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La Línea de la Concepción, Spain

Sanchez-Porto A.,Hospital of La Linea | Casanova-Roman M.,Hospital of La Linea | Casas-Ciria J.,Hospital of La Linea | Santaella M.J.,Hospital of La Linea | And 2 more authors.
Infezioni in Medicina | Year: 2010

There is an increasing need for alternative agents in endocarditis, especially with the increasing incidence of vancomycin-intermediate Staphylococcus aureus (VISA). We evaluated the in vitro activity of daptomycin and several comparator agents against 33 non-duplicate clinical Staphylococcus aureus isolates from intravenous drug users with right endocarditis. Wider microdilution panels were used for all the comparator agents and daptomycin. Daptomycin was also tested using E-test strips. E-test strips were used to confirm the vancomycin MICs. Methicillin-resistant Staphylococcus aureus (MRSA isolates with vancomycin MICs ≥2 g/mL were screened using the E-test GRD. In all, 30 isolates were methicillin-susceptible (MSSA) and 3 MRSA. The three MRSA isolates exhibited a false vancomycin MIC >2 g/mL determined by Wider microdilution panels. They were screened using the E-test GRD and they were GRD negative. Their final MIC was 2 g/mL. Three MSSA and three MRSA isolates had a vancomycin MIC of 2 g/mL. Four MSSA isolates had a vancomycin MIC of 1.5 g/mL, daptomycin MIC90 0.25 g/mL, linezolid MIC90 2 g/mL. As regards daptomycin, wider microdilution panels and E-test strips yielded the same results. Our findings suggest that daptomycin and linezolid are a viable alternative for treating right endocarditis and bacteraemia caused by MSSA, MRSA and hVISA.

Perez-Rubio A.,Regional Office for Public Health | Luquero F.J.,Hospital Clinico Universitario | Bouza J.M.E.,Hospital Clinico Universitario | Sanz J.J.C.,Regional Office for Public Health | And 3 more authors.
Infezioni in Medicina | Year: 2011

Rotavirus is one of the main causes of acute gastroenteritis in infants and young children. Furthermore, rotavirus is the leading cause of hospitalization and death from acute gastroenteritis among infants and young children worldwide. Although death due to rotavirus is rare in industrialized regions such as Spain, the rotavirus disease burden and its economic impact is severe. This study aims to assess systematic vaccination against rotavirus economically and socially in a Spanish region. Economic cost-effectiveness and cost-benefit assessment through a choice tree was designed. We estimated health provider costs, economic costs and quality-adjusted life years (QALYs) lost due to rotavirus infections. The study includes a fictitious cohort of 100,000 children from Castilla y León who were also administered the rotavirus vaccine together with diphtheria and tetanus toxoids and pertussis (DTP). The study adopted a society and health care system perspective. A sensitivity analysis was developed to assess the uncertainty of some variables. According to the estimated incidence rate for children in Castilla y León, rotavirus immunization is projected to prevent 45% of cases with RotaTeq® and 57% with Rotarix®. The respective cost per QALY is about € 75,000 and 50,000 from the perspective of the health care system. Routine infant vaccination in Castilla y León using either rotavirus vaccine is not profitable from the payer's perspective and is not cost-effective under basic case assumptions unless the vaccine is available at a lower cost.

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