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Biomedical subjects

E Simarro

Publications and source records attributed to E Simarro.

48 records · Page 3Linked to original sources
PubMedDate not supplied

[Nosocomial fungemias in a general hospital. Epidemiology and prognostic factors. Prospective study 1993-1998].

BACKGROUND: Nosocomial fungemias are infections with a high mortality rate. In last years the incidence of these infections has increased probably because of the growing population of immunocompromised patients who undergo aggressive diagnostic and therapeutic techniques. OBJECTIVE: To know the epidemiologic characteristics, risk factors, clinical features and prognosis of fungemia. PATIENTS AND METHODS: We prospectively evaluated all the patients with proven fungemia in our center during a 5 year-period. After finishing antifungal treatment a minimum follow-up of 1 month was carried out. Fungal isolation and identification were performed by standard tests. RESULTS: During the period of study we evaluated 81 patients with an episode of nosocomial fungemia. Global incidence was 0,9 episodes per thousand admitted patients. Candida albicans was the more frequently isolated species (n=53), followed by C. parapsilosis (n=11), C. tropicalis (n=6) and C. glabrata (n=5). Most of the patients had a central intravenous line and were on parenteral nutrition therapy. All of them previously received at least one course of broad-spectrum antibiotics. Overall mortality was 49,6%. A worst prognosis was significantly associated with: age over 65 years, surgical procedures during present admission, leucocytosis, shock, and delay in antifungal treatment. CONCLUSIONS: Fungal bloodstream infection incidence is high in our environment. It is associated with a high mortality rate, specially in patients in whom the beginning of antifungal treatment was delayed. A higher clinical suspicion index may improve the poor outcome in these patients.

Adolescent↗
PubMedDate not supplied

[Pacemaker lead endocarditis: analysis of 11 cases].

BACKGROUND: The prevalence of infection of permanent pacemaker ranges from 0.13 to 19.9%. Our objective is to review our experience and to analyze the epidemiology and treatment of those diagnosed as having pacemaker lead endocarditis. METHODS: A retrospective study include all cases diagnosis of pacemaker endocarditis in our hospital, since 1991 to 1998. Eleven patients with pacemaker endocarditis were included. RESULTS: Eleven patients were admitted for endocarditis related to pacemaker-lead infection. Fever occurred in nine patients (81.8%). A germ was isolated in nine patients (81.8%) and was a Staphylococcus in eight (88.9%). Transthoracic echocardiography demonstrated vegetations in only two patients (18.2%), whereas transesophageal echocardiography disclosed abnormal appearances on the pacemaker lead in eleven patients (100%). Six patients were treated with antibiotics initially and four patients required the removal of the whole infected material after finishing treatment with antibiotic. Five patients were treated since the beginning with a electrode removal who responded favorably. CONCLUSIONS: The diagnosis of endocarditis related to pacemaker infection should be suspected in the presence of fever and patient with pacemaker. Transesophageal echocardiography should be performed to look for vegetations. S. aureus and S. epidermidis are involved in the majority of these infections. The best treatment is an immediate removal of the entire pacing system and antimicrobial therapy.

Aged↗
PubMedDate not supplied

[Haemophilus influenzae infections in children less than 5 years of age in the community of Murcia during the 1992-1999 period].

BACKGROUND: Invasive disease due to Haemophilus influenzae has changed substantially since the introduction of the conjugated vaccine. This report studies the incidence and the clinical-epidemiological characteristics of invasive H. influenzae disease in children under five years of age during 1992-94 (before vaccination), 1995-97 (voluntary vaccination) and 1998-99 (obligatory vaccination). PATIENTS AND METHODS: The study was performed by reviewing the clinical histories of 39 patients with H. influenzae isolates from sterile samples, according to microbiology data. The reference population's subgroup of the study, 40,322 children under 5, comprises 60% of the total in our community. RESULTS: The overall incidence of invasive H. influenzae disease was 12.1/100,000 children under 5 and 15.7, 12.4 and 6.2 for the following periods respectively: before vaccination, during voluntary vaccination, and obligatory vaccination. All cases except one of them, were produced by H. influenzae type b and they were seen in children under 3. Meningitis accounted for more than half of the cases (51.3%). Fever was the most frequent sign (38 of 39 cases). Epiglottitis was the cause of the highest average hospital stay (20.8 days). All the patients were treated with cefotaxime, but half were also administered other antibiotics. Sequelae were seen in 7 cases, with no deaths. CONCLUSIONS: The incidence of invasive H. influenzae disease was drastically reduced and no cases were seen in the last year. However, one vaccinated patient suffered a bacteremic etmoiditis. This case and the possibility of infection due to non-b serotypes requires ongoing surveillance for these infections.

Child, Preschool↗