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Biomedical subjects

E Bouza

Publications and source records attributed to E Bouza.

At least 109 records · Page 6Linked to original sources
PubMed1999

Cytopathic effect inhibition assay for determining the in-vitro susceptibility of herpes simplex virus to antiviral agents.

We compare a rapid dilution method for the determination of antiviral susceptibility of herpes simplex virus (HSV) with the plaque reduction assay. A total of 84 HSV clinical isolates were studied by both methods to detect in-vitro resistance to acyclovir and foscarnet. The rapid method showed for the detection of HSV isolates resistant to acyclovir and foscarnet, a sensitivity of 96. 8% and 100% and specificity of 100% and 100%, respectively. This method provides an easy and accurate screening procedure for the susceptibility testing of HSV to antiviral agents.

Acyclovir↗
PubMed1999

Pseudomonas aeruginosa: a survey of resistance in 136 hospitals in Spain. The Spanish Pseudomonas aeruginosa Study Group.

We carried out a nationwide study with all of the isolates of Pseudomonas aeruginosa collected in a week in 136 hospitals in Spain. The data on 1,014 isolates included resistance to the following antimicrobials: piperacillin-tazobactam, 7%; meropenem, 8%; amikacin, 9%; tobramycin, 10%; piperacillin, 10%; ticarcillin, 13%; imipenem, 14%; ceftazidime, 15%; cefepime, 17%; ciprofloxacin, 23%; aztreonam, 23%; ofloxacin, 30%; gentamicin, 31%. The most frequent serotypes were O:1 (25.1%), O:4 (21.6%), and O:11 (11.3%).

Anti-Bacterial Agents↗
PubMed1999

Is there an ecological relationship between rates of antibiotic resistance of species of the genus Streptococcus? The Spanish Surveillance Group for Respiratory Pathogens.

The relationship between resistance to antibiotics on the part of Streptococcus pneumoniae and Streptococcus pyogenes was studied by comparing different prevalences of resistance among hospitals obtained from a recent microbiological surveillance of community-acquired respiratory tract infections. A high correlation for erythromycin resistance was found between S. pneumoniae isolates from lower respiratory tract infections and S. pyogenes isolates collected from pharyngeal swabs.

Drug Resistance, Microbial↗
PubMed1999

Dual qualitative-quantitative nested PCR for detection of JC virus in cerebrospinal fluid: high potential for evaluation and monitoring of progressive multifocal leukoencephalopathy in AIDS patients receiving highly active antiretroviral therapy.

JC polyomavirus (JCV) is the causative agent of progressive multifocal leukoencephalopathy (PML), a central nervous system infection that mainly affects AIDS patients. The extensive application of highly active antiretroviral therapy (HAART) is leading to the appearance of "long-term" survival PML patients. A reliable and feasible qualitative-quantitative test for both the detection of JCV and follow-up of its viral burden in this emerging group of patients is clearly required. With this aim, a dual qualitative-quantitative nested PCR is presented in this study for the analysis of JCV DNA in cerebrospinal fluid (CSF). Two newly designed internal controls, one competitive and the other noncompetitive, have been constructed to adapt this PCR to either measure the JCV burden or to allow a highly confident determination of JCV presence or clearance. The analytical sensitivity of the technique allows the detection of 0.01 fg (three genomes) of JCV DNA. Its qualitative application has been evaluated by analyzing single CSF samples from a group of 17 patients with PML and a control group of 20 patients with diverse neurological conditions other than PML, yielding sensitivity and specificity values of 100 and 90%, respectively. The quantitative application has been evaluated in vitro in blind tests with samples including serial dilutions of JCV, and in all cases the samples were successfully ordered considering the JCV titer. The dual quantitative-qualitative application offered by this nested PCR may provide an answer to the new requirements for evaluating and finely monitoring PML in AIDS patients receiving HAART.

AIDS-Related Opportunistic Infections↗
PubMed1999

Influence of comorbidity and severity on the clinical outcome of bacteremic pneumococcal pneumonia treated with beta-lactam monotherapy.

The influence of the severity of pneumonia and comorbidity factors, as predictors of clinical outcome, was assessed in patients with microbiologically documented pneumococcal bacteremic pneumonia treated with penicillin or third generation cephalosporin monotherapy in a 5-year retrospective study. Among 288 patients admitted to three Spanish hospitals with bacteremic pneumococcal pneumonia, 65 (23%) were included. Twenty-four were treated with penicillins and 41 with a third-generation cephalosporin. Twenty-seven patients (42%) had severe pneumonia and 41 (63%) had a comorbidity index >1. Twenty-one patients (32%) were infected with penicillin-resistant strains. Four cases (2 with penicillin-resistant strains; 3 treated with cephalosporins) were clinical failures. Four cases (3 with penicillin-resistant strains; 2 treated with cephalosporins) died, i.e. 6% mortality rate. The only factor that influenced empirical treatment election was HIV-positive condition. Clinical outcome was not influenced by treatment election, penicillin susceptibility of the infecting pneumococci, patient basal conditions or severity of pneumonia, but the latter was associated with mortality and length of hospitalization.

Adolescent↗
PubMed1998

Treatment of AIDS-associated progressive multifocal leukoencephalopathy with highly active antiretroviral therapy.

OBJECTIVES: To evaluate the efficacy of highly active antiretroviral therapy (HAART) in 12 patients with AIDS-associated progressive multifocal leukoencephalopathy (PML). PATIENTS AND METHODS: The diagnosis of PML was established by brain biopsy in six patients and by neuroimaging findings and PCR detection of JC virus in cerebrospinal fluid (CSF) in six patients. We also studied 13 consecutive AIDS patients with biopsy-proven PML cared for in the same institution before HAART was available. Eleven patients of the HAART group and eight patients of the control group received intravenous arabinoside cytosine cycles. RESULTS: With HAART, the median decrease in the HIV viral load was 3.58 log10 copies/ml and the median increase in the CD4 cell count was 74x10(6)/l. The median survival time after PML diagnosis was 545 days in the HAART group and 60 days in the control group (P<0.001, log-rank test). In the HAART group, the neurological deficits improved substantially in six patients and stabilized in six patients. Eleven patients underwent follow-up cranial computed tomography or magnetic resonance scan that showed improvement of PML lesions in 10 patients and stabilization in one patient. Follow-up CSF analysis showed clearance of JC virus in six out of seven patients who had an initial positive result. CONCLUSIONS: This study shows that HAART may increase the survival, clinical status and radiological features of AIDS patients with PML. Clearance of JC virus from CSF has been found, suggesting that immune reconstitution can interrupt the JC virus lytic cycle.

AIDS-Related Opportunistic Infections↗
PubMed1998

Rhodococcus equi infection in transplant recipients: case report and review of the literature.

BACKGROUND: Rhodococcus equi is an opportunistic pathogen that usually causes infection in immunocompromised hosts, mainly human immunodeficiency virus-positive patients, yet solid organ transplant recipients may be affected as well. Infections in this group of patients have not been sufficiently analyzed. METHODS: We report an R equi pneumonia in a heart transplant recipient and review another 11 cases. RESULTS: Infection appeared a mean of 49 months (range 1-180) after transplantation. Lung was primarily involved in 10 cases (83.3%). The remaining two cases presented with a paravertebral abscess and a purulent pericarditis. Invasive techniques were necessary to reach the diagnosis in nine cases. One patient healed with surgical resection of the lesion; the remaining 11 received antimicrobial agents. Six of them required additional surgical treatment. Three patients died. CONCLUSIONS: Clinicians should consider R equi when evaluating a solid organ recipient with an asymptomatic lung nodule. Microbiology laboratories should be alerted in these cases because it could be mistaken for a contaminant diphtheroid and will not respond to the standard empirical therapy.

Actinomycetales Infections↗
PubMed1998

LCx: a diagnostic alternative for the early detection of Mycobacterium tuberculosis complex.

This study aims to evaluate the performance of a new diagnostic method (LCx Tuberculosis Assay, Abbott Laboratories) based on Ligase Chain Reaction (LCR) technology, for the detection of Mycobacterium tuberculosis in respiratory and non-respiratory specimens and compare it with standard microbiological data and the clinical diagnosis of tuberculosis. Nine hundred specimens were collected from patients with a high suspicion of tuberculosis (740 respiratory samples and 160 non-respiratory specimens). The study was divided into two separate groups: samples washed and distilled water (207 samples) and unwashed samples that were directly resuspended in phosphate buffer (693 samples). The overall sensitivity, specificity, positive and negative predictive values of samples washed with distilled water after decontamination with SDS-NaOH were: 54%, 100%, 100%, and 94%, respectively. If these results were divided according to origin of specimens, the sensitivity, specificity, positive and negative predictive values in respiratory and non-respiratory samples were 54.5%, 100%, 100%, 94% and 50 100%, 100%, 93%, respectively. In contrast, for the non-washed samples, values were 85%, 95%, 80% and 98%, respectively. Respiratory and non-respiratory samples gave values of 84%, 96%, 77%, and 97.5% versus 89%, 99%, 94%, and 98%. The LCx M. tuberculosis assay is a novel, semi-automated assay and a rapid and highly specific technique for screening all forms of tuberculosis, including non-respiratory forms.

DNA, Bacterial↗
PubMed1998

In vitro activity of the new glycopeptide LY333328 against multiply resistant gram-positive clinical isolates.

The in vitro activity of LY333328 was compared with those of vancomycin and teicoplanin against 425 gram-positive clinical isolates, including a variety of multiply resistant strains. LY333328 at </=4 microgram/ml inhibited all microorganisms tested, including methicillin- and teicoplanin-resistant staphylococci, glycopeptide-resistant enterococci, penicillin- and multiply resistant pneumococci, and viridans and beta-hemolytic streptococci.

Anti-Bacterial Agents↗
PubMed1998

Comparison of broth microdilution method using Haemophilus test medium and agar dilution method for susceptibility testing of Eikenella corrodens.

Susceptibility testing of Eikenella corrodens is usually performed by a Mueller-Hinton sheep blood agar dilution (AD) method. However, this method is impractical for testing only a few strains. We compared AD with the broth microdilution method using Haemophilus test medium (HTM) in order to determine the susceptibility of 36 clinical isolates of E. corrodens to eight antimicrobial agents. MICs obtained by the HTM method yielded 95.5 and 84% agreement (within 2 and 1 log2 dilutions, respectively) with those obtained by AD. The HTM method with incubation in CO2 for 48 h was highly reproducible and constitutes an easy alternative for antimicrobial susceptibility testing of E. corrodens.

Agar↗
PubMed1998

[Infective endocarditis caused by unusual microorganisms].

All series of infective endocarditis had a variable proportion of cases without an etiologic agent because all cultures were negative. New microbiologic techniques have permitted the discovery of the role of many microorganisms in infective endocarditis. C. burnetii is an increasing causative agent of subacute infective endocarditis. In the diagnosis, to the detection of antiphase-I antibodies, immunohistochemical, molecular techniques and cellular cultures have been added. Total cure is difficult to obtain. The combination of doxicicline plus ciprofloxacin for at least 3 years has been proposed as the treatment of choice. Surgery must be reserved for patients with cardiac insufficiency. Less than 2% of cases of acute brucellosis are complicate with infective endocarditis. Infective endocarditis produces serious and rapid valvular destruction with high mortality rates if valve surgery is not performed. For medical treatment at least 3 active agents are required. Bartonella has recently been described as an etiologic agent of infective endocarditis. It mainly affects to homeless people living in poor hygienic conditions. The aortic valve is most commonly involved and, frequently, valve insufficiency requires valve replacement. Blood culture isolation needs long incubation periods. Parenteral nutrition, immunosuppression, wide spectrum antibiotic regimens, intravenous drug addiction and cardiovascular surgery are risk factors previously described in the development of fungal endocarditis. C. albicans and Aspergillus spp. are most frequent etiologic agents. Infective endocarditis should be suspected in any patient with systemic fungal disease. Blood cultures are often negative except for Candida spp. Peripheral emboli and large vegetations are frequent. Mortality is high, antifungal therapy combined with surgery is the treatment of choice. Legionella, Mycoplasma, Chlamydia, Mycobacteria, viruses are potential agents of infective endocarditis, and difficult to diagnose because of special culture requirements. Epidemiological clues, serologic and molecular techniques and blood cultures could identify them.

Anti-Bacterial Agents↗
PubMed1998

[A national multicenter study of the in-vitro activity of piperacillin-tazobactam. The Spanish Piperacillin-Tazobactam Group].

The action of piperacillin-tazobactam on 4,137 of the 4,364 strains collected in a Spanish multicenter study involving 46 participating hospitals was studied. The samples were from the following: 41% urine, 18% exuded from wound abscesses, 13% respiratory, 9% blood, 3% peritoneal liquid, and the remainder from other various sources. The gram-negative bacteria included 2,778 strains from 13 genera: Escherichia (1,289), Pseudomonas (451), Proteus (230), Klebsiella (203), Haemophilus (172), Enterobacter (145), Acinetobacter (88), Salmonella (60), Bacteroides (57), Morganella (53), Serratia (46), Citrobacter (46), Stenotrophonomas (23) and Moraxella (21). The gram-positive bacteria were S. aureus (316), E. faecalis (239), S. epidermis (130), S. pneumoniae (115) and Clostridium spp. (12). The global susceptibility of the gram-negatives to piperacillin-tazobactam was 94%: E. coli 98%, P. aeruginosa 92%, and P. mirabilis, Morganella, K. pneumoniae, Serratia and Salmonella spp. all greater than 94%. The susceptibility of other bacteria was as follows: 91% Citrobacter, 77% E. cloacae, 42% A. baumannii, 61% S. maltophilia, 97% E. faecalis, 93% S. epidermidis, 100% M. catarrhalis, 99% H. influenzae and 100% anaerobic bacteria. The action on S. pneumoniae and S. aureus varied according to the susceptibility or lack there of to penicillin or methicillin. In comparison to other antibiotics (piperacillin, cefoxitin, cefotaxime, ceftazidime, cefepime, imipenem and ciprofloxacin), piperacillin-tazobactam was far better than piperacillin alone and better or similar to the others.

Bacteria↗
PubMed1998

[Cerebral abscess as a complication of chronic otitis media].

A case is reported of chronic otitis media and cholesteatoma in an adult patient with behavioral disorders who developed a pyogenic brain abscess. Initially, clinical management focused on the otogenic disease in view of the patient's symptoms and medical history. Finally, less easily recognized discriminating signs and symptoms, and the results of imaging studies were emphasized. These data confirmed the clinical diagnosis of pyogenic brain abscess secondary to cholesteatoma. The case illustrates how one of the most severe infective complications related with cholesteatoma may appear and its a remainder to clinicians to take this possibility into consideration.

Adult↗