningitis Bacterianas/mortalidad , Complicaciones Posoperatorias/mortalidad , Infecciones Comunitarias Adquiridas/complicaciones , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/mortalidad , Infección Hospitalaria/complicaciones , Infección Hospitalaria/microbiología , Humanos , Meningitis Bacterianas/etiología , Meningitis Bacterianas/microbiología , Meningitis Bacterianas/terapia , Procedimientos Neuroquirúrgicos/efectos adversos , Complicaciones Posoperatorias/microbiología , Factores de Riesgo , Eslovaquia/epidemiología , Estadísticas no Paramétricas , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
Craniocerebral trauma is one of major risk factors for development of meningitis. We reviewed 30 cases of bacterial meningitis occurring in community after craniocerebral trauma. Alcohol abuse was significant risk factor occurring in trauma patients with meningitis present in 50% in our cohort (p=0.0001). The most common pathogen in posttraumatic meningitis was Str. pneumoniae (90% vs. 33.8%, p=0.0001). However mortality was very low, only 5% probably because of early diagnosis and treatment of patients at risk for bacterial meningitis but neurologic sequellea were significantly more common (p=0.00001) in patients after craniocerebral trauma.
Asunto(s)
Trastornos Relacionados con Alcohol/complicaciones , Traumatismos Craneocerebrales/complicaciones , Meningitis Bacterianas/etiología , Antibacterianos/uso terapéutico , Bacterias/clasificación , Bacterias/patogenicidad , Daño Encefálico Crónico/etiología , Daño Encefálico Crónico/prevención & control , Estudios de Cohortes , Infecciones Comunitarias Adquiridas/etiología , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/mortalidad , Infecciones Comunitarias Adquiridas/terapia , Humanos , Meningitis Bacterianas/microbiología , Meningitis Bacterianas/mortalidad , Meningitis Bacterianas/terapia , Evaluación de Resultado en la Atención de Salud , Factores de RiesgoRESUMEN
We investigated how many cases of bacterial meningitis in our national survey were associated with sinusitis or otitis media. Among 372 cases of bacterial meningitis within our nationwide 17 years survey, 201 cases were community acquired (CBM) and in 40 (20%) otitis media or sinusitis acuta/chronica were reported 1-5 weeks before onset of CBM. Diabetes mellitus (20% vs. 7.5%, p=0.01), alcohol abuse (35% vs. 15.4%, p=0.003) and trauma (30% vs. 14.9%, p=0.02) were significantly associated with CBM after ENT infections. Concerning etiology, CBM after sinusitis/otitis was insignificantly associated with pneumococcal etiology (50% vs. 33.8 %, NS) and significantly associated with other (L. monocytogenes, Str. agalactiae) bacterial agents (9.9 % vs. 25 %, p=0.008) . However those significant differences for new ENT related CBM had no impact on mortality (12.4 % vs. 5%, NS), failure after initial antibiotics (10 % vs. 9.5%, NS) and neurologic sequellae (12.5 % vs. 15.4 %, NS).
Asunto(s)
Meningitis Bacterianas/etiología , Otitis Media/complicaciones , Sinusitis/complicaciones , Trastornos Relacionados con Alcohol/complicaciones , Antibacterianos/uso terapéutico , Infecciones Comunitarias Adquiridas/etiología , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/mortalidad , Infecciones Comunitarias Adquiridas/terapia , Complicaciones de la Diabetes , Humanos , Meningitis Bacterianas/microbiología , Meningitis Bacterianas/mortalidad , Meningitis Bacterianas/terapia , Otitis Media/microbiología , Evaluación de Resultado en la Atención de Salud , Factores de Riesgo , Sinusitis/microbiología , Heridas y Lesiones/complicacionesRESUMEN
The aim of this short note is to assess gram-negative bacillary community acquired meningitis (CBM) and nosocomial meningitis (NM) within 17 years nationwide survey. All cases of gram-negative bacillary CBM within 1990-2007 were assessed in national database of 372 patients with bacterial meningitis: 69 of gram-negative cases were nosocomial and 24 of gram-negative meningitis cases were CBM. Those 24 cases were compared with all CBM (201 cases) for risk factors and outcome. Among nosocomial gram-negative pathogens, A. baumannii in 23 cases, Ps. aeruginosa in 15 cases and Enterobacteriaceae in 31 cases were isolated. Among CBM, in 13 cases Enterobacteriaceae (Escherichia coli 6, Klebsiella pneumoniae 3, Proteus mirabilis 2, Enterobacter cloacae 2), in 5 cases Ps. aeruginosa and in 6 cases Acinetobacter baumannii were isolated from cerebrospinal fluid (CSF). The only significant risk factor for CBM due to gram-negative bacilli was neonatal age (12.5% vs. 3.5%, p=0.04) as underlying disease. However, mortality among gram-negative bacillary meningitis was significantly higher (12.4% vs. 37.5%, p=0.001) in comparison to other meningitis.
Asunto(s)
Infección Hospitalaria/microbiología , Infecciones por Bacterias Gramnegativas/complicaciones , Meningitis Bacterianas/complicaciones , Distribución de Chi-Cuadrado , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/mortalidad , Bacterias Gramnegativas/clasificación , Infecciones por Bacterias Gramnegativas/mortalidad , Humanos , Recién Nacido , Meningitis Bacterianas/microbiología , Meningitis Bacterianas/mortalidad , Evaluación de Resultado en la Atención de Salud , Enfermedades Raras , Factores de RiesgoRESUMEN
Listeria monocytogenes is not a rare pathogen causing meningitis, mainly in small children and in close contacts to livestock. The pathogen is naturally resistant to cephalosporins and some glycopeptides as well, therefore despite of syndromologic diagnosis of meningitis and initial therapy with 3rd generation cephalosporins according to the guidelines therapeutic failures with clinical consequences may occur.
Asunto(s)
Ampicilina/uso terapéutico , Antibacterianos/uso terapéutico , Listeriosis/microbiología , Meningitis Bacterianas/microbiología , Adulto , Anciano , Cefotaxima/uso terapéutico , Farmacorresistencia Bacteriana , Femenino , Humanos , Listeriosis/tratamiento farmacológico , Listeriosis/mortalidad , Masculino , Meningitis Bacterianas/tratamiento farmacológico , Meningitis Bacterianas/mortalidad , Persona de Mediana Edad , Evaluación de Resultado en la Atención de SaludAsunto(s)
Infección Hospitalaria/epidemiología , Meningitis/epidemiología , Procedimientos Neuroquirúrgicos/efectos adversos , Periodo Posoperatorio , Infecciones Estreptocócicas/epidemiología , Infección de la Herida Quirúrgica/epidemiología , Infección Hospitalaria/líquido cefalorraquídeo , Infección Hospitalaria/microbiología , Bacterias Gramnegativas/clasificación , Bacterias Gramnegativas/aislamiento & purificación , Humanos , Meningitis/líquido cefalorraquídeo , Meningitis/microbiología , Eslovaquia/epidemiología , Infección de la Herida Quirúrgica/microbiologíaRESUMEN
Despite of 10 years vaccination of all children within 1st year in Slovakia against H. influenzae, this severe infection still occurs. Among 201 cases of community acquired bacterial meningitis, 14 (7%) were caused by H. influenzae serotype B. Outcome however, after early institution of treatment was fortunately positive - only 1 patient died (7.1% mortality) and in 2 other neurologic sequellae occurred (14.3%), which were transient and mild.
Asunto(s)
Haemophilus influenzae tipo b , Programas de Inmunización , Meningitis por Haemophilus/epidemiología , Niño , Preescolar , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/prevención & control , Humanos , Lactante , Meningitis por Haemophilus/prevención & control , Evaluación de Resultado en la Atención de Salud , Eslovaquia/epidemiologíaRESUMEN
We performed a prospective point prevalence study with a simple prospective protocol and analyzed spectrum of infections (ID) etiology and antimicrobial therapy in all cases coming for one month (June 2006). Respiratory tract infections represented 33% of all visits followed by diarrheal infections (197 cases) and sexually transmitted disease (86), skin and soft tissue infection (68), AIDS (40) and malaria (26) cases. Majority of isolates were St. aureus (only 3 MRSA), C. albicans and NAC (19), (only 2 Fluconazol resistant) and S. pneumoniae (8) (2 penicillin resistant).
Asunto(s)
Antiinfecciosos/uso terapéutico , Enfermedades Transmisibles/epidemiología , Diarrea/epidemiología , Vigilancia de la Población , Enfermedades Respiratorias/epidemiología , Antiinfecciosos/clasificación , Enfermedades Transmisibles/clasificación , Enfermedades Transmisibles/tratamiento farmacológico , Estudios Transversales , Diarrea/tratamiento farmacológico , Diarrea/microbiología , Humanos , Kenia/epidemiología , Áreas de Pobreza , Prevalencia , Estudios Prospectivos , Enfermedades Respiratorias/tratamiento farmacológico , Enfermedades Respiratorias/microbiologíaRESUMEN
In 1993-1998 and in 1999-2004 we have performed two surveys of pediatric bacterial meningitis in all 8 neurosurgery/pediatrics and infectious diseases departments in Slovakia. We have detected 101 and another 54 cases with attributable mortality of 15% and sequellae in 18%.
Asunto(s)
Infección Hospitalaria/epidemiología , Infecciones por Bacterias Gramnegativas/epidemiología , Meningitis Bacterianas/epidemiología , Infecciones Estafilocócicas/epidemiología , Niño , Preescolar , Infección Hospitalaria/mortalidad , Infección Hospitalaria/terapia , Recolección de Datos , Infecciones por Bacterias Gramnegativas/terapia , Humanos , Lactante , Recién Nacido , Meningitis Bacterianas/microbiología , Meningitis Bacterianas/mortalidad , Meningitis Bacterianas/terapia , Factores de Riesgo , Eslovaquia/epidemiología , Infecciones Estafilocócicas/terapia , Resultado del TratamientoAsunto(s)
Antibacterianos/uso terapéutico , Infección Hospitalaria/mortalidad , Meningitis Bacterianas/mortalidad , Aminoglicósidos/uso terapéutico , Carbapenémicos/uso terapéutico , Niño , Preescolar , Infección Hospitalaria/tratamiento farmacológico , Quimioterapia Combinada , Humanos , Lactante , Recién Nacido , Meningitis Bacterianas/tratamiento farmacológico , Estudios Retrospectivos , Insuficiencia del Tratamiento , Vancomicina/uso terapéutico , beta-Lactamas/uso terapéuticoRESUMEN
Twenty five (25) cases of nosocomial postsurgical meningitis due to Acinetobacter baumannii meningitis were compared to other 146 cases of meningitis after surgery caused by other pathogens. Prior neurosurgical ventriculo-peritoneal shunt insertion and CNS abnormality as well as very low birth weight were significant risk factors for acquisition of Acinetobacter baumannii meningitis. Mortality - 40% among children with nosocomial meningitis was unacceptably high and significantly higher than among meningitis caused by microorganisms other than Acinetobacter baumannii.
Asunto(s)
Infecciones por Acinetobacter/mortalidad , Acinetobacter baumannii/aislamiento & purificación , Infección Hospitalaria/microbiología , Meningitis Bacterianas/microbiología , Infección de la Herida Quirúrgica/microbiología , Infecciones por Acinetobacter/tratamiento farmacológico , Acinetobacter baumannii/inmunología , Antibacterianos/uso terapéutico , Sistema Nervioso Central/anomalías , Sistema Nervioso Central/patología , Niño , Preescolar , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/mortalidad , Humanos , Recién Nacido , Recién Nacido de muy Bajo Peso/inmunología , Meningitis Bacterianas/tratamiento farmacológico , Meningitis Bacterianas/mortalidad , Factores de Riesgo , Infección de la Herida Quirúrgica/tratamiento farmacológico , Infección de la Herida Quirúrgica/mortalidad , Derivación Ventriculoperitoneal/efectos adversosRESUMEN
Risk factors, therapy and outcome of 15 cases of nosocomial meningitis due to Pseudomonas aeruginosa is reviewed. No difference in risk factors was found, however mortality for Ps. aeruginosa was significantly higher (33.3 vs 15.1% p<0.04).
Asunto(s)
Antibacterianos/uso terapéutico , Infección Hospitalaria/microbiología , Meningitis Bacterianas/microbiología , Infecciones por Pseudomonas/mortalidad , Adolescente , Cefotaxima/uso terapéutico , Ceftazidima/uso terapéutico , Distribución de Chi-Cuadrado , Preescolar , Cloranfenicol/uso terapéutico , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/mortalidad , Quimioterapia Combinada , Femenino , Gentamicinas/uso terapéutico , Humanos , Lactante , Recién Nacido , Masculino , Meningitis Bacterianas/tratamiento farmacológico , Meningitis Bacterianas/mortalidad , Meropenem , Infecciones por Pseudomonas/tratamiento farmacológico , Estudios Retrospectivos , Factores de Riesgo , Análisis de Supervivencia , Tienamicinas/uso terapéuticoRESUMEN
Analysing 101 cases of nosocomial meningitis due to staphylococci other than S. aureus within last 15 years, coagulase negative staphylococci represented the commonest pathogen. Major risk factor for staphylococcal meningitis was prior neurosurgery, mainly ventriculoperitoneal shunt insertion. Ten of 101 cases were caused by glycopeptide intermediate resistant strains in patients pretreated with multiple combination of antibiotics including vancomycin and shunt exchanges: 76% of strains were also oxacillin resistant.