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Biomedical subjects

J Canueto

Publications and source records attributed to J Canueto.

8 recordsLinked to original sources
PubMed2002

Prognostic evaluation of bacteremia and fungemia in patients with acquired immunodeficiency syndrome.

The incidence of bacterial infections in general and of bacteremia in particular is high among patients with acquired immunodeficiency syndrome (AIDS). The factors influencing the prognosis of bacteremia in these patients are not well known. In order to better define those factors associated with a poor prognosis, all episodes of bacteremia or fungemia in patients with AIDS who were hospitalized in four general hospitals between 1 September 1987 and 31 December 1996 were studied prospectively. Among 1,390 patients diagnosed with AIDS, 238 (17.1%) developed 274 episodes of bacteremia or fungemia. Mortality related to bacteremia was 21.3%. Variables associated with high mortality were fungemia (odds ratio [OR], 6.19; 95% confidence interval [CI], 1.99 - 19.28), hypotension (OR, 19.65; 95%CI, 7.42 - 52.07), inappropriate antimicrobial treatment (OR, 16.94; 95%CI, 4.92 - 58.32), and unknown origin of bacteremia (OR, 3.93; 95%CI, 1.58 - 9.76). The mortality rate among patients with at least one of these factors was 46.7%, whereas in patients without any of these factors, the rate was 4.9% ( P < 0.001). Bacteremic episodes of unknown origin were significantly more frequently associated with community acquisition ( P = 0.001), inappropriate antimicrobial treatment ( P = 0.04), and etiology by gram-negative microorganisms or fungi ( P < 0.001) and were significantly less frequently associated with the presence of a previous intravenous catheter ( P = 0.004), resulting in peculiar etiologic and epidemiological profiles. The factors that influence the outcome of AIDS patients who develop bacteremia are sometimes avoidable or known during the first days after admission. Therefore, knowledge about these factors could improve the prognosis of bloodstream infections in this population.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Bacteremias due to the Streptococcus milleri group. An analysis of 18 episodes].

OBJECTIVE: To study the epidemiological and clinical characteristics of bacteremia caused by Streptococcus milleri group streptococci (SMG). METHODS: Prospective evaluation of all bacteremic episodes with clinical significance from 1990 to 1995 in two general hospitals. In this study all episodes caused by SMG were analyzed. RESULTS: A total of 905 bacteremic episodes with clinical significance were detected; 18 (1.98%) were caused by SMG (0.16/1,000 admissions). The mean age of patients were 43 years and the male/female ratio 1.6. Seventeen patients (94.4%) had some underlying disease; nine patients had diabetes, four were parenteral drug abusers, and two had neoplasms. The most common sources of bacteremia were intraabdominal in four episodes (two liver abscesses, one subphrenic abscess and one pancreatic pseudocyst), cutaneous and/or soft tissues in four, surgical wound in two and respiratory in two; no source was identified in five episodes. Four episodes had a polymicrobial origin. In 13 isolates the identification was at species level (Streptococcus anginosus eight, Streptococcus intermedius four and Streptococcus constellatus one). All strains were susceptible to penicillin. Six patients (33.3%) required surgery. In ten episodes a favorable outcome was recorded, although four patients required surgery. The infection associated mortality rate was 31.2%. The mean age of deceased patients was higher than for cured patients (62.2 +/- 20.2 versus 35.3 +/- 20.3; p < 0.05). CONCLUSIONS: SMB bacteremia is uncommon. It involved mainly diabetic patients or parenteral drug abusers, commonly with an intraabdominal suppurative source or in skin or soft tissues. The mortality rate was high despite surgery in one third of patients. Patients with advanced age had a poorer prognosis. All isolates investigated were susceptible to penicillin.

Adolescent↗
PubMed1995

[Changes in heroin administration route and frequency of human immunodeficiency virus infection].

BACKGROUND: Self-administration of drugs by different intravenous routes may induce a reduction in the organic complications of drug addiction (DA). The aim of this study was to evaluate the changes in the way of drug administration in a series of DA individuals in the province of Cádiz, Spain, and the evolution of the frequency of infection by the human immunodeficiency virus (HIV) in these patients. METHODS: The reports of all the drug users from the province of Cádiz admitted to the Detoxication Unit of the Hospital Punta de Europa in Algeciras, from January, 1989 to July, 1993 were reviewed. At the time of admission many data were evaluated, fundamentally the main route of drug administration, and anti-HIV seropositivity. RESULTS: Seven hundred ten drug users were included in the study. Ninety-seven percent used mainly heroin. The route of drug administration on admission was intravenous in 56.1%, pulmonary in 39.7%, inhalatory in 3.2% and oral in 0.8%. Forty-one point seven percent patients were seropositive for HIV. The frequency of the use of the intravenous route throughout the semesters analyzed was I/89: 85.7%, II/89: 89.6%, I/90: 80%, II/90: 80.8%, I/91: 59.8%, II/91: 50%, I/92: 44.9%, II/92: 39%, I/93: 34.3% (p < 0.00001). The use of the respiratory route significantly increased. The percentage of anti HIV positivity in the drug users evaluated was 67.4, 80.8, 56.4, 46.9, 40.7, 34.1, 30.6, 36.3, 23.2% (p < 0.00001), respectively for the same periods. The decrease in the use of the intravenous route and the reduction in anti HIV seropositivity demonstrated a correlation coefficient of 0.91 with a confidence interval from 0.62 to 0.98 (p < 0.05). CONCLUSIONS: The decrease, over time, in the use of the intravenous route for heroin administration in the collective analyzed was significantly associated with a decrease in HIV infection in these patients.

Adult↗
PubMed1994

Prospective evaluation of a two-week course of intravenous antibiotics in intravenous drug addicts with infective endocarditis. Grupo de Estudio de Enfermedades Infecciosas de la Provincia de Cádiz.

In a prospective study, a two-week course of antibiotics (cloxacillin 2 g/4 h plus amikacin 7.5 mg/kg/12 h) was evaluated in the therapy of right-sided infective endocarditis in intravenous drug users (IVDU). All IVDU admitted to hospital during the study period who fulfilled the strict criteria for diagnosis of infective endocarditis were analysed. A subgroup of patients with right-sided endocarditis caused by Staphylococcus aureus who had a good prognosis were selected as being eligible for the two-week course of treatment. In a total of 139 episodes of infective endocarditis in IVDU, 72 (51.8%) cases were eligible for the two-week treatment. Of this group, 67 were cured, 4 needed prolongation of treatment to cure the infection and 1 died in hospital of respiratory distress syndrome on day 10 of treatment. In patients not eligible for the two-week treatment, the mortality was higher (24.2% versus 0.7%; p = 0.00015). Drug toxicity in the treated group was low. It can be concluded that administration of cloxacillin and amikacin parenterally for 14 consecutive days was successful in the therapy of right-sided endocarditis in IVDU.

Adult↗
PubMed1991

[Tuberculosis in 34 patients with HIV infection].

The clinical and microbiological finding of 34 patients with HIV infection and tuberculosis (30 were men), 32 were intravenous drug addicts. Fever, adenopathies, hepatomegaly and splenomegaly were the most encountered manifestations on admittance. 61.8% had a disseminated form of tuberculosis; the main locations were lymphatic (73.5%) and lung (64.7%). The detection of circulating viral antigen was associated with disseminated form of tuberculosis.

Adult↗