RESUMO
OBJECTIVE: Analysis of Enterococcus faecalis bacteremia epidemiological, clinical, microbiological and prognostic characteristics. METHODS: Retrospective analysis of clinical records of patients with E. faecalis bacteremia throughout 7 years (January 1995-December 2001). RESULTS: 95 episodes of bacteremia were documented, 83.2% with nosocomial origin, 85.3% associated to previous invasive procedures and 9.5% in neonates. 57.9% patients suffered an underlying disease and 41.1% had received previously broad-spectrum antibiotics without activity against enterococcus. 32.6% bacteremia episodes was considered primary and, in the rest, the most frequent associated sources of infection were cardiovascular, intra-abdominal, urogenital, and lung. The resistance study showed a single case of resistance to ampicillin and none to glucopeptides. Global mortality was 23.9%, although only in 9.9% was directly attributable to bacteremia. Inadecuate treatment and mechanical ventilation were factors of poor prognosis in the multivariate analysis. CONCLUSIONS: E. faecalis bacteremia is in our environment essentially a hospital-acquired infection in patients with severe underlying diseases, subject to invasive procedures, and previously treated with wide spectrum antibiotherapy. Ampicillin continues to be the treatment of choice. Inappropriateness of the initial empirical antibiotic treatment and mechanical ventilation are factors of poor prognosis.
Assuntos
Bacteriemia/microbiologia , Enterococcus faecalis/isolamento & purificação , Infecções por Bactérias Gram-Positivas/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/epidemiologia , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Feminino , Infecções por Bactérias Gram-Positivas/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Análise Multivariada , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
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Assuntos
Pessoa de Meia-Idade , Masculino , Feminino , Humanos , Kingella kingae , Infecções por Neisseriaceae , Artrite Infecciosa , Tornozelo , Adenocarcinoma , Endocardite Bacteriana , Doença de Paget Extramamária , Neoplasias Cutâneas , Neoplasias do ÂnusRESUMO
Chronic granulomatous disease (CGD) is an heterogeneous inherited disorder where the microbicidal phagocytic properties of leukocytes are impaired. Patients with CGD are prone to severe ious with many microorganisms such as Aspergillus spp (1,2). Recently, interferon gamma (IFN-8) which significantly reduces the frequency of infections in these patients, has been proved useful (3,4). We present our experience with the clinical use of these cytoscine. A 26-year-old woman with CGD suffered recement multiple brain abscesses by Aspergillus fumigatus treated in many occasions with surgical drainage. Since treatment with IFN-8 was started, two years ago, she is well and asymptomatic until the moment.
