Silvia Attorri | Universidad Nacional de Cuyo (original) (raw)
Papers by Silvia Attorri
Journal of Clinical Microbiology, 2000
Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identificati... more Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identification of the organism. A. urinae is a gram-positive coccus that grows in pairs and clusters, produces alpha-hemolysis on blood agar, and is negative for catalase and pyrrolidonyl aminopeptidase. Some of these characteristics and its being absent from the databases of most commercial identification systems could allow A. urinae to be misidentified as a streptococcus, enterococcus, or staphylococcus. We report two cases of urinary tract infection (UTI) caused by A. urinae and characterize these isolates by morphology, biochemical testing, whole-cell fatty acid analysis, 16S rRNA gene sequencing, and antibiotic susceptibilities. Most patients infected with A. urinae are elderly males with predisposing conditions who present initially with UTI. Because A. urinae is resistant to sulfonamides, treatment could be inappropriate, with infections resulting in serious complications, including death. I...
El Dengue es una enfermedad infecciosa, endemo-epidémica, hoy emergente, producida por virus ARN ... more El Dengue es una enfermedad infecciosa, endemo-epidémica, hoy emergente, producida por virus ARN de la familia flaviviridae, que precisa de un vector, mosquitos del género aedes, para ser transmitida al hombre. Los casos que aparecen en nuestro medio son importados, por lo que siempre es importante investigar la epidemiología ante cuadros febriles inespecíficos en pacientes que han estado en zonas endémicas.- Se comunica un caso de dengue hemorrágico importado en una mujer joven con compromiso hepático con el propósito de destacar la importancia de indagar acerca de los antecedentes epidemiológicos y realizar una revisión del tema.Dengue is an infectious disease, endemic and epidemic, now emerging, produced by RNA virus of the Flaviviridae family, which requires a vector, the Aedes mosquitoes, to be transmitted to humans. The cases that appear in our city are imported, and it's always important to investigate the epidemiology in nonspecific febrile patients who have been in ende...
The Lancet. Infectious diseases, 2016
Antibiotic resistance is a major global health problem and pathogens such as meticillin-resistant... more Antibiotic resistance is a major global health problem and pathogens such as meticillin-resistant Staphylococcus aureus (MRSA) have become of particular concern in the management of lower respiratory tract infections. However, few data are available on the worldwide prevalence and risk factors for MRSA pneumonia. We aimed to determine the point prevalence of MRSA pneumonia and identify specific MRSA risk factors in community-dwelling patients hospitalised with pneumonia. We did an international, multicentre study of community-dwelling, adult patients admitted to hospital with pneumonia who had microbiological tests taken within 24 h of presentation. We recruited investigators from 222 hospitals in 54 countries to gather point-prevalence data for all patients admitted with these characteristics during 4 days randomly selected during the months of March, April, May, and June in 2015. We assessed prevalence of MRSA pneumonia and associated risk factors through logistic regression analy...
Medicina, 1998
Disseminated Gonococcal Infection (DGI) is very unusual in elderly patients and its association w... more Disseminated Gonococcal Infection (DGI) is very unusual in elderly patients and its association with Rhabdomyolysis (RML) has not been published for which reason we are presenting a case of RML secondary to DGI in an elderly women. We presume that the muscle damage was directly related with the gonococcal infection through toxin generation and release of endogenous mediators from mononuclear phagocytes and neutrophils and/or with ischemic injury due to altered tissue perfusion evidenced in this case by the presence of hypotension, oliguria and acidosis. We suggest that DGI be added to the RML infectious etiologies and considered in the initial differential diagnosis of all patients with polyarthritis and RML in order to facilitate an optimal treatment.
sam.org.ar
USO DE ANTIBIOTICOS. EN UN HOSPITAL GENERAL DE AGUDOS. Autores. Acosta Soledad. Salomón Susana. T... more USO DE ANTIBIOTICOS. EN UN HOSPITAL GENERAL DE AGUDOS. Autores. Acosta Soledad. Salomón Susana. Torres Alfredo. Prieto Sebastián. Attorri Silvia. Carena José. Servicio de Clínica Médica. Hospital Luis Lagomaggiore. Mendoza. Facultad de Ciencias Médicas. ...
revista.medicina.edu.ar
significativamente por tener predominio del foco pulmonar y urinario, de hipotensión arterial, ol... more significativamente por tener predominio del foco pulmonar y urinario, de hipotensión arterial, oliguria y encefalopatía, de bacteriemia por BGN, principalmente A. baumanii y E. coli; mayor desarrollo de shock séptico, menor frecuencia de fiebre >38°C y de bacteriemia por MSSA, y significativa mayor mortalidad.-Palabras claves: bacteriemias, pacientes mayores de 65 años, mortalidad ABSTRACT BACTEREMIA IN ELDERLY PATIENTS: RESULTS OF A COMPARATIVE ANALYSIS Objectives: To evaluate clinical and bacteriological parameters and morbimortality in patients older than 65 years old with bacteremia (Group A), and to compare with patients younger than 65 years old (Group B), hospitalized in an Internal Medicine Service.-Material and methods: In a protocolized, descriptive and observational study from year 1989 through 2006 we studied patients with two or more positive blood cultures. Data was analized with Epi Info 6.4.
Revista Médica Universitaria, Dec 4, 2020
This article cites 8 articles, 5 of which can be accessed free at:
СЕРГЕЙ ЗЕНКИН * ЗАКОНЫ ТРАНСГРЕССИИ * * Аннотация: Эпоха модерна, обосновавшая создание обществен... more СЕРГЕЙ ЗЕНКИН * ЗАКОНЫ ТРАНСГРЕССИИ * * Аннотация: Эпоха модерна, обосновавшая создание общественных и гуманитарных наук, столкнулась с непостоянством законов этих наук, которые исторически меняются, допускают возмущающие воздействия индивидов и, следовательно, включают в себя закономерные исключения и нарушения-то, что в социальной теории называют трансгрессией. В отличие от обычного исключения из правил трансгрессия всегда переживается и осознается субъектом; в отличие от диалектического противоречия она не обязательно включает в себя момент развития. Трансгрессия может затрагивать как дескриптивные, так и прескриптивные законы, распространяться на логические классификации, языковые правила, социальное поведение людей. Ее динамическая структура заставляет сопоставлять ее с устройством повествования-текста, интегрирующего во временной последовательности разнородные, нередко противоречащие друг другу элементы (события). В статье рассматриваются различные виды трансгрессивных нарушений в науке и художественной литературе, связанных с законами разных дисциплин: логические исключения (на примере одного из эпизодов романа Флобера «Бувар и Пекюше», где обнаруживается противоречивость ботанической классификации), психологическое остранение (на примере теорий русских формалистов-в таких литературных эффектах, как аномальное скопление плавных согласных в фонетике поэтических текстов или «единство и теснота стихового ряда» в их семантике), ритуальная трансгрессия в антропологии (на примере теорий Жоржа Батая о нарушении сексуальных запретов, подтверждающем их существование и переживаемом субъектом как прегрешение). Воспроизводя трансгрессивные практики в художественном творчестве, литература и искусство вырабатывают новую форму мимесиса, специфически присущую современной культуре: происходящее при трансгрессии взаимообращение «плюса» и «минуса», иерархический переворот ценностей составляют постоянную черту новоевропейской мысли; такова форма самоосуществления современного субъекта, переживающего свою «экзистенцию» в выходе за пределы законопослушного поведения и творчества.
Objetivos: Comparar si el tamano de la vegetacion tiene implicancias en la morbimortalidad de la ... more Objetivos: Comparar si el tamano de la vegetacion tiene implicancias en la morbimortalidad de la endocarditis infecciosa. Material y Metodos: Estudio comparativo entre pacientes con vegetacion mayor o igual a 10 mm de diametro (Grupo A) y menor de 10 (Grupo B). Criterios de inclusion: pacientes mayores de 16 anos con endocarditis segun criterios de Duke. Analisis estadistico con Epi Info 6.04. Resultados: Se incluyeron 106 pacientes, 49 (46,2 %) grupo A y 57 (53,8 %) B. La edad media de A fue 49,73 anos vs. 44,61 de B, p 0,12, sin diferencias en mayores de 65 anos, 20,4 vs.17,5 %, p 0,7, con predominio de hombres, 67,3 vs. 66,7 %, p 0,9. Tenian valvulopatia conocida 29,2 vs. 40,4 %, p 0,23 y hemocultivos positivos 73,5 vs. 72,7 %, p 0,93. Los cocos Gram positivos predominaron, 67,3 en A vs. 76,6 % en B, p 0,49. La infeccion por S. aureus meticilino resistente fue mayor en A, 14,3 vs. 3,5 %, p 0,04. El 43,18 % de las endocarditis izquierdas tenian vegetacion mayor de 10 mm vs. 61,11 ...
Objetivos Comparar caracteristicas clinicas, complicaciones y mortalidad entre pacientes internad... more Objetivos Comparar caracteristicas clinicas, complicaciones y mortalidad entre pacientes internados con neutropenia febril postquimioterapia (NFQ), debidas a neoplasias hematologicas (NH) o de organo solido (NOS). Material y Metodos Estudio prospectivo y comparativo en pacientes con neutropenia febril posquimioterapia definida por criterios IDSA. Resultados Se incluyeron 68 episodios de NFQ en 44 pacientes; NH 73,5 % y NOS 26,5 %. La edad media fue 39,6 ± 16,1 anos en NH vs. 52,2 ± 11,3 en NOS (p 0,003); mujeres 56 % vs. 38,9 % (p 0,21). La mediana de permanencia fue 18 (4-63) y 6 (3-10) dias respectivamente (p 0,0002). Tuvieron neutropenia prolongada 48 % vs. 5,6 % (p 0,001). Presentaron sepsis al ingreso 64 % vs. 22,2 % (p 0,002). El foco documentado fue cutaneo mucoso en 48 % vs. 50 % (p 0,88); pulmonar 36 % vs. 11,1 % (p 0,04); endovascular 20 % vs. 5,6 % (p 0,15); via aerea superior 12 % vs. 11,1 % (p 0,92); abdominal 12 % vs. 11,1 % (p 0,92) y genitourinario 8 % vs 5,6 % (p 0,...
Objetivo. Determinar parametros hematimetricos de celularidad como predictores de bacteriemia. M... more Objetivo. Determinar parametros hematimetricos de celularidad como predictores de bacteriemia. Material y metodo. Estudio prospectivo, comparativo (junio de 2012-junio de 2014). Criterios de inclusion: pacientes a los que se realizo dos hemocultivos (HC) por sospecha de bacteriemia. Se considero bacteriemia (GA) al crecimiento de bacterias con capacidad patogena conocida en al menos uno de dos HC o desarrollo de saprofitos cutaneos en las dos muestras, y contaminacion a los HC positivos que no cumplieron los criterios mencionados; estos ultimos fueron incluidos en el analisis junto a los pacientes con HC negativos y se conformo el grupo (GB). Se analizo en el hemograma de las primeras 24 horas de la bacteriemia, el recuento total de neutrofilos, linfocitos y eosinofilos (/mm3) y la relacion neutrofilos-linfocitos (RN/L). Analisis estadistico univariado: para las variables categoricas χ2 y para las numericas con test de Student; criterio de significacion: error α 37 °C; p = 0,25, T°...
Journal of Clinical Microbiology, 2000
Mycobacterium tuberculosis often exhibits serpentine cording when grown in liquid medium, whereas... more Mycobacterium tuberculosis often exhibits serpentine cording when grown in liquid medium, whereas Mycobacterium kansasii can be larger and cross-barred. We assessed the use of these morphologic characteristics as a cost-effective method for rapid presumptive identification of isolates from BACTEC bottles. Without specific training, using the Kinyoun acid-fast stain, definitive cording was found in 237 of 373 specimens positive for M. tuberculosis (64%) and cross-barring was recognized within 63 of 76 (83%) of the specimens positive for M. kansasii , giving sensitivities specificities, positive predictive values, and negative predictive values of 63.5, 96, 92, and 79%, respectively, for M. tuberculosis and 83, 95, 59, and 98%, respectively, for M. kansasii . With training and experience, these results improved to 74.5, 98, 96, and 84% and 93, 98, 79, and 98%, respectively. The major improvements were in distinguishing the pseudocording, or loose aggregation of Mycobacterium avium com...
Clinical Infectious Diseases, 2001
Difficulties in distinguishing organisms of the "Streptococcus milleri group" (SMG; Streptococcus... more Difficulties in distinguishing organisms of the "Streptococcus milleri group" (SMG; Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus), have caused ambiguity in determining their pathogenic potential. We reviewed 118 cases in which SMG isolates had been identified using 16S rDNA sequence. S. constellatus and S. anginosus were isolated far more frequently than was S. intermedius. Nearly all isolates of S. intermedius and most isolates of S. constellatus, but only 19% of those of S. anginosus, were associated with abscess. Our findings suggest that speciation of the SMG may guide diagnostic evaluation, give insight into the possible role of coinfecting organisms, and help assess the need to search for occult abscess. The "Streptococcus milleri group" (SMG) has been known by a variety of names [1] and, in the past, has been considered a single species that is loosely synonymous with S. anginosus [2]. Members of the SMG are now separated into 3 distinct species-Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus-with S. constellatus and S. intermedius being more closely related to each other than to S. anginosus [3-5]. However, because many phenotypic tests for the characterization of these species yield similar results, identification of isolates can be difficult.
Clinical Infectious Diseases
Background The correct management of immunocompromised patients with pneumonia is debated. We eva... more Background The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. Methods We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. Results At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CA...
Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identificati... more Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identification of the organism. A. urinae is a gram-positive coccus that grows in pairs and clusters, produces alpha-hemolysis on blood agar, and is negative for catalase and pyrrolidonyl aminopeptidase. Some of these characteristics and its being absent from the databases of most commercial identification systems could allow
Journal of Clinical Microbiology, 2000
Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identificati... more Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identification of the organism. A. urinae is a gram-positive coccus that grows in pairs and clusters, produces alpha-hemolysis on blood agar, and is negative for catalase and pyrrolidonyl aminopeptidase. Some of these characteristics and its being absent from the databases of most commercial identification systems could allow A. urinae to be misidentified as a streptococcus, enterococcus, or staphylococcus. We report two cases of urinary tract infection (UTI) caused by A. urinae and characterize these isolates by morphology, biochemical testing, whole-cell fatty acid analysis, 16S rRNA gene sequencing, and antibiotic susceptibilities. Most patients infected with A. urinae are elderly males with predisposing conditions who present initially with UTI. Because A. urinae is resistant to sulfonamides, treatment could be inappropriate, with infections resulting in serious complications, including death. I...
El Dengue es una enfermedad infecciosa, endemo-epidémica, hoy emergente, producida por virus ARN ... more El Dengue es una enfermedad infecciosa, endemo-epidémica, hoy emergente, producida por virus ARN de la familia flaviviridae, que precisa de un vector, mosquitos del género aedes, para ser transmitida al hombre. Los casos que aparecen en nuestro medio son importados, por lo que siempre es importante investigar la epidemiología ante cuadros febriles inespecíficos en pacientes que han estado en zonas endémicas.- Se comunica un caso de dengue hemorrágico importado en una mujer joven con compromiso hepático con el propósito de destacar la importancia de indagar acerca de los antecedentes epidemiológicos y realizar una revisión del tema.Dengue is an infectious disease, endemic and epidemic, now emerging, produced by RNA virus of the Flaviviridae family, which requires a vector, the Aedes mosquitoes, to be transmitted to humans. The cases that appear in our city are imported, and it's always important to investigate the epidemiology in nonspecific febrile patients who have been in ende...
The Lancet. Infectious diseases, 2016
Antibiotic resistance is a major global health problem and pathogens such as meticillin-resistant... more Antibiotic resistance is a major global health problem and pathogens such as meticillin-resistant Staphylococcus aureus (MRSA) have become of particular concern in the management of lower respiratory tract infections. However, few data are available on the worldwide prevalence and risk factors for MRSA pneumonia. We aimed to determine the point prevalence of MRSA pneumonia and identify specific MRSA risk factors in community-dwelling patients hospitalised with pneumonia. We did an international, multicentre study of community-dwelling, adult patients admitted to hospital with pneumonia who had microbiological tests taken within 24 h of presentation. We recruited investigators from 222 hospitals in 54 countries to gather point-prevalence data for all patients admitted with these characteristics during 4 days randomly selected during the months of March, April, May, and June in 2015. We assessed prevalence of MRSA pneumonia and associated risk factors through logistic regression analy...
Medicina, 1998
Disseminated Gonococcal Infection (DGI) is very unusual in elderly patients and its association w... more Disseminated Gonococcal Infection (DGI) is very unusual in elderly patients and its association with Rhabdomyolysis (RML) has not been published for which reason we are presenting a case of RML secondary to DGI in an elderly women. We presume that the muscle damage was directly related with the gonococcal infection through toxin generation and release of endogenous mediators from mononuclear phagocytes and neutrophils and/or with ischemic injury due to altered tissue perfusion evidenced in this case by the presence of hypotension, oliguria and acidosis. We suggest that DGI be added to the RML infectious etiologies and considered in the initial differential diagnosis of all patients with polyarthritis and RML in order to facilitate an optimal treatment.
sam.org.ar
USO DE ANTIBIOTICOS. EN UN HOSPITAL GENERAL DE AGUDOS. Autores. Acosta Soledad. Salomón Susana. T... more USO DE ANTIBIOTICOS. EN UN HOSPITAL GENERAL DE AGUDOS. Autores. Acosta Soledad. Salomón Susana. Torres Alfredo. Prieto Sebastián. Attorri Silvia. Carena José. Servicio de Clínica Médica. Hospital Luis Lagomaggiore. Mendoza. Facultad de Ciencias Médicas. ...
revista.medicina.edu.ar
significativamente por tener predominio del foco pulmonar y urinario, de hipotensión arterial, ol... more significativamente por tener predominio del foco pulmonar y urinario, de hipotensión arterial, oliguria y encefalopatía, de bacteriemia por BGN, principalmente A. baumanii y E. coli; mayor desarrollo de shock séptico, menor frecuencia de fiebre >38°C y de bacteriemia por MSSA, y significativa mayor mortalidad.-Palabras claves: bacteriemias, pacientes mayores de 65 años, mortalidad ABSTRACT BACTEREMIA IN ELDERLY PATIENTS: RESULTS OF A COMPARATIVE ANALYSIS Objectives: To evaluate clinical and bacteriological parameters and morbimortality in patients older than 65 years old with bacteremia (Group A), and to compare with patients younger than 65 years old (Group B), hospitalized in an Internal Medicine Service.-Material and methods: In a protocolized, descriptive and observational study from year 1989 through 2006 we studied patients with two or more positive blood cultures. Data was analized with Epi Info 6.4.
Revista Médica Universitaria, Dec 4, 2020
This article cites 8 articles, 5 of which can be accessed free at:
СЕРГЕЙ ЗЕНКИН * ЗАКОНЫ ТРАНСГРЕССИИ * * Аннотация: Эпоха модерна, обосновавшая создание обществен... more СЕРГЕЙ ЗЕНКИН * ЗАКОНЫ ТРАНСГРЕССИИ * * Аннотация: Эпоха модерна, обосновавшая создание общественных и гуманитарных наук, столкнулась с непостоянством законов этих наук, которые исторически меняются, допускают возмущающие воздействия индивидов и, следовательно, включают в себя закономерные исключения и нарушения-то, что в социальной теории называют трансгрессией. В отличие от обычного исключения из правил трансгрессия всегда переживается и осознается субъектом; в отличие от диалектического противоречия она не обязательно включает в себя момент развития. Трансгрессия может затрагивать как дескриптивные, так и прескриптивные законы, распространяться на логические классификации, языковые правила, социальное поведение людей. Ее динамическая структура заставляет сопоставлять ее с устройством повествования-текста, интегрирующего во временной последовательности разнородные, нередко противоречащие друг другу элементы (события). В статье рассматриваются различные виды трансгрессивных нарушений в науке и художественной литературе, связанных с законами разных дисциплин: логические исключения (на примере одного из эпизодов романа Флобера «Бувар и Пекюше», где обнаруживается противоречивость ботанической классификации), психологическое остранение (на примере теорий русских формалистов-в таких литературных эффектах, как аномальное скопление плавных согласных в фонетике поэтических текстов или «единство и теснота стихового ряда» в их семантике), ритуальная трансгрессия в антропологии (на примере теорий Жоржа Батая о нарушении сексуальных запретов, подтверждающем их существование и переживаемом субъектом как прегрешение). Воспроизводя трансгрессивные практики в художественном творчестве, литература и искусство вырабатывают новую форму мимесиса, специфически присущую современной культуре: происходящее при трансгрессии взаимообращение «плюса» и «минуса», иерархический переворот ценностей составляют постоянную черту новоевропейской мысли; такова форма самоосуществления современного субъекта, переживающего свою «экзистенцию» в выходе за пределы законопослушного поведения и творчества.
Objetivos: Comparar si el tamano de la vegetacion tiene implicancias en la morbimortalidad de la ... more Objetivos: Comparar si el tamano de la vegetacion tiene implicancias en la morbimortalidad de la endocarditis infecciosa. Material y Metodos: Estudio comparativo entre pacientes con vegetacion mayor o igual a 10 mm de diametro (Grupo A) y menor de 10 (Grupo B). Criterios de inclusion: pacientes mayores de 16 anos con endocarditis segun criterios de Duke. Analisis estadistico con Epi Info 6.04. Resultados: Se incluyeron 106 pacientes, 49 (46,2 %) grupo A y 57 (53,8 %) B. La edad media de A fue 49,73 anos vs. 44,61 de B, p 0,12, sin diferencias en mayores de 65 anos, 20,4 vs.17,5 %, p 0,7, con predominio de hombres, 67,3 vs. 66,7 %, p 0,9. Tenian valvulopatia conocida 29,2 vs. 40,4 %, p 0,23 y hemocultivos positivos 73,5 vs. 72,7 %, p 0,93. Los cocos Gram positivos predominaron, 67,3 en A vs. 76,6 % en B, p 0,49. La infeccion por S. aureus meticilino resistente fue mayor en A, 14,3 vs. 3,5 %, p 0,04. El 43,18 % de las endocarditis izquierdas tenian vegetacion mayor de 10 mm vs. 61,11 ...
Objetivos Comparar caracteristicas clinicas, complicaciones y mortalidad entre pacientes internad... more Objetivos Comparar caracteristicas clinicas, complicaciones y mortalidad entre pacientes internados con neutropenia febril postquimioterapia (NFQ), debidas a neoplasias hematologicas (NH) o de organo solido (NOS). Material y Metodos Estudio prospectivo y comparativo en pacientes con neutropenia febril posquimioterapia definida por criterios IDSA. Resultados Se incluyeron 68 episodios de NFQ en 44 pacientes; NH 73,5 % y NOS 26,5 %. La edad media fue 39,6 ± 16,1 anos en NH vs. 52,2 ± 11,3 en NOS (p 0,003); mujeres 56 % vs. 38,9 % (p 0,21). La mediana de permanencia fue 18 (4-63) y 6 (3-10) dias respectivamente (p 0,0002). Tuvieron neutropenia prolongada 48 % vs. 5,6 % (p 0,001). Presentaron sepsis al ingreso 64 % vs. 22,2 % (p 0,002). El foco documentado fue cutaneo mucoso en 48 % vs. 50 % (p 0,88); pulmonar 36 % vs. 11,1 % (p 0,04); endovascular 20 % vs. 5,6 % (p 0,15); via aerea superior 12 % vs. 11,1 % (p 0,92); abdominal 12 % vs. 11,1 % (p 0,92) y genitourinario 8 % vs 5,6 % (p 0,...
Objetivo. Determinar parametros hematimetricos de celularidad como predictores de bacteriemia. M... more Objetivo. Determinar parametros hematimetricos de celularidad como predictores de bacteriemia. Material y metodo. Estudio prospectivo, comparativo (junio de 2012-junio de 2014). Criterios de inclusion: pacientes a los que se realizo dos hemocultivos (HC) por sospecha de bacteriemia. Se considero bacteriemia (GA) al crecimiento de bacterias con capacidad patogena conocida en al menos uno de dos HC o desarrollo de saprofitos cutaneos en las dos muestras, y contaminacion a los HC positivos que no cumplieron los criterios mencionados; estos ultimos fueron incluidos en el analisis junto a los pacientes con HC negativos y se conformo el grupo (GB). Se analizo en el hemograma de las primeras 24 horas de la bacteriemia, el recuento total de neutrofilos, linfocitos y eosinofilos (/mm3) y la relacion neutrofilos-linfocitos (RN/L). Analisis estadistico univariado: para las variables categoricas χ2 y para las numericas con test de Student; criterio de significacion: error α 37 °C; p = 0,25, T°...
Journal of Clinical Microbiology, 2000
Mycobacterium tuberculosis often exhibits serpentine cording when grown in liquid medium, whereas... more Mycobacterium tuberculosis often exhibits serpentine cording when grown in liquid medium, whereas Mycobacterium kansasii can be larger and cross-barred. We assessed the use of these morphologic characteristics as a cost-effective method for rapid presumptive identification of isolates from BACTEC bottles. Without specific training, using the Kinyoun acid-fast stain, definitive cording was found in 237 of 373 specimens positive for M. tuberculosis (64%) and cross-barring was recognized within 63 of 76 (83%) of the specimens positive for M. kansasii , giving sensitivities specificities, positive predictive values, and negative predictive values of 63.5, 96, 92, and 79%, respectively, for M. tuberculosis and 83, 95, 59, and 98%, respectively, for M. kansasii . With training and experience, these results improved to 74.5, 98, 96, and 84% and 93, 98, 79, and 98%, respectively. The major improvements were in distinguishing the pseudocording, or loose aggregation of Mycobacterium avium com...
Clinical Infectious Diseases, 2001
Difficulties in distinguishing organisms of the "Streptococcus milleri group" (SMG; Streptococcus... more Difficulties in distinguishing organisms of the "Streptococcus milleri group" (SMG; Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus), have caused ambiguity in determining their pathogenic potential. We reviewed 118 cases in which SMG isolates had been identified using 16S rDNA sequence. S. constellatus and S. anginosus were isolated far more frequently than was S. intermedius. Nearly all isolates of S. intermedius and most isolates of S. constellatus, but only 19% of those of S. anginosus, were associated with abscess. Our findings suggest that speciation of the SMG may guide diagnostic evaluation, give insight into the possible role of coinfecting organisms, and help assess the need to search for occult abscess. The "Streptococcus milleri group" (SMG) has been known by a variety of names [1] and, in the past, has been considered a single species that is loosely synonymous with S. anginosus [2]. Members of the SMG are now separated into 3 distinct species-Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus-with S. constellatus and S. intermedius being more closely related to each other than to S. anginosus [3-5]. However, because many phenotypic tests for the characterization of these species yield similar results, identification of isolates can be difficult.
Clinical Infectious Diseases
Background The correct management of immunocompromised patients with pneumonia is debated. We eva... more Background The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. Methods We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. Results At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CA...
Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identificati... more Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identification of the organism. A. urinae is a gram-positive coccus that grows in pairs and clusters, produces alpha-hemolysis on blood agar, and is negative for catalase and pyrrolidonyl aminopeptidase. Some of these characteristics and its being absent from the databases of most commercial identification systems could allow