[Bacteremia originated in intravascular cannulae: an epidemiologic study of 91 episodes]. / Bacteriemia originada en cánulas intravasculares: estudio epidemiológico de 91 episodios.

This reports the analysis of an epidemiologic study of intravascular cannula bacteriemia (ICB) in a Barcelona university hospital. There were 91 episodes of ICB representing the 26.7% of the total hospital bacteriemia. In 60.6% of ICB the diagnosis was made in an intensive care area. The most common microorganisms were Staphylococcus epidermidis (27.8%), Pseudomonas aeruginosa (18.5%), and Staphylococcus aureus (14.4%). Intravascular cannulae with higher incidence of bacteriemia were the central venous catheters (55%) and the arterial lines (29%). Bacteriemia produced by arterial lines had short free period interval (7.7 days) and in 80% of the cases were produced by Gram negative bacteria whereas that bacteriemia produced by central venous catheters had a long free period (11.2 days) and the most frequent agents were Gram positive bacteria. The overall mortality was 17% and that attributed to the infection 6%. An age above 65 years had a mortality rate of 33% and was identified as the only significant prognostic factor (p less than 0.001). The mean hospitalization period was 49.9 days and the cost of the treatment 830.000 ptas/patient.

[Bacteremia in patients with chronic hepatopathy: a study of 54 cases]. / Bacteriemia en pacientes con hepatopatía crónica: estudio de 54 casos.

The authors reviewed 54 cases of bacteremia in 48 patients with chronic liver disease over a period of two years. Thirty-three were outpatients and 21 were hospitalized. Fifty-eight microorganisms were detected, which represented 10.3% of the total number of germs isolated in all the cases of bacteremia in the hospital during that same period of time. Gram-negative bacilli were predominant, especially Escherichia coli (19 cases); among the gram-positive ones, the most frequent was Staphylococcus aureus (8 cases). There was ascites in 62.9% of the patients, but the predominant symptom was fever. The most frequent sources of infection were: unknown (29.6%), urinary (22.2%), catheter (16.6%) and lung (14.8%). All the in-hospital cases were preceded by an aggressive diagnostic or therapeutic technique. The rate of mortality was 29.6%, and it was highest among patients with gram-negative bacteremia, ascites, Child C (p less than 0.05), complications (hepatic encephalopathy, hemorrhage and/or septic shock) (p less than 0.03), unknown origin or originating from catheter and in-hospital episodes.

[Bacteremia of cutaneous origin]. / Bacteriemia de origen cutáneo.

558 episodes of bacteremia were detected in our medical center during a 2-year period. 17 of them (3%) were of cutaneous origin. 12 cases were community-acquired and 5 were hospital-acquired. The patients median age was of 65 years. 15 patients had a baseline disease, the most frequent being diabetes mellitus and neoplastic disease. The most common bacteria isolated were group A beta-hemolytic Streptococcus, Staphylococcus aureus, and Escherichia coli; 2 patients had multibacterial episodes. Decubitus ulcer and cellulitis were the most frequently associated skin disease. Global mortality was of 47% and was sepsis related in 29% of the cases. Death prognosis factors were old age, diabetes mellitus, gram-negative causal bacteria, nonappropriate antibiotic therapy, low index of clinical suspicion.