RESUMO
We retrospectively assessed the renal toxicity associated with the use of intravenous colistin. Fifty-four patients with multidrug-resistant Acinetobacter infections were included. At the end of therapy 6/54 patients (11%) suffered renal impairment. Renal impairment associated with the use of colistin is less frequent than initially reported.
Assuntos
Antibacterianos/efeitos adversos , Colistina/efeitos adversos , Nefropatias/induzido quimicamente , Infecções por Acinetobacter/tratamento farmacológico , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Colistina/administração & dosagem , Colistina/farmacologia , Creatinina/sangue , Humanos , Injeções Intravenosas , Nefropatias/sangue , Testes de Função Renal , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Estatísticas não ParamétricasRESUMO
BACKGROUND: Influenza virus is the most common cause of influenza-like illness (ILI) in adults. In Argentina, studies on influenza and other respiratory viruses were performed mostly in pediatric populations. OBJECTIVES: To determine: (1) the frequency of influenza virus and other common respiratory viruses in adult outpatients with ILI, (2) whether the signs and symptoms predict viral etiology, (3) whether viral diagnosis changes clinical management or infection control measures and (4) to characterize the influenza strains circulating in the community. POPULATION AND METHODS: Nasal and pharyngeal swabs from adult outpatients with ILI attending the emergency room during the winter seasons of 2004 and 2005 in Argentina were evaluated by immunofluorescence and RT-PCR. RESULTS: Of 151 samples analyzed, 39 (26%) were influenza A positive, 5 (3.3%) influenza B positive and 4 (2.6%) respiratory syncytial virus positive by immunofluorescence. Two samples (1.3%) were human metapneumovirus positive by RT PCR. Cell culture detected six additional influenza viruses and one adenovirus positive sample. The sensitivity of immunofluorescence for influenza compared with culture was 70%. Symptoms did not predict etiology. CONCLUSIONS: In this study, 40% of the patients with ILI had a specific viral infection and 83% were influenza viruses. Viral detection was necessary to determine the etiology as signs and symptoms were not different between patients with or without viral infection. Viral diagnosis was important to implement infectious control measures. Circulating influenza strains in this study were similar to the correspondent vaccine strains selected for the Southern hemisphere.