RESUMO
We report a case of a 66-year-old man with multiple thoracoabdominal mycotic aortic aneurysms caused by Streptococcus agalactiae (S agalactiae). The infectious aortitis (IA) was diagnosed by transesophageal echocardiography and computed tomography and confirmed by positive blood cultures. The patient was treated with antibiotics, but, after worsening of the aortitis, a successful surgical procedure was performed. A review of the literature is presented together with a series of 7 other cases of IA caused by S agalactiae.
Assuntos
Aneurisma Infectado/microbiologia , Aneurisma Aórtico/microbiologia , Aortite/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/isolamento & purificação , Idoso , Aneurisma Infectado/diagnóstico , Aneurisma Infectado/terapia , Antibacterianos/uso terapêutico , Aneurisma Aórtico/diagnóstico , Aneurisma Aórtico/terapia , Aortite/diagnóstico , Aortite/terapia , Aortografia/métodos , Implante de Prótese Vascular , Ecocardiografia Transesofagiana , Humanos , Masculino , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/terapia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
OBJECTIVES: To assess whether nursing homes (NHs) made organizational improvements to increase influenza vaccination rates in healthcare workers (HCWs) and to quantify the beliefs of NH administrators on the arguments used in favor of implementation of mandatory influenza vaccination of HCWs. DESIGN: Anonymous questionnaire study. SETTING: Dutch NHs. PARTICIPANTS: Dutch NH administrators. MEASUREMENTS: Influenza vaccination rates in NH residents and NH HCWs, organizational aspects of influenza vaccination of HCWs, and agreement of respondents with arguments in favor of implementation of mandatory influenza vaccination in HCWs. RESULTS: Of the 310 distributed questionnaires, 185 were returned (response rate 59.7%). The average vaccination rate in NH HCWs was 18.8% and in NH residents was 91.6%. In all, 126 (68.1%) NHs had a written policy, 161 (87.0%) actively requested that their employees be immunized, and 161 (87.0%) offered information to HCWs in any way. Despite the fact that the majority of NH administrators (>69%) agreed with all arguments in favor of implementation of mandatory influenza vaccination, only a minority (24.3%) agreed that mandatory vaccination should be implemented if voluntary vaccination fails to reach sufficient vaccination rates. CONCLUSION: Despite the low vaccination rate of NH HCWs, most NH administrators did not support mandatory influenza vaccination of NH HCWs.
