En pacientes con infecciones urinarias de repetición. Prof.Dr.Mauricio Martí-Brenes (original) (raw)
Related papers
Existe indicación de vacunas orales para el tratamiento de infecciones urinarias recurrentes.pdf
by Prof.Dr.Mauricio Martí-Brenes and Alberto Juan Dorta-Contreras
De acuerdo con dos revisiones sistemáticas de ensayos clínicos controlados, la vacuna oral de cepas de E. Coli OM-89 parece mostrar resultados prometedores en pacientes diagnosticados de infecciones urinarias recurrentes (IUR); aunque estos hallazgos no han sido confirmados en un ensayo publicado más recientemente. Una guía de práctica clínica europea y el sumario de Dynamed señalan una posible indicación de la vacuna OM-89; pero las demás guías y sumarios aconsejan realizar mas estudios antes de generar una recomendación clara a favor de las vacunas orales como profilaxis en IUR.
Tratamiento de una bacteriuria asintomática en el varón
Tratamiento de una bacteriuria asintomática en el varón
De acuerdo con la información de preguntas relacionadas, formuladas previamente al servicio Preevid (Ver enlaces más abajo), y de los sumarios de evidencia (1,2) ,revisión sistemática (3) y guías de práctica clínica (4, consultadas, tan solo estaría indicado el tratamiento con antibióticos de la bacteriuria asintomática, en los hombres a los que se les va a realizar una cirugía o exploración urológica que implique daño en la mucosa.
Três anos de avaliação das taxas de infecção nosocomial em UTI
Revista Brasileira De Anestesiologia, 2013
Background and objectives: Evaluating the incidence of nosocomial and invasive device-related infections enables the comparison of the health care associated infection (HAI) between the intensive care units of different hospitals and different units in the same hospital. Material and methods: A retrospective surveillance study was performed to identify nosocomial infections, device-related infections rates, and causal agents from January 2007 through December 2010 in the Anesthesiology Intensive care unit (ICU). HAI were defi ned according to the CDC (Centers for Disease Control and Prevention) criteria, and invasive device-related infections were defi ned according to National Nosocomial Infection Surveillance System (NNIS) criteria. Results: During a two-year period, 939 patients were analyzed throughout a total of 7,892 patientdays. The rates of HAI were 53% in 2007, 29.15% in 2008, 28.85% in 2009 while 16.62% in 2010. Most common HAI was blood stream infection. The rate of soft tissue and skin infection was the second most common. Overall, the most common agents were Gram(-) 56.68 %, Gram(+) 31.02% and Candida spp 12.3% among patients with nosocomial infections. Conclusions: The incidence of HAI in the ICU of our hospital was high, compared to the Turkish overall rates obtained at the Refi k Saydam Center in 2007. When the rates of device-related infections between 2007 and 2008 were compared, they were higher in 2007. The rates of devicerelated infections were diminished in 2008 to below-national mean rates by infection control measures. Since the rate of urinary catheter-related infections are still high, we should exert continuous efforts for infection control.
Introduction Urinary tract infections (UTI) are common infections encountered by physicians either on an outpatient or inpatient basis. These infections have taken center stage due to increasing resistance being reported for commonly used antibiotics. Understanding the distribution and antibiotic susceptibility patterns of uropathogens would facilitate appropriate therapy. Methods A retrospective analysis of the culture isolates obtained from urine samples received at the Results Of the 5592 urine specimens received, 28.2% showed significant growth. A total of 1673 identified pathogens were used in the analysis. Escherichia coli (54.6%) was the most common Gram-negative bacillus, followed by Klebsiella species (9.7%) and Pseudomonas species (7.5%). The most common Gram-positive coccus was Enterococcus (8.8%). Most of the Gram-negative isolates were resistant to ampicillin (79.3%) and cephalosporins (60%). Resistance to cephalosporins and fluoroquinolones was higher in isolates from inpatients. Other than Klebsiella spp., all other Enterobacteriaceae were susceptible to carbapenems (93%) and aminoglycosides (85%), whilst fluoroquinolones were effective for all Gram-positive bacteria. Conclusion Due to a high level of antimicrobial resistance amongst the pathogens causing UTI in India, it is cautious to advise or modify therapy, as far as possible, after culture and sensitivity testing have been performed. Regional surveillance programs are warranted for the development of national UTI guidelines.
This study is a follow up of the study with urine samples in which the value of the PREVI Isola (bioMérieux) system in the routine diagnostic laboratory was analyzed (ECCMID 2009 − Ab.Nr. 1459. PREVI Isola is a system for automated inoculation and streaking and is able to process any material from patients (liquid format). For urine samples we observed less sub culturing and earlier identification resulting in saving labor time and costs. The aim of this study was to explore the usefulness of the PREVI Isola for more difficult samples as feces and genital swabs. Methods: Feces or genital swabs from 100 different patients were processed manual and by the PREVI Isola. Fecal samples were cultured for Campylobacter (Campylobacter agar), Salmonella and Shigella (XLD-agar) and Yersinia (Yersinia agar). Genital swabs were cultured for aerobic bacteria (blood agar), anaerobic bacteria (anaerobic blood agar), Neisseria gonorrhoeae (GO agar), Gardnerella vaginalis (Gardnerella agar) and for yeasts (Sabouraud agar). For the PREVI Isola both feces (20 ml) and the genital swabs were suspended in 2.5 ml NaCl. Results for fecal samples: All samples could be evaluated. No Salmonella or Shigella was found. In 5 samples a Campylobacter was found but with the PREVI Isola individual, suspected colonies were better distinguished and were seen earlier (after 1 day). High counts of Yersinia were found in 1 sample but only with the PREVI Isola method. Results for genital swabs: In general counts of the different bacteria were somewhat higher (+) with the PREVI Isola method than after manual inoculation. With PREVI Isola individual colonies of the different bacteria were much better distinguished No difference in the isolation of gonococci (3 samples) was seen with both methods. Gardnerella was 1 day earlier seen and much easier distinguished from other bacteria with the PREVI Isola method. Conclusions: As with urine samples PREVI Isola leads to better readable results for the more difficult cultures of feces and genital swabs: individual suspected colonies were better distinguished and counts were higher. Cultures were also often 1 day earlier positive for suspected colonies. Therefore PREVI Isola is very useful in the time consuming culture of especially genital swabs but also for fecal cultures in which identification can be done earlier.