Late onset prosthetic joint infection caused by Parvimonas micra.

Parvimonas micra (P.micra) is a difficult to culture gram positive anaerobic microorganism, typically found in the human microbiota, specially in the oral cavity. There are limited cases in literature reporting prosthetic joint infection due to this bacteria, although its isolation has been reported in different settings in later years. We present the case of a late onset knee prosthetic joint infection caused by Parvimonas micra in an 87 year old woman treated with antibiotics and two-step surgery with prosthetic material removal, antibiotic-loaded cement spacer placement and new prosthetic material replacement after 2 weeks of intravenous antimicrobial therapy followed by 6 weeks of oral therapy.

Outpatient Parenteral Antimicrobial Therapy With Ceftolozane/Tazobactam via Continuous Infusion for Multidrug-Resistant Pseudomonas aeruginosa Osteomyelitis.

We present a case of Pseudomonas aeruginosa osteomyelitis treated with surgery and antibiotic therapy with ceftolozane-tazobactam in continuous infusion at home using an elastomeric pump. We discuss the use of ceftolozane-tazobactam in continuous infusion administered at home as an effective alternative for the treatment of multidrug-resistant Pseudomonas aeruginosa osteomyelitis.

Treatment duration of complicated urinary tract infections by extended-spectrum beta-lactamases producing enterobacterales.

BACKGROUND: Urinary tract infections caused by extended-spectrum beta-lactamase producing Enterobacterales (ESBL-EB) are a problem increasing in our clinical practice. OBJECTIVES: The aim of this study was to evaluate the clinical outcome in patients who received short (≤ 7 days) versus long courses (>7 days) of antimicrobial therapy for complicated ESBL-EB urinary tract infections. METHODS: This is a retrospective and observational study. Positive urine cultures for ESBL-EB in our hospital between March 2015 and July 2017 were identified. Patients with complicated urinary tract infection were included. Differences between treatment groups (7 days or less vs more than 7 days) were analyzed according to baseline characteristics and severity of clinical presentation. Primary outcome was all cause 30-day mortality. Secondary outcome was a combined item of all cause mortality and reinfection by the same enterobacteria at 30 days. RESULTS: 273 urine cultures were positive for ESBL-EB during the study period. 75 episodes were included, 40 in the long treatment group and 35 in the short treatment group. Mean treatment duration in short and long treatment groups was 6,1 and 13,8 days respectively. Mortality at 30 days was 5,7% in the short treatment group and 5% in the long treatment group without significant differences (P = 0,8). Mortality or reinfection by the same ESBL-EB at 30 days was 8,6% in the short treatment group and 10% in the long treatment group, without significant differences (P = 0,8). CONCLUSIONS: Short courses of antimicrobial treatment seems to be effective as treatment of complicated urinary tract infections by ESBL-EB.

[Chronic obstructive pulmonary disease: differences between men and women]. / Enfermedad pulmonar obstructiva: diferencias entre hombres y mujeres.

Chronic obstructive pulmonary disease (COPD) has increased its prevalence in females. Women have been described as more symptomatic. There are few studies considering gender differences in COPD. The aim of our study was to determine the influence of gender on quality of life, symptoms, treatment, risk factors and cardiovascular disease in a population of patients with COPD. In this prospective observational cross-sectional study, the included COPD patients were consecutively admitted between September 1, 2008 to March 1, 2010. We registered age, sex, smoking history, risk factors and cardiovascular disease, treatment and severity of COPD. We measured ankle-brachial index (ABI) and performed EuroQol-5D. Two hundred forty six patients were included (195 men). There were more former smokers among men (68.7% vs. 15.7%, p < 0.001), men had a lower FEV1 (48.7% ± 15.7 vs. 58.2% ± 10.9 of theoretical, p < 0.001) and higher frequency of ischemic heart disease (16.4% vs. 5.9%, p = 0.04). Women showed a higher prevalence of COPD without exposure to smoke cigarette (64.7% vs. 7.2%, p < 0.001), more symptoms of anxiety and depression (p = 0.004) and less frequently altered ABI (20% vs. 41. 6%, p = 0.01).There were differences in COPD with respect to sex with more severe pulmonary and cardiovascular disease in men and more symptoms of anxiety and depression in women.

Enfermedad pulmonar obstructiva: diferencias entre hombres y mujeres / Chronic obstructive pulmonary disease: differences between men and women

La enfermedad pulmonar obstructiva crónica (EPOC) ha aumentado su prevalencia en el sexo femenino. Los casos de mujeres se describen como más sintomáticas. A pesar de que la EPOC se ha vinculado a elevado riesgo cardiovascular, hay pocos estudios sobre diferencias por sexo. El objetivo de nuestro estudio fue determinar la influencia del sexo sobre calidad de vida y síntomas, tratamiento, factores de riesgo y enfermedad cardiovascular (ECV) en una población de pacientes con EPOC. En este estudio prospectivo observacional de corte transversal, se incluyeron pacientes con EPOC ingresados consecutivamente entre el 1 de septiembre de 2008 al 1 de marzo de 2010. Se registraron edad, sexo, habito tabáquico, factores de riesgo y enfermedad cardiovascular, tratamiento y gravedad de la EPOC. Se midió índice tobillo-brazo (ITB) y se realizó Euroqol-5D. Se incluyeron 246 pacientes (195 hombres). Los hombres fueron más ex fumadores (68.7% vs. 15.7%, p < 0.001), tuvieron un VEF1 menor (48.7% ± 15.7 vs. 58.2% ± 10.9 de teórico, p < 0.001) y mayor frecuencia de cardiopatía isquémica (16.4% vs. 5.9%, p = 0.04). Las mujeres presentaron más prevalencia de EPOC sin exposición al tabaco (64.7% vs. 7.2%, p < 0.001), más síntomas de ansiedad y depresión (p = 0.004) e ITB alterado en menor frecuencia (20% vs. 41.6%, p = 0.01). Concluimos que hubo diferencias en la EPOC en relación al sexo, con compromiso pulmonar y cardiovascular más grave en hombres y más síntomas de ansiedad y depresión en mujeres.

Chronic obstructive pulmonary disease (COPD) has increased its prevalence in females. Women have been described as more symptomatic. There are few studies considering gender differences in COPD. The aim of our study was to determine the influence of gender on quality of life, symptoms, treatment, risk factors and cardiovascular disease in a population of patients with COPD. In this prospective observational cross-sectional study, the included COPD patients were consecutively admitted between September 1, 2008 to March 1, 2010. We registered age, sex, smoking history, risk factors and cardiovascular disease, treatment and severity of COPD. We measured ankle-brachial index (ABI) and performed EuroQol-5D. Two hundred forty six patients were included (195 men). There were more former smokers among men (68.7% vs. 15.7%, p < 0.001), men had a lower FEV1 (48.7% ± 15.7 vs. 58.2% ± 10.9 of theoretical, p < 0.001) and higher frequency of ischemic heart disease (16.4% vs. 5.9%, p = 0.04). Women showed a higher prevalence of COPD without exposure to smoke cigarette (64.7% vs. 7.2%, p < 0.001), more symptoms of anxiety and depression (p = 0.004) and less frequently altered ABI (20% vs. 41. 6%, p = 0.01).There were differences in COPD with respect to sex with more severe pulmonary and cardiovascular disease in men and more symptoms of anxiety and depression in women.