Orbital cellulitis and endogenous endophthalmitis secondary to Proteus mirabilis cholecystitis.

We report the first case of orbital cellulitis and endogenous endophthalmitis secondary to Proteus mirabilis bacteremia that resulted from a calculus cholecystitis. Despite resolution of the gallbladder infection with antimicrobial therapy, the patient required evisceration of the affected eye. The pathogenesis of hematogenous endophthalmitis due to Gram-negative bacilli is discussed.

[Prosthetic joint infection: a prospective study in five Catalonian hospitals]. / Infección de prótesis articulares: estudio prospectivo en 5 hospitales de Cataluña.

BACKGROUND: Prosthetic joint infections are a cause of increasing morbidity and medical expenditure. OBJECTIVES: To determine the incidence and the clinical and the epidemiological characteristics of knee and hip prosthetic infections (PI) in patients undergoing elective surgery in five Catalonian hospitals. To determine the predictive factors of PI. METHODS: A total of 425 patients operated on between 8 January and 8 July 2001 were prospectively followed for a period of two years. The cumulative incidence, incidence rate and effect measures were determined. Logistic regression was used to identify variables associated with PI. RESULTS: Average age was 71 years and 63.1% were women. Antibiotic prophylaxis with cefazolin was given to 44.7% of the patients, with a mean duration of two days. Prophylaxis was administered during anesthesia induction in 75.6% of the patients. Among the total, 63.4% of the patients were ASA 2. Microbiological confirmation was obtained in all the infected patients; Staphylococcus epidermidis was found in 58%. Fourteen PI were diagnosed, 71% during the first 3 months, with a cumulative incidence of 3.29% and a 3-month incidence rate of 63 patients/10,000 patients/month. Diabetes mellitus was the only variable related to PI in the multivariate analysis: 3.18, 95% CI (1.1-9.9). CONCLUSIONS: The cumulative incidence of PI was slightly higher than that seen in other studies. Variations were observed in the antibiotic used for prophylaxis, and the place where it was administered. PI occurred 3.18 times more frequently in diabetic patients.

Infección de prótesis articulares: estudio prospectivo en 5 hospitales de Cataluña / Prosthetic joint infection: A prospective study in five Catalonian hospitals

Antecedentes. Las infecciones de prótesis (IP) articulares son causa de morbilidad y aumento del gasto. Objetivos. Conocer la incidencia y características clínicas y epidemiológicas de las IP de cadera y rodilla, en pacientes intervenidos en cinco hospitales. Identificar factores predictores. Métodos. Se identificaron prospectivamente 425 pacientes intervenidos entre el 8 de enero y el 8 de julio de 2001. Se realizó un seguimiento de 2 años. Se determinaron la incidencia acumulada (IA), tasa de incidencia (TI) y medidas de efecto. Para identificar variables relacionadas con la IP se realizó una regresión logística. Resultados. La edad media fue de 71 años; el 63,1% fueron mujeres. En el 44,7% se realizó profilaxis antibiótica con cefazolina, con una duración media de 2 días. Se administró durante la inducción anestésica en el 75,6%. El 63,4% de los pacientes tenían un ASA 2. Se obtuvo confirmación microbiológica en todos, aislándose Staphylococcus epidermidis en el 58%. Se diagnosticaron 14 IP, 71% de ellas en el primer trimestre; con una IA acumulada a los 2 años del 3,29%, una tasa de incidencia a los 3 meses de 63 casos por 10.000 sujetos/mes de exposición. En el análisis multivariado la diabetes mellitus fue la única variable relacionada con la IP (OR: 3,18; IC 95%: 1,1-9,9). Conclusiones. La IA de la IP es algo superior que en otros estudios. Se evidencia una variabilidad en el antibiótico utilizado en la profilaxis y en el lugar de administración. La IP es 3,18 veces más frecuente en pacientes diabéticos (AU)

Background. Prosthetic joint infections are a cause of increasing morbidity and medical expenditure. Objectives. To determine the incidence and the clinical and the epidemiological characteristics of knee and hip prosthetic infections (PI) in patients undergoing elective surgery in five Catalonian hospitals. To determine the predictive factors of PI. Methods. A total of 425 patients operated on between 8 January and 8 July 2001 were prospectively followed for a period of two years. The cumulative incidence, incidence rate and effect measures were determined. Logistic regression was used to identify variables associated with PI. Results. Average age was 71 years and 63.1% were women. Antibiotic prophylaxis with cefazolin was given to 44.7% of the patients, with a mean duration of two days. Prophylaxis was administered during anesthesia induction in 75.6% of the patients. Among the total, 63.4% of the patients were ASA 2. Microbiological confirmation was obtained in all the infected patients; Staphylococcus epidermidis was found in 58%. Fourteen PI were diagnosed, 71% during the first 3 months, with a cumulative incidence of 3.29% and a 3-month incidence rate of 63 patients/10,000 patients/month. Diabetes mellitus was the only variable related to PI in the multivariate analysis: 3.18, 95% CI (1.1-9.9). Conclusions. The cumulative incidence of PI was slightly higher than that seen in other studies. Variations were observed in the antibiotic used for prophylaxis, and the place where it was administered. PI occurred 3.18 times more frequently in diabetic patients (AU)