San Nicolás de los Arroyos, Argentina
San Nicolás de los Arroyos, Argentina

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Espinoza R.,Servicio de Infectologia | Quera R.,Servicio de Gastroenterologia | Meyer L.,Servicio de Urgencia
Revista Chilena de Infectologia | Year: 2014

Clostridium diffcile (CD) infection is increasing in frequency and severity in in-hospital and outpatient clinical settings, with a recurrence that can reach 30% after frst episode. The recurrences are usually treated with longer courses of metronidazole or vancomycin. Other treatments have been used, such as probiotics, fdaxomicin, rifaxi-min, immunoglobulins and monoclonal antibodies against toxins A and B. Fecal microbiota transplantation (FMT) has emerged as a promising strategy in this group of patients, with effectiveness greater than 90%. We present the frst case reported in Chile of this therapeutic strategy in a patient with Crohn´s disease and recurrent CD infection who presented after the fecal transplantation an Escherichia coli bacteremia, suggesting the need for caution in the use of this strategy. 10 months after the FMT the patient presented a new episode of E. coli bacteremia and two episodes of diarrhea due to CD infection, treated both of them with vancomycin with good clinical response. © 2014, Sociedad Chilena de Infectologia. All rights reserved.


Hernandez J.L.S.,Servicio de Infectologia | Perez C.A.P.,Medicina Intensiva | Cordova L.D.C.,Servicio Social | Cordova C.A.C.,National Autonomous University of Mexico
Gaceta Medica de Mexico | Year: 2013

Klebsiella pneumoniae liver abscess syndrome (KLAS) is an emerging infection characterized by primary monomicrobial liver abscess, bacteremia and metastatic complications. KLAS is endemic in Taiwan but additional cases has also been described in other world regions. It's caused by strains of K. pneumonia serotype K1, rmpA, magA positive, displaying hypermucoviscosity. We present the case of a previously healthy 69 years old patient who developed fever, liver abscess, septic shock, bacteremia, and pneumonia. In cultures grew hypermucoviscous phenotype of K. pneumonia characterized by positive "string test". The patient responded favourably to antibiotic therapy with ceftriaxone, meropenem, amykacin and percutaneous drainage of the abscess. Increased awareness about this globally emerging infection by physicians could allow earlier detection and optimal treatment.


Background: Resistance to anti-tuberculosis treatment is a matter of great interest in terms of public health. TB/HIV coinfection changed what was previously known about TB. Our study attempts to determine the prevalence of resistance to TB drugs among a local TB/HIV population. Methods: A retrospective study was conducted, which consisted of a review of the clinical records of new and relapsing cases of TB/HIV coinfected patients, with drug susceptibility tests, who attended an advanced medical care centre in Cali, Colombia, between 2007 and 2010. Results: Just over half (52%) of the patients were native from Cali, and 8% were from Buenaventura. An extra-pulmonary presentation of TB was seen in 80% of the subjects. Almost half (48%) were HIV positive before the diagnosis of tuberculosis was made, 40% of whom were on HAART treatment. Of the total cases, 16% were relapses, including one case of multi-drug resistant (MDR)-TB. Among the new cases, 14% were resistant to isoniazid only, making a total of 28% being resistant to this. Conclusions: There was a higher than expected prevalence of resistance in TB/HIV patients. There is an urgent need to improve the team work between public health organizations and private medical institutions, and this cooperation should be of great priority, as it is a means to control and promote early diagnosis with drug-susceptibility tests. © 2012 ACIN.


Praino M.L.,Hospital Of Ninos Ricardo Gutierrez | Berberian G.,Hospital Of Pediatria Prof Dr J P Garrahan | Torroija C.,Servicio de Infectologia
Archivos Argentinos de Pediatria | Year: 2015

The number of children who travel outside their home countries has increased dramatically. Whatever the reason for it, it involves exposure to an environment with characteristics that must be taken into account. Similarly, the transfer itself can generate anxiety in the family and presents the risk of vehicle-related injuries (which is the leading cause of death in children who travel). Parents will often seek for pre-travel advice. The aim of this paper is to review the recommendations to assess a family who is planning to travel with children. Initially, general recommendations will be addressed in the preparation of the trip and afterwards insect-borne diseases prevention.


Berberian G.,Hospital Of Pediatria Prof Dr J P Garrahan | Rosanova M.T.,Hospital Of Pediatria Prof Dr J P Garrahan | Torroija C.,Servicio de Infectologia | Praino M.L.,Hospital Of Ninos Ricardo Gutierrez
Archivos Argentinos de Pediatria | Year: 2014

The development and spread of drug resistant Malaria parasites, population and travelers movements to Malaria zones have led to the resurgence of Malaria as a global health problem. Estimates suggest that 660 000 deaths occur annually, mainly in infants, children and pregnant woman. Disease knowledge and protection against mosquito bites are the first line of defense against Malaria. Malaria chemoprophylaxis adds to these measures, it must be evaluated based on the individual risk.


PubMed | Hospital Of Pediatria Prof Dr J P Garrahan, Hospital Of Ninos Ricardo Gutierrez and Servicio de Infectologia
Type: Journal Article | Journal: Archivos argentinos de pediatria | Year: 2015

The number of children who travel outside their home countries has increased dramatically.Whatever the reason for it, it involves exposure to an environment with characteristics that must be taken into account. Similarly, the transfer itself can generate anxiety in the family and presents the risk of vehicle-related injuries (which is the leading cause of death in children who travel). Parents will often seek for pre-travel advice. The aim of this paper is to review the recommendations to assess a family who is planning to travel with children. Initially,general recommendations will be addressed in the preparation of the trip and afterwards insect-borne diseases prevention.


Cornistein W.,Servicio de Infectologia | Mora A.,Servicio de Infectologia | Orellana N.,Laboratorio Of Bacteriologia | Capparelli F.J.,Servicio de Clinica Medica | Del Castillo M.,Servicio de Infectologia
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2013

Introduction: Nosocomial fungal infections have increased significantly in the last decade. Candida detection in clinical specimens can mean either colonization or an infection which can be local (muguet) or invasive. Knowledge of the species helps in choosing the best treatment. The aims of this study were to determine the frequency and distribution of Candida species detected in clinical samples, to analyze the clinical characteristics of the involved population and to determine the risk factors for Candida non-albicans species. Methods: Retrospective, observational. Period: 2006-2010. Inclusion criteria: all isolates of Candida in clinical specimens from patients hospitalized - at least 48 hours in a neurological center. We analyzed epidemiological characteristics, co morbidities, risk factors, factors associated with Candida non-albicans detection, antifungal treatment, development of adverse events and mortality. Results: Candida spp. was isolated from 321 clinical specimens: 139 (43.3%) were C. albicans and 182 (56.7%) Candida non-albicans. The distribution of the sample was: urine 122 (Candida non-albicans 67.2%), airway 81, oropharynx 45 (C. albicans) and candidemia 40 (Candida non-albicans 75%). The most frequent co-morbidity was solid tumor (35.5%). The main risk factors were antibiotic therapy (85.5%), steroid therapy (61.7%) and in ICU at diagnosis (61.6%). The analysis of risk factors and the isolation of Candida non-albicans shows that chemotherapy, previous surgery, treatment with aminopenicillins, carbapenems and glycopeptides were statistically significant (P <.05). There is a trend in neutropenic patients (P =.055) and in ICU at diagnosis (P =.076). Overall survival was 71%. Conclusions: Candida species distribution varies with the type of sample analyzed. Non-albicans species make up the majority of the isolates. The identification of the species involved per sample helps to optimize treatment. The high frequency of isolation of Candida in patients on steroids and antibiotics and admitted to ICU, is worth pointing out. Patients with previous surgery, treated with the aforementioned antibiotics or chemotherapy, could receive non-azole antifungals in the initial empirical treatment strategy. © 2013 Elsevier España, S.L. All rights reserved.


Perez Diaz C.E.,Servicio de Infectologia | Perez Diaz C.E.,Hospital Militar Central | Perez Diaz C.E.,Hospital Universitario Of La Samaritana Bogota | Bravo Ojeda J.S.,University Militar Nueva Granada
Urologia Colombiana | Year: 2014

The usefulness of gram urine in urology's surgical pathology is established as a predictive tool for urine culture, characterized by the speed and facility of technique. In addition, descriptions of Colombian studies which demonstrate its usefulness. Factors and characteristics of asymptomatic bacteriuria and its management in patients scheduled for urological surgery are described. © 2014 Sociedad Colombiana de Urología.


Ayala-Gaytan J.J.,Servicio de Infectologia | Aleman-Bocanegra M.C.,Servicio de Infectologia | Guajardo-Lara C.E.,Hospital San Jose Tec Of Monterrey | Valdovinos-Chavez S.B.,Ensenanza e Investigacion SSNL Hospital
Medicina Interna de Mexico | Year: 2014

Background: Recently the susceptibility cutoff point of S. aureus to vancomycin was reduced 4 to 2 mg/mL due to poor response, now questions whether a further reduction should be done. Objective: To review the frequency of isolations of methicillin and vancomycin resistant strains of S aureus in our hospital. Material and method: A retrospective, cross-sectional and descriptive study was done; within 3 years we isolated strains of S. aureus and MICs to vancomycin were obtained with the MicroScan system (Dade-Behring, Sacramento, CA) according to the Clinical and Laboratory Standards Institute. Results: Seven (13.2%) out of 53 MSSA and 17 (19.1%) out of 89 MRSA strains gave vancomycin MIC of 2 μg/mL, MIC was not greater in any case. From these 24 samples, 10 (41.6%) were from subcutaneous abscesses, 8 (33.3%) from bronchial lavage, 4 from blood cultures and two from joint fluid. Conclusions: The resistance in our isolates of S. aureus to methicillin is high, and important the coexistence of meticyline-resistant and -susceptible S. aureus with vancomycin MICs of 2 μg/mL. We found no strains with MICs ≥ 4 μg/mL. The laboratory must be aware of the strains with vancomycin MIC > 2 μg/mL, and this information should be confirmed in cases of severe infections.


introduction. Leptospirosis is an infectious disease caused by a spirochete genus Leptospira sp. comprising 24 serogroup and 250 serovars. It has been reported a fatality rate of up to 22%. materials and methods. From September 2007 to December 2011, 43 clinical records of discharged patients with presumptive diagnosis of leptospirosis were reviewed. Suspected case was considered with a MAT positive test greater than or equal to 1:80. results. 21 cases (48.83%) were positive by any of the serovars of Leptospira identified. Of the 21 positive patients, 14 cases (66.6%) had a benign or anicteric form, 7 cases (33.3%) were severe and of these, 4 patients (19.04%) had Weil's disease. conclusions. It is important to consider in those patients with acute febrile illness accompanied by hepatic and renal involvement, with thrombocytopenia with or without bleeding manifestations the possible presence of Leptospira sp.

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