Increase in the frequency of catheter-related bloodstream infections during the COVID-19 pandemic: a plea for control.

BACKGROUND: The incidence of nosocomial infections including ventilator-associated pneumonia and bacteraemia has been described during the COVID-19 pandemic. However, information regarding the impact of COVID-19 on the incidence of catheter-related bloodstream infections (CR-BSIs) is very limited. AIM: To evaluate the impact of the COVID-19 pandemic in the evolution of CR-BSIs in a large hospital. METHODS: This was a retrospective study comparing the incidence, aetiology and outcome of CR-BSIs during the months of March to May 2019 (pre-pandemic) and 2020 (during the pandemic). FINDINGS: The number of patients with one or more CR-BSIs in 2019 and 2020 were 23 and 58, respectively (1.89 vs 5.53/1000 admissions); P<0.001. Median time from catheter implantation to demonstration of CR-BSI was 27.5 days (range 11.75-126.00 days) in the 2019 cases and 16.0 days (range 11.00-23.50 days) in the 2020 population (P=0.032). CONCLUSIONS: A dramatic increase of CR-BSIs was found during the COVID-19 pandemic. Reinforcement of classic and new preventive measures is necessary.

Continuous intravenous versus intermittent ampicillin therapy of experimental endocarditis caused by aminoglycoside-resistant enterococci.

We studied the efficacy of continuous intravenous infusion of ampicillin compared with that of intermittent administration of ampicillin alone or in combination with gentamicin for the therapy of highly aminoglycoside-resistant enterococcal experimental endocarditis. Rabbits were infected with a gentamicin-susceptible (MIC, 256 micrograms/ml) strain of Enterococcus faecalis or a strain of E. faecalis which was highly resistant to gentamicin in vitro (MIC, greater than 2,000 micrograms/ml). Administration of ampicillin by continuous intravenous infusion did not significantly enhance the killing of enterococci in vivo compared with that by intermittent administration of ampicillin for either the aminoglycoside-susceptible or the aminoglycoside-resistant strain. In combination with gentamicin, there were no significant differences in efficacies obtained with intermittent versus continuous intravenous infusion of ampicillin therapy for experimental endocarditis caused by either strain of E. faecalis.

[Bacteremic pneumonia caused by Rhodococcus equi and HIV infection. Report of a new case and review of the literature]. / Neumonía bacteriémica por Rhodococcus equi e infección por VIH. Comentario de un nuevo caso y revisión de la literatura.

Rhodococcus equi (Corynebacterium equi) is able to produce infections not only in animals but also in patients, usually immunosuppressed ones. We report a new case of bacteremic pneumonia in a drug addict who was also infected by HIV. X-ray film of the chest showed a cavitated infiltrate in right upper lobe. R. equi was recovered from blood, respiratory secretions and lung tissue. The patient was with a prolonged course of antibiotics and also surgical treatment. In spite of both therapies, the patient died. We believe that this infection has to be considered in HIV infected patients with cavitated pneumonia and that early surgical treatment, combined with a prolonged course of multiple antibiotics, is advisable. Finally, in view of the severity of this infection, and its relation with other opportunistic infections, we believe that could be included as AIDS diagnostic criteria.