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1.
Artigo em Inglês | IBECS | ID: ibc-171416

RESUMO

In a global world, knowledge of imported infectious diseases is essential in daily practice, both for the microbiologist-parasitologist and the clinician who diagnoses and treats infectious diseases in returned travelers. Tropical and subtropical countries where there is a greater risk of contracting an infectious disease are among the most frequently visited tourist destinations. The SEIMC considers it appropriate to produce a consensus document that will be useful to primary care physicians as well as specialists in internal medicine, infectious diseases and tropical medicine who help treat travelers returning from tropical and sub-tropical areas with infections. Preventive aspects of infectious diseases and infections imported by immigrants are explicitly excluded here, since they have been dealt with in other SEIMC documents. Various types of professionals (clinicians, microbiologists, and parasitologists) have helped produce this consensus document by evaluating the available evidence-based data in order to propose a series of key facts about individual aspects of the topic. The first section of the document is a summary of some of the general aspects concerning the general assessment of travelers who return home with potential infections. The main second section contains the key facts (causative agents, diagnostic procedures and therapeutic measures) associated with the major infectious syndromes affecting returned travelers [gastrointestinal syndrome (acute or persistent diarrhea); febrile syndrome with no obvious source of infection; localized cutaneous lesions; and respiratory infections]. Finally, the characteristics of special traveler subtypes, such as pregnant women and immunocompromised travelers, are described (AU)


En el mundo global, el conocimiento de las enfermedades infecciosas importadas es esencial en la práctica diaria, tanto para el microbiólogo-parasitólogo como para el clínico en enfermedades infecciosas que atiende a viajeros internacionales. Entre los destinos turísticos más visitados se encuentran muchos países tropicales o subtropicales, donde el riesgo de contraer una enfermedad infecciosa es más elevado. La SEIMC ha considerado pertinente la elaboración de un documento de consenso que sirva de ayuda tanto a médicos de Atención Primaria como a especialistas en Medicina Interna, Enfermedades Infecciosas y Medicina Tropical que atienden a viajeros que regresan con infecciones tras un viaje a zonas tropicales y subtropicales. Se han excluido de forma explícita los aspectos de prevención de estas y las infecciones importadas por inmigrantes, objeto de otros documentos de la SEIMC. Varios tipos de profesionales (clínicos, microbiólogos y parasitólogos) han desarrollado este documento de consenso tras evaluar los datos disponibles basados en la evidencia para proponer una serie de datos clave acerca de este aspecto. Inicialmente se revisan los aspectos generales acerca de la evaluación general del viajero que regresa con una potencial infección. En un segundo bloque se señalan los datos clave (agentes causales, procedimientos diagnósticos y medidas terapéuticas) de los síndromes infecciosos principales en el viajero que regresa (síndrome gastrointestinal (diarrea aguda o persistente), síndrome febril sin foco aparente, lesiones cutáneas localizadas e infecciones respiratorias). Finalmente se describen las características en viajeros especiales como la viajera embarazada y el viajero inmunodeprimido (AU)


Assuntos
Humanos , Masculino , Feminino , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/microbiologia , Consenso , Eosinofilia/epidemiologia , Doenças do Sistema Nervoso/epidemiologia , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Microbiologia , Microbiologia/organização & administração , Saúde do Viajante , Medicina de Viagem/organização & administração
2.
Enferm Infecc Microbiol Clin ; 36(3): 187-193, 2018 03.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28396090

RESUMO

In a global world, knowledge of imported infectious diseases is essential in daily practice, both for the microbiologist-parasitologist and the clinician who diagnoses and treats infectious diseases in returned travelers. Tropical and subtropical countries where there is a greater risk of contracting an infectious disease are among the most frequently visited tourist destinations. The SEIMC considers it appropriate to produce a consensus document that will be useful to primary care physicians as well as specialists in internal medicine, infectious diseases and tropical medicine who help treat travelers returning from tropical and sub-tropical areas with infections. Preventive aspects of infectious diseases and infections imported by immigrants are explicitly excluded here, since they have been dealt with in other SEIMC documents. Various types of professionals (clinicians, microbiologists, and parasitologists) have helped produce this consensus document by evaluating the available evidence-based data in order to propose a series of key facts about individual aspects of the topic. The first section of the document is a summary of some of the general aspects concerning the general assessment of travelers who return home with potential infections. The main second section contains the key facts (causative agents, diagnostic procedures and therapeutic measures) associated with the major infectious syndromes affecting returned travelers [gastrointestinal syndrome (acute or persistent diarrhea); febrile syndrome with no obvious source of infection; localized cutaneous lesions; and respiratory infections]. Finally, the characteristics of special traveler subtypes, such as pregnant women and immunocompromised travelers, are described.


Assuntos
Doenças Transmissíveis Importadas/diagnóstico , Doenças Transmissíveis Importadas/terapia , Humanos , Viagem
3.
Med. clín (Ed. impr.) ; 134(9): 392-395, abr. 2010. tab
Artigo em Espanhol | IBECS | ID: ibc-82751

RESUMO

Fundamento y objectivos: Pocos trabajos han valorado el riesgo específico de infección urinaria bacteriémica por Escherichia coli productor de betalactamasas de espectro extendido (BLEE). Pacientes y métodos: Serie de casos retrospectiva de todos los pacientes con infección urinaria bacteriémica por E. coli atendidos en nuestro centro durante el 2006. Resultados: Se aisló BLEE en 19 casos (17,9%) de 106 bacteriemias de foco urinario. Los pacientes con bacteriemia por BLEE eran predominantemente varones, de mayor edad, procedentes de residencia de ancianos, con enfermedad urológica previa y manipulación urológica más frecuente, con mayor uso de antibiótico previo, con porcentaje más alto de infecciones urinarias previas, mayor frecuencia de infección nosocomial e ingreso en el mes previo. En la regresión logística, resultaron variables independientes predictoras de infección urinaria bacteriémica por BLEE la enfermedad urológica previa (odds ratio [OR]: 13,9, intervalo de confianza [IC] del 95%: 2,5–8,2) y estar institucionalizado en residencia (OR: 6,5, IC del 95%: 1,4–30,9) Conclusiones: La enfermedad urológica previa y estar institucionalizado en residencia son factores de riesgo independientes para presentar infección urinaria bacteriémica por BLEE (AU)


Background and objective: Although risk factors for extended spectrum beta lactamase E. coli (EBLE) infection have been explored, specific risk factors for bacteremic urinary tract infection by EBLE have been hardly analyzed. Patients and methos: We collected data from all patients with bacteremic urinary tract infection by E. coli attended in our hospital during 2006. Logistic regression was performed to explore predictors for EBLE bloodstream infection in this group of patients. Results: EBLE was present in 19 cases (17,9%) out of 106 bacteraemia from urinary origin. Patients with bloodstream infection by EBLE were male, older, demented, living in a nursing home, with previous urologic diseases and urologic manipulation, with a higher percentage of previous urinary tract infection, previous antibiotic use, more frequent nosocomial infection, and hospital admission in the previous month. In the logistic regression analysis, only previous urologic diseases (OR 13,9; IC95% 2,5–78,2) and living in a nursing home (OR 6,5; IC95% 1,4–0,9) were associated with EBLE bacteremic urinary tract infection. Conclusions: Previous urologic disease and living in a nursing home are independent risk factors for EBLE bacteremic urinary tract infection (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Bacteriemia/microbiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/patogenicidade , Escherichia coli/enzimologia , Estudos Retrospectivos , Fatores de Risco , beta-Lactamases , Bacteriemia/urina , Infecções Urinárias/microbiologia
4.
Med Clin (Barc) ; 134(9): 392-5, 2010 Apr 03.
Artigo em Espanhol | MEDLINE | ID: mdl-20044105

RESUMO

BACKGROUND AND OBJECTIVE: Although risk factors for extended spectrum beta lactamase E. coli (EBLE) infection have been explored, specific risk factors for bacteremic urinary tract infection by EBLE have been hardly analyzed. PATIENTS AND METHODS: We collected data from all patients with bacteremic urinary tract infection by E. coli attended in our hospital during 2006. Logistic regression was performed to explore predictors for EBLE bloodstream infection in this group of patients. RESULTS: EBLE was present in 19 cases (17,9%) out of 106 bacteraemia from urinary origin. Patients with bloodstream infection by EBLE were male, older, demented, living in a nursing home, with previous urologic diseases and urologic manipulation, with a higher percentage of previous urinary tract infection, previous antibiotic use, more frequent nosocomial infection, and hospital admission in the previous month. In the logistic regression analysis, only previous urologic diseases (OR 13,9; IC95% 2,5-78,2) and living in a nursing home (OR 6,5; IC95% 1,4-0,9) were associated with EBLE bacteremic urinary tract infection. CONCLUSIONS: Previous urologic disease and living in a nursing home are independent risk factors for EBLE bacteremic urinary tract infection.


Assuntos
Bacteriemia/microbiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/enzimologia , Infecções Urinárias/microbiologia , Idoso , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , beta-Lactamases
5.
Enferm Infecc Microbiol Clin ; 26 Suppl 5: 6-11, 2008 May.
Artigo em Espanhol | MEDLINE | ID: mdl-18590661

RESUMO

The clinical manifestations of HIV infection vary widely in distinct geographical areas. While HIV-related disease has been well characterized in western countries, relatively few publications have described the clinical manifestations of these diseases in tropical areas, where the vast majority of HIV-infected people are concentrated. In addition, HIV infection may alter the natural history of tropical diseases in several ways and tropical diseases influence the course of HIV infection. The present review describes the major opportunistic infections afflicting people with HIV/AIDS in Africa, Latin America, and Asia and discusses the mutual interactions between HIV and the major tropical diseases.


Assuntos
Infecções por HIV/diagnóstico , África , Ásia , Região do Caribe , Saúde Global , Infecções por HIV/complicações , Humanos , América Latina
6.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 26(supl.5): 6-11, mayo 2008. tab
Artigo em Espanhol | IBECS | ID: ibc-177791

RESUMO

Las manifestaciones clínicas de la infección por el virus de la inmunodeficiencia humana (VIH) varían considerablemente según las diferentes áreas geográficas. Mientras en los países occidentales las enfermedades relacionadas con el VIH son bien conocidas, hay relativamente pocos estudios que describan las manifestaciones clínicas del VIH en países tropicales, donde vive la gran mayoría de los pacientes infectados por el VIH. Además, el VIH puede variar la historia natural de las enfermedades tropicales de diversas maneras, y éstas pueden tener un impacto en el curso de la infección por el VIH. En esta revisión, se describen las enfermedades oportunistas más relevantes que aparecen en pacientes con infección por el VIH/sida en África, América Latina y Asia, y se revisan las interacciones mutuas entre el VIH y las principales enfermedades tropicales propias de cada región


The clinical manifestations of HIV infection vary widely in distinct geographical areas. While HIV-related disease has been well characterized in western countries, relatively few publications have described the clinical manifestations of these diseases in tropical areas, where the vast majority of HIV-infected people are concentrated. In addition, HIV infection may alter the natural history of tropical diseases in several ways and tropical diseases influence the course of HIV infection. The present review describes the major opportunistic infections afflicting people with HIV/AIDS in Africa, Latin America, and Asia and discusses the mutual interactions between HIV and the major tropical diseases


Assuntos
Humanos , Síndrome de Imunodeficiência Adquirida/complicações , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Síndrome de Imunodeficiência Adquirida/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Malária/etiologia , Demografia , Síndrome de Imunodeficiência Adquirida/transmissão
9.
Med Clin (Barc) ; 128(4): 130-2, 2007 Feb 03.
Artigo em Espanhol | MEDLINE | ID: mdl-17288933

RESUMO

BACKGROUND AND OBJECTIVE: There is scant data comparing the incidence of pneumonia in the community and in the human immunodeficiency virus (HIV) population in highly active antiretroviral therapy (HAART) era. PATIENTS AND METHOD: Prospective study during 18 months. Data were obtained by the means of the electronic clinical record. Incidence rate was compared between HIV positive and negative patients. RESULTS: There were 529 pneumonia episodes in global population (n = 220,000), 1.6 cases/1000 person-year. HIV-infected patients (n = 170) suffered 12 episodes of pneumonia; 46 cases/1000 person-year (relative risk = 29.3, 95% confidence interval, 16.34-51.4; p < 0.01). HIV infected patients with pneumonia have a lower CD4 count (mean 434 versus 230 cells/ml; p = 0.04), higher viral load (4.1 versus 3.2 log copies/ml; p = 0.07) and received antiretroviral treatment in a similar proportion compared to HIV without pneumonia (62 versus a 66.7%, p = 0.5). CONCLUSIONS: Pneumonia in HIV infected patients may be about 30 times more frequent than general population in HAART era. Prevention measures should be reinforced.


Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV/complicações , Pneumonia Bacteriana/epidemiologia , Pneumonia Bacteriana/etiologia , Adulto , Feminino , Humanos , Incidência , Masculino , Estudos Prospectivos
10.
Med. clín (Ed. impr.) ; 128(4): 130-132, feb. 2007. tab
Artigo em Espanhol | IBECS | ID: ibc-051166

RESUMO

Fundamento y objetivo: Apenas hay datos sobre la incidencia de neumonía en los pacientes infectados por el virus de la inmunodeficiencia humana (VIH) respecto a la población general en la era del tratamiento antirretroviral de gran actividad (TARGA). Pacientes y método: Se ha realizado un registro prospectivo de las neumonías atendidas en un hospital de zona durante 18 meses. Se comparan las tasas de incidencia entre la población general y los pacientes infectados por el VIH. Resultados: En la población general (n = 220.000) la incidencia de neumonía fue de 1,6 casos/1.000 personas/año, frente a 46 casos/ 1.000 personas/año en pacientes infectados por el VIH (n = 170) (riesgo relativo = 29,3; intervalo de confianza del 95%, 16,34-51,4; p < 0,01). Los pacientes seropositivos con neumonía tenían una cifra inferior de linfocitos CD4 (media de 434 frente a 230 células/ml; p = 0,04), una carga viral más elevada (4,1 frente a 3,2 log copias/ml; p = 0,07) y recibían TARGA en un porcentaje similar a los que no presentaron neumonía (el 62 frente al 66,7%; p = 0,5). Conclusiones: En la era del TARGA, la incidencia de neumonía en la población infectada por el VIH puede ser unas 30 veces superior a la de la población general, por lo que es necesario reforzar las medidas de prevención en este tipo de pacientes


Background and objective: There is scant data comparing the incidence of pneumonia in the community and in the human immunodeficiency virus (HIV) population in highly active antiretroviral therapy (HAART) era. Patients and method: Prospective study during 18 months. Data were obtained by the means of the electronic clinical record. Incidence rate was compared between HIV positive and negative patients. Results: There were 529 pneumonia episodes in global population (n = 220,000), 1.6 cases/1000 person-year. HIV-infected patients (n = 170) suffered 12 episodes of pneumonia; 46 cases/1000 person-year (relative risk = 29.3, 95% confidence interval, 16.34-51.4; p < 0.01). HIV infected patients with pneumonia have a lower CD4 count (mean 434 versus 230 cells/ml; p = 0.04), higher viral load (4.1 versus 3.2 log copies/ml; p = 0.07) and received antiretroviral treatment in a similar proportion compared to HIV without pneumonia (62 versus a 66.7%, p = 0.5). Conclusions: Pneumonia in HIV infected patients may be about 30 times more frequent than general population in HAART era. Prevention measures should be reinforced


Assuntos
Masculino , Feminino , Adulto , Humanos , Pneumonia/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/complicações , Estudos Prospectivos , Fatores de Risco
12.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 41(5): 297-300, sept. 2006. tab
Artigo em Espanhol | IBECS | ID: ibc-050356

RESUMO

La limitación de esfuerzos terapéuticos es una medida escasamente evaluada en nuestro medio. Se valoran las características de los pacientes en los que se retiran los antibióticos en presencia de una infección activa. Se recogieron datos de todos los pacientes ancianos ingresados consecutivamente en medicina interna con infección activa a los que se les suspendía el antibiótico. Se compararon las características de los pacientes que fallecieron y de los que no. En el estudio se incluyó a 63 pacientes (8,9% de los ingresos); 84,6 ± 9,1 años. Un 86% tenía demencia, un 73%, incapacidad, y un 30%, neoplasia activa. El motivo de la retirada de los antibióticos fue siempre la percepción de una muerte cercana y/o la falta de respuesta al tratamiento. La mortalidad fue del 89%. Entre los que fallecieron, predominó el sexo femenino (el 95 frente al 76%) y tanto el tiempo sin antibiótico (2,9 frente a 8,5 días) como la estancia media (9,6 frente a 16,0 días) fueron más breves (p < 0,05). La suspensión del antibiótico es una medida no infrecuente en nuestro medio y está concentrada en pacientes con mal pronóstico vital y mala situación previa


Limitation of therapy has been little studied in our environment. Data were gathered on all patients with active infection consecutively admitted to the internal medicine department of our hospital in whom antibiotic therapy was withdrawn or withheld. The characteristics of patients who died and those of patients who survived were compared. A total of 63 patients (8.9% of admissions) were included; the mean age was 84.6 years ± 9.1. Dementia was present in 86%, incapacity in 73% and neoplasms in 30%. In all patients, the reason for withdrawing or withholding antibiotic treatment was the perception of impending death and/or lack of response to active treatment. In all patients, the families were involved in the decision to forego treatment. Mortality was 89%. Female sex was more common (95% versus 76%) and length of stay (9.6 versus 16.0 days) and time without antibiotic treatment (2.9 versus 8.5 days) were shorter in patients who died than in the group who survived. The decision to forego antibiotic treatment is not infrequent in our hospital. Most patients were elderly, had diseases with poor vital prognosis, and showed poor prior health status


Assuntos
Idoso , Humanos , Atitude Frente a Morte , Atitude do Pessoal de Saúde , Tomada de Decisões , Assistência Terminal , Suspensão de Tratamento , Antibacterianos , Infecção/mortalidade , Estudos Prospectivos
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