Manuel L. Fernandez Guerrero | Universidad Autónoma de Madrid (original) (raw)

Papers by Manuel L. Fernandez Guerrero

Research paper thumbnail of Multidrug-resistant Corynebacterium striatum endocarditis successfully treated with daptomycin

International J Antimicrobial Agents 2012

Research paper thumbnail of Infective Endocarditis at Autopsy: a Review of Pathologic Manifestations and Clinical Crrelates

Medicine (Baltimore) 2012

Research paper thumbnail of Long-Term Survival of Salvage Cardiac Transplantation for Infective Endocarditis

Annals Thoracic Surgery 2011

Research paper thumbnail of Endocarditis Caused by Staphylococcus aureus: A Reappraisal of the Epidemiologic, Clinical, and Pathologic Manifestations With Analysis of Factors Determining Outcome

Medicine, 2009

Staphylococcus aureus is the leading cause of infectious endocarditis and its mortality has remai... more Staphylococcus aureus is the leading cause of infectious endocarditis and its mortality has remained high despite better diagnostic and therapeutic procedures over time. We conducted a retrospective review of 133 cases of definite S. aureus endocarditis seen at a single tertiary care hospital over 22 years to assess changes in the epidemiology and incidence of the infection, manifestations, outcome, risk factors for mortality, and impact of cardiac surgery on prognosis.Patients were classified into 2 groups: 1) right-sided endocarditis (64 patients) and 2) left-sided endocarditis (69 patients). While the number of cases of left-sided endocarditis remained steady at 1-3 cases per 10,000 admissions, the incidence of right-sided endocarditis, after a peak in the early 1990s, declined to almost disappear in 2001. Among the cases of right-sided endocarditis, we found 2 subsets of patients with different clinical features and prognosis: the first subset comprised 53 intravenous drug abusers, and the second subset comprised 11 patients with catheter-associated S. aureus bacteremia and endocarditis. Fifty-one patients were human immunodeficiency virus (HIV)-positive drug abusers, most of whom (80.3%) had right-sided endocarditis. We did not find differences in mortality between HIV-positive and HIV-negative individuals; mortality seemed to depend more on the site of the heart involved than on HIV status.Among the cases of left-sided endocarditis, the mitral valve was more commonly involved than the aortic valve (61% vs. 30%). Overall, 74% of patients with left-sided endocarditis developed 1 or more cardiac or extracardiac complication. In comparison, only 23.4% of patients with right-sided endocarditis developed complications.Prosthetic valve endocarditis (PVE) was hospital-acquired more frequently than native valve endocarditis (NVE). Patients with PVE had a shorter duration of symptoms until diagnosis and presented with or developed cardiac murmurs less frequently than patients with NVE. Cardiac failure (49%), renal failure (43%) and central nervous system (CNS) events (35%) were frequently observed in patients with both PVE and NVE. Valve replacement was more frequently needed and more rapidly performed in patients with PVE than in their counterparts with NVE.The overall mortality of patients with right-sided endocarditis was 17%. While the mortality of right-sided endocarditis in injection drug users was 3.7%, the mortality of patients with right-sided endocarditis associated with infected intravenous catheters was 82% (odds ratio [OR], 0.01; 95% confidence interval [CI], 0.001-0.07). For left-sided endocarditis mortality was 38% and was not significantly different in patients with NVE or PVE (OR, 0.65; 95% CI, 0.23-1.87). CNS complications were associated with mortality in both NVE (OR, 6.55; 95% CI, 1.78-24.04) and PVE (OR, 32; 95% CI, 2.63-465.40). Development of 2 or 3 complications was associated with an increased risk of mortality (OR, 5.59; 95% CI, 1.08-28.80 and OR, 9.25; 95% CI, 1.36-62.72 for 2 vs. 1 complication and for 3 vs. 2 complications, respectively).Surgical treatment did not significantly influence mortality in cases of NVE, (OR, 3.19; 95% CI, 0.76-13.38) but significantly improved the prognosis of patients with PVE (OR, 69; 95% CI, 2.89-1647.18).S. aureus endocarditis is an aggressive, often fatal, infection. The results of the current study suggest that valve replacement will improve the outcome of infection, particularly in patients with PVE.

Research paper thumbnail of Antimicrobial treatment of invasive nonperinatal listeriosis and the impact of the underlying disease on prognosis

Research paper thumbnail of Acute Hepatitis C Outbreak Among HIV-infected Men in Madrid.

Emerging Infectious Diseases 2011

Research paper thumbnail of Visceral leishmaniasis in immunocompromised hosts

American Journal of Medicine 1987

Research paper thumbnail of Q fever endocarditis on porcine bioprosthetic valves. Clinico-pathologic features, microbiologic findings of three cases successfully treated with doxycycline, cotrimoxazole plus valve replacement

Annals of Internal Medicine 1988

Research paper thumbnail of Zoonotic Endocarditis

Infectious Disease Clinics of North America 1993

Research paper thumbnail of Hospital-acquired infectious endocarditis not associated with cardiac surgery: an emerging problem

Clinical Infectious Diseases 1995

Research paper thumbnail of Bone marrow biopsy in the diagnosis of fever of unknown origin in patients with acquired immunodeficiency syndrome

Archives of Internal Medicine 1997

Research paper thumbnail of Nosocomial entetococcal endocarditis: a serious hazard for hospitalized patients with enterococcal bacteremia

Journal of Internal Medicine 2002

Research paper thumbnail of The spectrum of cardiovascular infections due to Salmonella enterica. A review of clinical features and factors determining outcome

Medicine (Baltimore) 2004

Research paper thumbnail of Serologic response to treatment in patients with syphilis

Clinical Infectious Diseases 2009

Research paper thumbnail of Long-term efficacy and safety of protease inhibitor (pi) switching to nevirapine in hiv-infected patients with undetectable viral load

Clinical Infectious Diseases 2004

Research paper thumbnail of Long-term follow-up of asumptomatic HIV-infected patients who discontinued antiretroviral therapy

Clinical Infectious Diseases 2005

Research paper thumbnail of The impact of hospital-acquired infections on the microbial etiology and prognosis of late-onset prosthetic valve endocarditis

Research paper thumbnail of Comparative activity of cloxacillin and vancomycin against Staphylococcus aureus experimental endocarditis

Journal of Antimicrobial Chemotherapy 2006

Research paper thumbnail of Left-sided Endocarditis caused by Staphylococcus aureus. A comparison of clinical and prognostic factors of patients with native- and prosthetic valve endocarditis.

Infectious Diseases in Clinical Practice 2010

Research paper thumbnail of Pulmonary Infections in Patients with Primary Immunodeficiency and those treated with biologic immunomodulating agents

Current Opinion in Pulmonary Medicine 2011

Research paper thumbnail of Multidrug-resistant Corynebacterium striatum endocarditis successfully treated with daptomycin

International J Antimicrobial Agents 2012

Research paper thumbnail of Infective Endocarditis at Autopsy: a Review of Pathologic Manifestations and Clinical Crrelates

Medicine (Baltimore) 2012

Research paper thumbnail of Long-Term Survival of Salvage Cardiac Transplantation for Infective Endocarditis

Annals Thoracic Surgery 2011

Research paper thumbnail of Endocarditis Caused by Staphylococcus aureus: A Reappraisal of the Epidemiologic, Clinical, and Pathologic Manifestations With Analysis of Factors Determining Outcome

Medicine, 2009

Staphylococcus aureus is the leading cause of infectious endocarditis and its mortality has remai... more Staphylococcus aureus is the leading cause of infectious endocarditis and its mortality has remained high despite better diagnostic and therapeutic procedures over time. We conducted a retrospective review of 133 cases of definite S. aureus endocarditis seen at a single tertiary care hospital over 22 years to assess changes in the epidemiology and incidence of the infection, manifestations, outcome, risk factors for mortality, and impact of cardiac surgery on prognosis.Patients were classified into 2 groups: 1) right-sided endocarditis (64 patients) and 2) left-sided endocarditis (69 patients). While the number of cases of left-sided endocarditis remained steady at 1-3 cases per 10,000 admissions, the incidence of right-sided endocarditis, after a peak in the early 1990s, declined to almost disappear in 2001. Among the cases of right-sided endocarditis, we found 2 subsets of patients with different clinical features and prognosis: the first subset comprised 53 intravenous drug abusers, and the second subset comprised 11 patients with catheter-associated S. aureus bacteremia and endocarditis. Fifty-one patients were human immunodeficiency virus (HIV)-positive drug abusers, most of whom (80.3%) had right-sided endocarditis. We did not find differences in mortality between HIV-positive and HIV-negative individuals; mortality seemed to depend more on the site of the heart involved than on HIV status.Among the cases of left-sided endocarditis, the mitral valve was more commonly involved than the aortic valve (61% vs. 30%). Overall, 74% of patients with left-sided endocarditis developed 1 or more cardiac or extracardiac complication. In comparison, only 23.4% of patients with right-sided endocarditis developed complications.Prosthetic valve endocarditis (PVE) was hospital-acquired more frequently than native valve endocarditis (NVE). Patients with PVE had a shorter duration of symptoms until diagnosis and presented with or developed cardiac murmurs less frequently than patients with NVE. Cardiac failure (49%), renal failure (43%) and central nervous system (CNS) events (35%) were frequently observed in patients with both PVE and NVE. Valve replacement was more frequently needed and more rapidly performed in patients with PVE than in their counterparts with NVE.The overall mortality of patients with right-sided endocarditis was 17%. While the mortality of right-sided endocarditis in injection drug users was 3.7%, the mortality of patients with right-sided endocarditis associated with infected intravenous catheters was 82% (odds ratio [OR], 0.01; 95% confidence interval [CI], 0.001-0.07). For left-sided endocarditis mortality was 38% and was not significantly different in patients with NVE or PVE (OR, 0.65; 95% CI, 0.23-1.87). CNS complications were associated with mortality in both NVE (OR, 6.55; 95% CI, 1.78-24.04) and PVE (OR, 32; 95% CI, 2.63-465.40). Development of 2 or 3 complications was associated with an increased risk of mortality (OR, 5.59; 95% CI, 1.08-28.80 and OR, 9.25; 95% CI, 1.36-62.72 for 2 vs. 1 complication and for 3 vs. 2 complications, respectively).Surgical treatment did not significantly influence mortality in cases of NVE, (OR, 3.19; 95% CI, 0.76-13.38) but significantly improved the prognosis of patients with PVE (OR, 69; 95% CI, 2.89-1647.18).S. aureus endocarditis is an aggressive, often fatal, infection. The results of the current study suggest that valve replacement will improve the outcome of infection, particularly in patients with PVE.

Research paper thumbnail of Antimicrobial treatment of invasive nonperinatal listeriosis and the impact of the underlying disease on prognosis

Research paper thumbnail of Acute Hepatitis C Outbreak Among HIV-infected Men in Madrid.

Emerging Infectious Diseases 2011

Research paper thumbnail of Visceral leishmaniasis in immunocompromised hosts

American Journal of Medicine 1987

Research paper thumbnail of Q fever endocarditis on porcine bioprosthetic valves. Clinico-pathologic features, microbiologic findings of three cases successfully treated with doxycycline, cotrimoxazole plus valve replacement

Annals of Internal Medicine 1988

Research paper thumbnail of Zoonotic Endocarditis

Infectious Disease Clinics of North America 1993

Research paper thumbnail of Hospital-acquired infectious endocarditis not associated with cardiac surgery: an emerging problem

Clinical Infectious Diseases 1995

Research paper thumbnail of Bone marrow biopsy in the diagnosis of fever of unknown origin in patients with acquired immunodeficiency syndrome

Archives of Internal Medicine 1997

Research paper thumbnail of Nosocomial entetococcal endocarditis: a serious hazard for hospitalized patients with enterococcal bacteremia

Journal of Internal Medicine 2002

Research paper thumbnail of The spectrum of cardiovascular infections due to Salmonella enterica. A review of clinical features and factors determining outcome

Medicine (Baltimore) 2004

Research paper thumbnail of Serologic response to treatment in patients with syphilis

Clinical Infectious Diseases 2009

Research paper thumbnail of Long-term efficacy and safety of protease inhibitor (pi) switching to nevirapine in hiv-infected patients with undetectable viral load

Clinical Infectious Diseases 2004

Research paper thumbnail of Long-term follow-up of asumptomatic HIV-infected patients who discontinued antiretroviral therapy

Clinical Infectious Diseases 2005

Research paper thumbnail of The impact of hospital-acquired infections on the microbial etiology and prognosis of late-onset prosthetic valve endocarditis

Research paper thumbnail of Comparative activity of cloxacillin and vancomycin against Staphylococcus aureus experimental endocarditis

Journal of Antimicrobial Chemotherapy 2006

Research paper thumbnail of Left-sided Endocarditis caused by Staphylococcus aureus. A comparison of clinical and prognostic factors of patients with native- and prosthetic valve endocarditis.

Infectious Diseases in Clinical Practice 2010

Research paper thumbnail of Pulmonary Infections in Patients with Primary Immunodeficiency and those treated with biologic immunomodulating agents

Current Opinion in Pulmonary Medicine 2011