An outbreak of norovirus infection in a long-term-care unit in Spain.

BACKGROUND: Norovirus belongs to the Caliciviridae family and causes outbreaks of infectious enteritis by fecal-oral transmission. In Spain, there have been few outbreaks reported due to this virus. We describe an outbreak on a long-term-care hospital ward. METHODS: Cases were classified as probable, confirmed, and secondary. Stool cultures were performed. Polymerase chain reaction detection of norovirus was also performed. RESULTS: The outbreak occurred from December 7 to 28, 2001, involving 60 cases (32 patients, 19 staff members, 8 patients' relatives, and 1 relative of a staff member). Most (82%) of the cases were female. The most frequently involved ages were 20 to 39 years for staff members and 70 to 89 years for patients. The incubation period of secondary cases in patients' families had a median of 48 hours (range, 1 to 7 days). Clinical symptoms included diarrhea (85%), vomiting (75%), fever (37%), nausea (23%), and abdominal pain (12%). Median duration of the disease was 48 hours (range, 1 to 7 days). All cases resolved and the outbreak halted with additional hygienic measures. Stool cultures were all negative for enteropathogenic bacteria and rotaviruses. In 16 of 23 cases, the norovirus genotype 2 antigen was detected. CONCLUSION: This outbreak of gastroenteritis due to norovirus genotype 2 affected patients, staff members, and their relatives in a long-term-care facility and was controlled in 21 days.

[Infectious osteitis pubis]. / Osteítis infecciosa del pubis.

INTRODUCTION: Infectious osteitis pubis is an uncommon disease that must be distinguished from the noninfectious form of this condition. METHODS: Four cases of infectious osteitis pubis diagnosed over the last ten years in our hospital are described. RESULTS: The diagnosis was established on the basis of clinical symptoms, consistent imaging studies, and positive blood cultures (2/4) or bone biopsy (2/4). Prolonged antibiotic treatment with previous debridement of abscesses provided favorable outcomes (4/4). CONCLUSION: Infectious osteitis pubis should be suspected in patients with groin pain and predisposing factors.

Transrectal ultrasound-guided prostate biopsy: is antibiotic prophylaxis necessary?

The aim of this study was to assess infectious complications in transrectal ultrasound-guided prostate biopsy (TRUSPB), comparing two groups of patients: one group with antibiotic prophylaxis and the other without prophylaxis. A total of 1,018 TRUSPBs were performed from April 1996 to July 2003. No antibiotic prophylaxis was given in the first 614; the remaining 404 procedures were performed under antibiotic prophylaxis. Biopsy complications were assessed at outpatient urologist visits after the procedure in the 212 first biopsies and by telephone interview in the remaining 806. A total of 78 infectious complications were found. Major infectious complications (n=41) were septic shock (n=3), sepsis (n=3), Fournier gangrene (n=1), urinary tract infection (n=2), and fever requiring hospital admission (n=32). Minor infectious complications were fever that did not require admission (n=29), prostatitis (n=6), and epididymitis (n=2). Infectious complications occurred in 63 of 614 (10.3%) procedures without antibiotic prophylaxis and in 15 of 404 (3.7%) of those with antibiotic prophylaxis (P=0.0001). Of the 41 major infectious complications, 31 (75.6%) occurred in procedures without antibiotic prophylaxis (n=583) versus ten (24.4%) in those with prophylaxis (n=394) (P=0.0410). In conclusion, transrectal ultrasound-guided biopsy of the prostate has a statistically significant higher risk of infectious complications when performed without antibiotic prophylaxis.

Osteítis infecciosa del pubis / Infectious osteitis pubis

INTRODUCCIÓN. La osteítis infecciosa del pubis es una entidad poco frecuente que debe diferenciarse de su formano infecciosa. MÉTODOS. Descripción de cuatro casos de osteítis infecciosa del pubis diagnosticados en los últimos 10 años en nuestro centro. RESULTADOS. El diagnóstico se estableció mediante clínica e imagen sugestiva junto con hemocultivos positivos (2/4) o por biopsia ósea (2/4). La antibioticoterapia prolongada, con desbridamiento en caso de absceso, ofreció resultados satisfactorios (4/4).CONCLUSIÓN. La osteítis infecciosa del pubis debe sospecharse en pacientes con dolor inguinal y factores predisponentes (AU)

INTRODUCTION. Infectious osteitis pubis is an uncommon disease that must be distinguished from the non-infectious form of this condition. METHODS. Four cases of infectious osteitis pubis diagnosed over the last ten years in our hospital are described. RESULTS. The diagnosis was established on the basis of clinical symptoms, consistent imaging studies, and positive blood cultures (2/4) or bone biopsy (2/4).Prolonged antibiotic treatment with previous debridement of abscesses provided favorable outcomes (4/4).CONCLUSION. Infectious osteitis pubis should be suspected in patients with groin pain and predisposing factors (AU)

Biopsia prostática transrectal dirigida por ecografía con desinfección local y doble preservativo / Transrectal ultrasound-guided prostate biopsy combined with local desinfection and double condom

Objetivo: Valorar las complicaciones infecciosas acaecidas después de la biopsia transrectal de próstata (BTP) ecodirigida sin utilizar profilaxis antibiótica.Material y métodos: Se realizó BTP bajo control ecográfico a 212 pacientes consecutivos sin usar profilaxis antibiótica, con doble preservativo y desinfección local con povidona yodada. Se revisaron todas las historias clínicas después de la visita con el urólogo, entre una semana y un mes después del procedimiento.Resultados: Se presentaron cuatro infecciones posbiopsia que representa un 2 por ciento. Dos pacientes tuvieron fiebre y escalofríos y fueron tratados ambulatoriamente con ciprofloxacino. Un tercer paciente presentó infección urinaria con cultivo positivo para E. coli. El cuarto sufrió una prostatitis aguda que requirió ingreso hospitalario y tratamiento antibiótico.Conclusión: La tasa de infecciones urinarias posbiopsia sin profilaxis antibiótica, con doble preservativo y desinfección local con povidona yodada no es mayor que en series que utilizan profilaxis (AU)