Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 5 de 5
Filtrar
1.
Clin Infect Dis ; 76(5): 800-808, 2023 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-36285530

RESUMO

BACKGROUND: Primary immunodeficiencies (PIDs) in adults are mainly revealed by recurrent and/or severe bacterial infections. The objective of this study was to evaluate a systematic research strategy of PIDs in adults with unexplained bacterial infections, with a special focus on specific polysaccharide antibody deficiency (SPAD). METHODS: In this prospective multicenter study, inclusion criteria were recurrent benign upper and lower respiratory tract infections (RTIs) for at least two years (group 1), at least one upper or lower RTI requiring hospitalization (group 2), and/or at least one invasive infection documented with encapsulated bacteria (group 3). Main exclusion criteria were all local and general conditions that could explain infections. If no PID diagnosis was made, response to polysaccharide antigens was assessed using a pneumococcal polysaccharide vaccine. RESULTS: From March 2015 to March 2020, 118 patients were included (37 males, median age of 41 years): 73, 17, and 28 in groups 1, 2, and 3, respectively. Forty-seven PIDs were diagnosed, giving an estimated frequency of 39.8% (95% confidence interval [CI] [30.4, 48.8]). SPAD was the most frequent diagnosis by far (n = 37/47, 78.7%), and was made in 23, 5, and 9 patients from groups 1 to 3, respectively. All SPAD patients received conjugate vaccines and, according to their infectious history, were on surveillance or treated with preventive antibiotics (n = 6) and/or with immunoglobulins replacement therapy (n = 10), the latter being dramatically efficient in all cases. CONCLUSIONS: Considering its high prevalence among adults with unexplained recurrent and/or severe bacterial infections, SPAD should be screened in those patients. CLINICAL TRIALS REGISTRATION: NCT02972281.


Assuntos
Infecções Bacterianas , Síndromes de Imunodeficiência , Infecções Pneumocócicas , Doenças da Imunodeficiência Primária , Masculino , Humanos , Adulto , Estudos Prospectivos , Síndromes de Imunodeficiência/complicações , Síndromes de Imunodeficiência/epidemiologia , Síndromes de Imunodeficiência/diagnóstico , Polissacarídeos , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/tratamento farmacológico , Doenças da Imunodeficiência Primária/tratamento farmacológico , Bactérias , Vacinas Pneumocócicas , Anticorpos Antibacterianos , Infecções Pneumocócicas/prevenção & controle
2.
Eur J Orthop Surg Traumatol ; 31(1): 155-160, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32743683

RESUMO

PURPOSE: Analyze the diagnostic performance of suction drainage fluid culture for acute surgical site infection, which has not been specifically reported in spine surgery patients. METHOD: This was a retrospective single-center observational study including data from 363 patients who underwent aseptic instrumented spine surgery between 2015 and 2017. A suction drain was inserted in all cases. Data analyzed were patient age, gender, ASA score, indication for surgery (degenerative disease, tumor, trauma), spine level (cervical, thoracic, lumbar), procedure performed and spine level, operative time, body temperature, postoperative C-reactive protein time-curve, clinical aspect of surgical scar, bacteriology results of suction drainage fluid, and in case of revision surgery, lavage fluid. Major criteria for periprosthetic infection proposed by the Musculoskeletal Infection Society (MSIS) were accepted as the gold standard for the diagnosis of acute surgical site infection. RESULTS: The overall rate of surgical site infection was 6.9% (5.76% for 1- or 2-level fusion, 5.81% for 3- or 4-level fusion, and 15.6% for 5-level fusion and above). The suction drain was withdrawn on the second postoperative day in 44.1% of cases and the third day in 39.1%. The sensitivity of suction drainage fluid culture for the diagnosis of surgical site infection was 20% [95%CI 6.8-40.7%] with a 96.2% [95%CI 93.2-97.9] specificity. CONCLUSION: The diagnostic performance of suction drainage fluid culture after aseptic instrumented spine surgery for acute surgical site infection is insufficient to warrant its use in routine practice.


Assuntos
Procedimentos Ortopédicos , Coluna Vertebral , Infecção da Ferida Cirúrgica , Doença Aguda , Adulto , Líquidos Corporais/microbiologia , Proteína C-Reativa/análise , Drenagem , Feminino , Humanos , Masculino , Procedimentos Ortopédicos/efeitos adversos , Reoperação , Estudos Retrospectivos , Coluna Vertebral/microbiologia , Coluna Vertebral/cirurgia , Sucção , Infecção da Ferida Cirúrgica/sangue , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/microbiologia
3.
Influenza Other Respir Viruses ; 18(3): e13272, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38501337

RESUMO

The emergence of SARS-CoV-2 Omicron variant has led to a complete reconfiguration of the therapeutic landscape, with all monoclonal antibodies having lost any neutralization activity. We report here a case series of 75 immunocompromised patients infected by the Omicron variant who benefited from COVID-19 convalescent plasma (CCP). At Day 28, the overall survival was 76% (95% CI 67-86) with no significant difference in the clinical outcome between patients with hematological malignancies, solid organ transplantation or autoimmune diseases. No safety concern was reported during the course of the study. These results showed that CCP is well tolerated and represents a treatment option for immunocompromised patients who remain highly impacted by the COVID19 epidemic.


Assuntos
COVID-19 , Humanos , COVID-19/terapia , Soroterapia para COVID-19 , SARS-CoV-2 , Imunização Passiva , Hospedeiro Imunocomprometido , Anticorpos Antivirais/uso terapêutico , Anticorpos Neutralizantes
4.
Ann Clin Microbiol Antimicrob ; 11: 4, 2012 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-22321435

RESUMO

We report the first case of extended-spectrum beta-lactamase producing E. coli community-acquired meningitis complicated with multiple aortic mycotic aneurysms. Because of the acute aneurysm expansion with possible impending rupture on 2 abdominal CT scan, the patient underwent prompt vascular surgery and broad spectrum antibiotic therapy but he died of a hemorrhagic shock. Extended-spectrum beta-lactamase producing E. coli was identified from both blood and cerebrospinal fluid culture before vascular treatment. The present case report does not however change the guidelines of Gram negative bacteria meningitis in adults.


Assuntos
Aneurisma Infectado/diagnóstico , Aneurisma Aórtico/diagnóstico , Infecções Comunitárias Adquiridas/diagnóstico , Escherichia coli/enzimologia , Meningite devida a Escherichia coli/diagnóstico , beta-Lactamases/metabolismo , Aneurisma Infectado/complicações , Aneurisma Infectado/cirurgia , Antibacterianos/administração & dosagem , Aneurisma Aórtico/complicações , Aneurisma Aórtico/cirurgia , Sangue/microbiologia , Líquido Cefalorraquidiano/microbiologia , Infecções Comunitárias Adquiridas/microbiologia , Escherichia coli/isolamento & purificação , Evolução Fatal , Humanos , Meningite devida a Escherichia coli/complicações , Meningite devida a Escherichia coli/microbiologia , Pessoa de Meia-Idade , Radiografia Abdominal , Tomografia Computadorizada por Raios X
5.
J Clin Med ; 9(10)2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-33003375

RESUMO

Describing the characteristics of COVID-19 patients in the hospital is of importance to assist in the management of hospital capacity in the future. Here, we analyze the trajectories of 1321 patients admitted to hospitals in northern and eastern France. We found that the time from onset to hospitalization decreased with age, from 7.3 days in the 20-65 year-olds to 4.5 in the >80 year-olds (p < 0.0001). Overall, the length of stay in the hospital was 15.9 days, and the death rate was 20%. One patient out of four was admitted to the intensive care unit (ICU) for approximately one month. The characteristics of trajectories changed with age: fewer older patients were admitted to the ICU and the death rate was larger in the elderly. Admission shortly after onset was associated with increased mortality (odds-ratio (OR) = 1.8, Confidence Interval (CI) 95% [1.3, 2.6]) as well as male sex (OR = 2.1, CI 95% [1.5, 2.9]). Time from admission within the hospital to the transfer to ICU was short. The age- and sex-adjusted mortality rate decreased over the course of the epidemic, suggesting improvement in care over time. In the SARS-CoV-2 epidemic, the urgent need for ICU at admission and the prolonged length of stay in ICU are a challenge for bed management and organization of care.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA