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1.
Rev Argent Microbiol ; 53(3): 183-193, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-33388181

RESUMO

Bloodstream infections (BI) are relevant in neutropenic patients because they are associated with an increased number of complications and death. The objective was determinate the epidemiologic and microbiologic features of the BI in neutropenic patients with solid neoplasm (SN) and hematologic neoplasm (HN). Retrospective study in two third level hospitals between 2009 and 2016. They were included all the patients older than 18 years-old with active oncologic disease and neutropenia, who had BI. Patients with dermatologic cancer other than melanoma where excluded. A total of 143 BI in neutropenic were observed, of which 80.4% occurred in HN. Around 97.9% of the patients had a high-risk neutropenia without differences between both groups. The most frequent site of BI was primary bacteremia (46.9%) and catheter-associated infection (21%), without significant differences between the two groups. The gram negatives bacilli (GNB) predominated over the gram positive cocci (GPC) and they represented 74.1% of the isolated bacteria, being Escherichia coli the most frequent (32.8%). Among the gram positive cocci, Staphylococcus aureus (28.1%) was the most frequent isolated, followed by coagulase-negative Staphylococci (CNS). There were no differences in microbiological isolates between both groups. With regard to the antimicrobial susceptibility 67.5% of the CNS, 17.6% of the E. coli and 27.6% of the Klebsiella pneumoniae were multiresistant with no differences between both groups. Only 11.1% of S. aureus isolates were methicillin resistant. In conclusion BI of the neutropenic patients where most frequents within patients with HN, GNB were the main microbiological isolates. High mortality was observed in neutropenic patients with BI.


Assuntos
Bacteriemia , Neutropenia , Adolescente , Adulto , Antibacterianos , Bacteriemia/epidemiologia , Escherichia coli , Humanos , Neutropenia/complicações , Estudos Retrospectivos , Staphylococcus aureus
2.
Rev Fac Cien Med Univ Nac Cordoba ; 78(1): 64-67, 2021 03 12.
Artigo em Espanhol | MEDLINE | ID: mdl-33787020

RESUMO

Introduction: COVID-19 disease is an acute viral pneumonia with multiple extrapulmonary manifestations, including certain hematological alterations. The leukoerythroblastic reaction or leukoerythroblastosis is defined by the presence in peripheral blood of nucleated erythroid cells and immature myeloids. Among its most frequent causes is medullary invasion by solid tumors and hematological neoplasms, so the recognition and consequent study of this reaction is extremely important. To date, only a single case of COVID-19 disease associated with a leukoerythroblastic reaction has been reported worldwide in adult patients. Methodology: In the following manuscript we describe the presence of leukoerythroblastosis in a male hospitalized for COVID-19, in which multiple causes were ruled out. Results: The patient had resolution of the leukoerythroblatosis as his respiratory symptoms resolved. Conclusion: The COVID-19 disease could be a new known cause of a leukoerythroblastic reaction, although we believe that a greater number of reported cases is necessary to affirm that the association was not random.


Introducción: La enfermedad COVID-19 es una neumonía viral aguda con múltiples manifestaciones extrapulmonares dentro de las cuales se incluyen ciertas alteraciones hematológicas. La reacción leucoeritroblástica o leucoeritroblastosis se define por la presencia en sangre periférica de células eritroides nucleadas y mieloides inmaduras. Dentro de sus causas más frecuentes se encuentra la invasión medular por tumores sólidos y neoplasias hematológicas, por lo que el reconocimiento y consecuente estudio de dicha reacción es sumamente importante. Hasta el momento sólo se ha reportado a nivel mundial un único caso de enfermedad COVID-19 asociado a reacción leucoeritroblástica en pacientes adultos. Metodología: En el siguiente manuscrito describimos la presencia de leucoeritroblastosis en un masculino internado por COVID-19, en el cual se descartaron múltiples causas secundarias.. Resultados: El paciente presentó resolución de la leucoeritroblatosis a medida que sus síntomas respiratorios se resolvieron. Conclusión: La enfermedad COVID-19 podría ser una nueva causa conocida de reacción leucoeritroblástica aunque creemos necesario un mayor número de casos reportados para afirmar que la asociación no fue al azar


Assuntos
COVID-19 , Humanos , Estudos Retrospectivos , SARS-CoV-2
3.
Rev Fac Cien Med Univ Nac Cordoba ; 77(4): 265-271, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33351394

RESUMO

INTRODUCTION: Urinary Tract Infections (UTI) are an important cause of morbidity in the community, constituting one of the main reasons for hospitalization, and the fourth cause of healthcare-associated infection. The objectives of this study were to determine the frequency of community-acquired UTI (CA-UTI) with need of hospitalization and healthcare-associated UTI (HA-UTI), their risk factors, etiologic agents and their antimicrobial susceptibility spectrum. METHODS: A prospective and analytic study was conducted, in which all admissions regarding CA-UTI with need of hospitalization and HA-UTI were evaluated during the period between 2016 and 2017 in two university hospitals. RESULTS: A total of 279 episodes of UTI in hospitalized patients were identified and, among those, 178 episodes corresponded to CA-UTI and 101 to HA-UTI. On average, patients were 60 years old in both groups. HA-UTI were more frequently associated with kidney transplant, recurrent UTI and chronic kidney disease compared with CA-UTI. The instrumentation of urinary tract within the previous month was more frequent in HA-UTI (75.2% vs 32.6%, p<0.001). Escherichia coli was the most frequent isolated microorganism (62.9% in CA-UTI and 56.4% in HA-UTI), followed by Klebsiella pneumoniae and Pseudomonas aeruginosa. A total of 101 multidrug resistant microorganisms were isolated, of which 53.5% were CA-UTI, and were associated with male patients, use of antimicrobials within the previous three months, chronic kidney disease and recurrent UTI. CONCLUSION: It is of great importance for the institutions to identify the local antimicrobial susceptibility spectrum of UTI in order to stablish adequate empiric treatments.


Assuntos
Infecções Urinárias , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/epidemiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia
4.
Rev Fac Cien Med Univ Nac Cordoba ; 77(3): 155-160, 2020 08 21.
Artigo em Espanhol | MEDLINE | ID: mdl-32991113

RESUMO

Introduction: Uncomplicated urinary tract infections(UC-UTI) represent a frequent reason for consultation. Most cases are empirically treated, but the antimicrobial susceptibility of the causative microorganisms has changed over the past years. The objectives of this study where to determine UC-UTI causative microorganism and their antimicrobial susceptibility profiles in adult women. Methods: A prospective analytic study was conducted in two hospital in Córdoba, Argentina, between November/2016 and October/2017. From the identification of positive urine cultures, urinary tract infections (UTI) in women ≥18 years without risk factors for complicated UTIs were included, excluding asymptomatic bacteriurias. Results: A total of 610 UC-UTI were identified and 62.6% of them in patients younger than 50 years; 73.3% of cases were cystitis, being more frequent in older women. Escherichia coli was isolated in 89.2% of UTI and negative coagulase Staphylococcus in 4.2%. As regards Escherichia coli, its resistance against ciprofloxacin was 18.8%; 4.4% against ceftriaxone and 1.8% against nitrofurantoin. There was an elevated resistance against ampicillin, trimethoprim­sulfamethoxazole and ampicillin­sulbactam. Main conclusion: The most frequent isolated microorganism was Escherichia coli, consistent with global epidemiology. This microorganism showed less than 20% total resistance against ciprofloxacin, ceftriaxone and nitrofurantoin.


Introducción: Las infecciones del tracto urinario no complicadas (ITU-NoC) representan un motivo frecuente de consulta ambulatorio, siendo la mayoría tratadas empíricamente. Han existido cambios en susceptibilidad antimicrobiana en los últimos años. Nuestros objetivos fueron determinar los microorganismos de las ITU-NoC y su perfil de susceptibilidad antimicrobiana en mujeres adultas. Métodos: Estudio analítico prospectivo en dos hospitales de Córdoba, Argentina, entre noviembre/2016 y octubre/2017. A partir de la identificación de urocultivos positivos, se incluyeron las infecciones urinarias(ITUs) en mujeres ≥18 años, sin factores de riesgo para ITUs complicada, excluyéndose las bacteriurias asintomáticas. Resultados: Se identificaron 610 episodios de ITU-NoC, 382(63%) en <50 años. El 73.3% de las ITU-noC correspondieron a cistitis, siendo más frecuentes en las mujeres mayores 50 años.  En el 89.2% de las ITUs se aisló Escherichia coli y 4.2% Staphylococcus coagulasa negativo. Respecto a E. coli, su resistencia a ciprofloxacina fue de 18.8%, ceftriaxona 4.4% y nitrofurantoína 1.8%. Se observó una resistencia elevada a ampicilina, trimetoprima-sulfametoxazol y ampicilina-sulbactam. Conclusiones: En conclusión, el microorganismo más frecuentemente aislado fue E. coli, concordando con la epidemiología global, presentando una resistencia menor al 20% a ciprofloxacina, ceftriaxona y nitrofurantoína.


Assuntos
Cistite , Infecções Urinárias , Antibacterianos/uso terapêutico , Argentina/epidemiologia , Cistite/tratamento farmacológico , Feminino , Humanos , Estudos Prospectivos , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia
5.
Rev. argent. microbiol ; Rev. argent. microbiol;53(3): 41-50, Sept. 2021.
Artigo em Espanhol | LILACS | ID: biblio-1376414

RESUMO

RESUMEN Las infecciones del torrente sanguíneo (IS) en pacientes oncológicos neutropénicos constituyen una patología de relevancia y se asocian a un aumento de la morbimortalidad. El objetivo de este estudio fue determinar las características epidemiológicas y microbiológicas de los episodios de IS en pacientes adultos neutropénicos con neoplasias hematológicas (NH) y neoplasias sólidas (NS). Se realizó un estudio retrospectivo en dos hospitales de tercer nivel entre 2009 y 2016. Se incluyeron todos los pacientes neutropénicos mayores de 18años con NH y NS que presentaron episodios de IS. Se excluyeron aquellos con neoplasias dermatológicas no melanoma. Se identificaron 143 episodios de IS, de los cuales el 80,4% fueron en personas con NH. El 97,9% de los pacientes tuvieron neutropenia de alto riesgo, sin diferencia entre los grupos NH y NS. Los orígenes más frecuentes de IS fueron bacteriemia primaria (46,9%) e infección asociada a catéter (21%), sin diferencias significativas entre grupos. El 74,1% de los aislamientos fueron bacilos gram negativos yEscherichiacolifue el microorganismo más frecuente (32,1%). El coco gram positivo más frecuentemente aislado fueStaphylococcusaureus(28,1%), seguido del grupo de los estafilococos coagulasa negativos (ECN), sin diferencias entre ambos tipos de neoplasias. El 67,5% de los ECN fueron multirresistentes; solo el 11,1% de los aislamientos deS. aureusfue resistente a la meticilina. El 17,6% de los aislamientos deE. coliy el 27,6% de los deKlebsiellapneumoniaefueron multirresistentes. No hubo diferencias en la frecuencia de aislamientos multirresistentes al comparar entre ambos tipos de neoplasia. Como conclusión, las IS en pacientes neutropénicos fueron más frecuentes en pacientes con NH y las causaron, principalmente, bacilos gram negativos. Se observó una elevada mortalidad en los pacientes neutropénicos con IS.


ABSTRACT Bloodstream infections (BI) are relevant in neutropenic patients because they are associated with an increased number of complications and death. The objective was determinate the epidemiologic and microbiologic features of the BI in neutropenic patients with solid neoplasm (SN) and hematologic neoplasm (HN). Retrospective study in two third level hospitals between 2009 and 2016. They were included all the patients older than 18 years-old with active oncologic disease and neutropenia, who had BI. Patients with dermatologic cancer other than melanoma where excluded. A total of 143 BI in neutropenic were observed, of which 80.4% occurred in HN. Around 97.9% of the patients had a high-risk neutropenia without differences between both groups. The most frequent site of BI was primary bacteremia (46.9%) and catheter-associated infection (21%), without significant differences between the two groups. The gram negatives bacilli (GNB) predominated over the gram positive cocci (GPC) and they represented 74.1% of the isolated bacteria, beingEscherichia colithe most frequent (32.8%). Among the gram positive cocci,Staphylococcus aureus(28.1%) was the most frequent isolated, followed by coagulase-negativeStaphylococci(CNS). There were no differences in microbiological isolates between both groups. With regard to the antimicrobial susceptibility 67.5% of the CNS, 17.6% of theE. coliand 27.6% of theKlebsiella pneumoniaewere multiresistant with no differences between both groups. Only 11.1% of S. aureus isolates were methicillin resistant. In conclusion BI of the neutropenic patients where most frequents within patients with HN, GNB were the main microbiological isolates. High mortality was observed in neutropenic patients with BI.


Assuntos
Adolescente , Adulto , Humanos , Bacteriemia , Neutropenia , Staphylococcus aureus , Estudos Retrospectivos , Bacteriemia/epidemiologia , Escherichia coli , Antibacterianos , Neutropenia/complicações
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