[Usefulness of body surface cultures in newborns with early infection risk. Study of 735 neonates]. / Valoración de los cultivos superficiales del neonato con riesgo de infección precoz. Estudio de 735 pacientes.

OBJECTIVE: Difficulty in the diagnosis of neonatal sepsis has lead to the practice of superficial cultures. The usefulness of this practice has been criticized repeatedly. PATIENTS AND METHODS: Results of 3881 cultures performed on 735 newborns (age < or = 48 hr) with early infection risk were reviewed. The types of samples chosen were urine (UR), gastric aspirate (GA), pharyngeal (PS), external ear (ES), umbilical swab (US), meconium (MC) and blood. BBV for sepsis for the different samples is calculated, as well as which ones better reflect vertical transmission. RESULTS: At the time of the study, 342 newborns (46.5%) were already colonized. Bacteria most frequently isolated were: E. coli (92), PCN staphylococci (85), enterococci (83) and S. agalactiae (70). Twenty-nine newborns had bacteriemia, with S. agalactiae being the leading cause (16). ES correlated best with positive blood cultures (83.3%). UR culture sensitivity was significantly lower than that of all other samples. The Highest PPVs were for GA, PS and US. NPV was high and similar for all samples (98-99%). ES and US best reflected vertical transmission (p < 0.0001). MC provided the highest number of positive mixed cultures, most of them difficult to evaluate. CONCLUSIONS: Body surface sample advantages are: 1) The possibility of discarding a vertically transmitted infection. 2) Quicker positive results than those in blood whenever liquid blood culture media are employed. 3) The possible identification of the etiologic agent when the mother has been given antibiotics intrapartum. 4). Information about dangerous colonization without infection. In order not to lose this useful information, but to save cost and effort, we advise that the number of surface cultures be reduced, keeping only ES and PS?

[16 cases of infection by Cryptococcosis neoformans in patients with AIDS]. / Estudio de 16 casos de infección por Cryptococcus neoformans en pacientes con SIDA.

Sixteen patients with AIDS (6% of the total AIDS patients) who had infection by Cryptococcus neoformans were studied. Most of these patients (94%) had cryptococcal meningitis. Only 50% of the cases showed clinical manifestations of neurological involvement. Blood cultures and antigen level measurement were the diagnostic techniques with best results due to their high percentage of positivity. Sixty nine percent of patients survived the acute phase of the infection and only 3 of those who died in this period showed evidence of active infection patients by the fungus.

[Adenopathy caused by Listeria monocytogenes]. / Adenopatía por Listeria monocytogenes.

Human infection by Listeria Monocytogenes has been considered a rare disease in adults, usually associated to immunosuppressed patients. Meningitis is the main clinical manifestation. Sepsis, endocarditis, peritonitis and circumscribed abscesses are occasionally found.