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J Castella

Publications and source records attributed to J Castella.

At least 19 recordsLinked to original sources
PubMed2003

In-use evaluation of Perasafe compared with Cidex in fibreoptic bronchoscope disinfection.

The mycobactericidal activity of Perasafe (0.26% peracetic acid) was compared with that of Cidex (2% alkaline glutaraldehyde) by an in-use test. Fibreoptic bronchoscopes were artificially contaminated with Mycobacterium tuberculosis or Mycobacterium avium-intracellulare in sputum and, after manual pre-cleaning with a neutral soap, 10 and 20 min disinfection periods were tested. Perasafe was as effective as Cidex, thus requiring a 10 min disinfection period against M. tuberculosis and 20 min against M. avium-intracellulare. The results demonstrate that Perasafe is an effective disinfectant for use in reprocessing fibreoptic bronchoscopes.

Bronchoscopes↗
PubMed1998

In vivo and in vitro sensitivity of Trichomonas gallinae to some nitroimidazole drugs.

A study was carried out in order to establish the in vivo efficacy of two nitroimidazole drugs against the flagellate Trichomonas gallinae. The results obtained showed a high proportion of therapeutic failures. Thus, carnidazole and dimetridazole failed to eliminate infection in 13 of 17 and 20 of 21 racing pigeons, respectively. The in vitro susceptibility of four T. gallinae isolates to five nitroimidazolic drugs, that is, carnidazole, dimetridazole, metronidazole, ornidazole and ronidazole, was also determined. Minimal lethal concentrations (MLCs) of these drugs were obtained. One of the isolates tested had already proved to be resistant in the first in vivo tests, while the other three had been obtained from wild birds. We were able to confirm in vitro the resistance of the racing pigeon isolate to all the nitroimidazole drugs tested. For carnidazole, dimetridazole, metronidazole and ornidazole the MLC ranged between 93.75-500 microg ml. Although ronidazole showed a greater potency than the other nitroimidazole derivatives against this isolate (MLC: 15.62-31.25 microg ml), 8-22 times more drug was necessary for efficacy against this isolate compared to the others. These other three parasite isolates proved to be sensitive to the five drugs tested (MLC: 0.97-7.81 microg ml).

Animals↗
PubMed1998

The crazy-paving pattern in exogenous lipoid pneumonia: CT-pathologic correlation.

OBJECTIVE: The purpose of our study was to show a distinctive appearance of exogenous lipoid pneumonia on thin-section CT that has not, to our knowledge, been previously documented. CONCLUSION: On thin-section CT, exogenous lipoid pneumonia is revealed as patchy well-defined areas of ground-glass attenuation with superimposed septal thickening (crazy-paving pattern). Exogenous lipoid pneumonia should be included in the differential diagnosis when thin-section CT reveals a crazy-paving pattern.

Aged↗
PubMed1997

Isolation of the trichomonad Tetratrichomonas buttreyi (Hibler et al., 1960) Honigberg, 1963 in bovine diarrhoeic faeces.

A trichomonad was found in the faeces of a heifer with watery diarrhoea. It was classified as Tetratrichomonas buttreyi according to its morphology as revealed by scanning electron microscopy. This flagellate was successfully maintained in a cysteine-peptone-liver medium. It is, to our knowledge, the first report of Tetratrichomonas buttreyi in Spain. This trichomonad appears to be a nonpathogenic commensal which often proliferates in fluid faeces.

Animals↗
PubMed1996

Phenotypic and genotypic characterization of spotted fever group Rickettsiae isolated from Catalan Rhipicephalus sanguineus ticks.

Eighty-nine Rhipicephalus sanguineus ticks and 21 Rhipicephalus bursa ticks collected in Catalonia were tested by the hemolymph test to establish their infection rate with spotted fever group rickettsiae. By Giménez staining, 11.2% of the R. sanguineus isolates and 0% of the R. bursa isolates were found to contain rickettsia-like organisms. Six spotted fever group rickettsial strains (Bar29, Bar31, Gir4, Tar1, Tar2, and Tar3) were isolated from these ticks and were characterized by phenotypic and genotypic analyses. PCR followed by restriction fragment length polymorphism analysis showed that the six strains were identical and were characterized by the same restriction profiles as a strain, Mtu5, previously isolated from Rhipicephalus turanicus ticks in the South of France. Microimmunofluorescence serotyping, sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified organisms, and Western blot (immunoblot) assay with mouse polyclonal sera confirmed this observation. Pulsed field gel electrophoresis of the whole genome of three of the strains showed that, although closely related, the profile of Tar1 was slightly different from that of the Bar strains. Phylogenetic analysis showed that this new rickettsial sero- and genotype, which will be named the "Catalan strain," is closely related to Rickettsia massiliae. This strain shows an unexpected resistance to rifampin. The epidemiological implications of these findings are considered.

Animals↗
PubMed1996

Diagnostic value of protected BAL in diagnosing pulmonary infections in immunocompromised patients.

STUDY OBJECTIVES: To assess the diagnostic utility of protected BAL (P-BAL) in respiratory infections in immunocompromised patients and to examine whether P-BAL alone could substitute the combined use of protected specimen brush (PSB) and BAL in such patients. PATIENTS AND STUDY DESIGN: Thirty-seven immunocompromised patients who underwent PSB, P-BAL, and BAL simultaneously for the diagnosis or exclusion of bacterial or nonbacterial opportunistic respiratory infections were studied prospectively. The P-BAL was performed through the inner catheter of a telescoping plugged catheter with 60 mL of saline solution. MAIN RESULTS: Thirteen (35%) cases of bacterial pneumonia were diagnosed. PSB obtained seven true-positive (TP) results, P-BAL obtained nine, and BAL obtained eight TP. Results of the three techniques were positive and concordant in 6 of the 13 cases. PSB remained free of contamination from oropharyngeal flora in all cases, P-BAL was contaminated twice, and BAL was contaminated in four cases. Opportunistic respiratory infections were diagnosed in 19 patients. P-BAL results were identical to those with BAL in all cases: 18 TP and 1 false-negative. The average volume of P-BAL fluid retrieved was 19 mL, sufficient for all microbiologic and cytologic processings. P-BAL was more time-consuming than both PSB and BAL procedures and was technically more complex. CONCLUSION: P-BAL alone can substitute the combined use of both PSB and BAL in immunocompromised patients and attains a higher sensitivity than PSB in diagnosing bacterial pneumonia. The combined strategy continues to be a good choice, but due to the high incidence of bacterial pneumonia in these patients, a highly efficient diagnostic procedure is required not only for nonbacterial opportunistic respiratory infections but also for bacterial pneumonia.

Adult↗
PubMed1995

Diagnosis and staging of bronchogenic carcinoma by transtracheal and transbronchial needle aspiration.

Transbronchial needle aspiration (TBNA) has been used in diagnosis and staging of bronchogenic carcinoma. However, its true effectiveness seems uncertain and some models of needles are expensive. The aim of this study was to procure new experiences on this method. TBNA was performed in 194 patients with bronchogenic carcinomas. Two models of cheap, re-usable, cytological needles were used. In diagnostic application, TBNA was positive in 34 of 39 (87%) central tumors and in 31 of 45 (69%) peripheral nodules or masses. In 19 patients, TBNA was the only positive sample. In staging application, TBNA was positive in 41 of the 90 cases (46%) in which the spread of the tumor compressed the wall of the airway. When the trachea or bronchus was endoscopically normal at the site of the puncture, TBNA was only positive in 3 of 20 cases (15%). These results suggest that TBNA is effective as a diagnostic tool. However, it appears to be less effective in staging, where the attainment of a good yield with TBNA probably demands a positive computed tomography and the use of a histological needle.

Biopsy, Needle↗
PubMed1994

[Fiberoptic bronchoscope disinfection with glutaraldehyde phenolate in 1:8 solution].

We evaluated the efficacy of phenolated glutaraldehyde in a 1:8 solution for the disinfection of bronchofibroscopes that were highly contaminated with Serratia marcescens and Pseudomonas aeruginosa. An Olympus BF-P10 bronchofibroscope was contaminated with artificial samples containing one of the aforementioned microorganisms in concentrations nearing 10(8) colony forming units per milliliter (cfu/ml). The instruments were then washed with soap and water and submerged in a 1:8 solution of phenolated glutaraldehyde. Samples were taken for culturing after contamination, after washing, and after 10, 15 and 30 min in the disinfectant solution. The level of cfu/ml in the cultures was measured and the definition of failure-to-disinfect was a finding of > or = 1 cfu/ml after each experimental procedure. Twenty procedures, 10 for each microorganism, were carried out. Washing of the bronchofibroscope afforded significant elimination of microorganisms and no colony growth was observed in cultures after 10 min submersion in phenolated glutaraldehyde. We conclude that immersion in a 1:8 solution of phenolated glutaraldehyde after careful washing is a valid way to disinfect bronchofibroscopes that are highly contaminated with S. marcescens and P. aeruginosa.

Bronchoscopes↗
PubMed1994

[Experimental study of bronchofibroscope disinfection].

BACKGROUND: Fibrobronchoscopes (FB) require high level disinfection following each procedure to prevent possible infectious complications. The aim of the present study was to evaluate three methods of disinfection of the FB: a) aspiration with a solution of iodine povidone (IP); b) immersion in fenolate glutaraldehyde (FG) diluted at 1:16, and c) aspiration of IP solution followed by immersion in FG. Cleaning of the FB with soap and water was also studied. METHODS: The FB was contaminated with artificial samples (sterilized respiratory secretions mixed with a suspension of a microorganism at a concentration of 10(8)-10(9) UFC/ml) and was later washed with soap and water and disinfected with one of the 3 above mentioned methods. Samples were taken following contamination, cleaning, the aspiration with IP and at 5, 10, 15, 20 and 30 minutes in FG. The c/u/ml were counted. Disinfection was considered as a failure with > or = 1 c/u/ml at the end of each experience. This test was performed 97 times: 37 with Mycobacterium tuberculosis, 17 with Serratia marcescens, 17 with Pseudomonas aeruginosa, 13 with Staphylococcus aureus, and 13 with Candida albicans. RESULTS: Cleaning with soap and water eliminated a mean of 99.9% of the microorganisms. IP failed to disinfect all the 5 microorganisms while FG and the association of IP and FG failed against S. marcescens and P. aeruginosa. The time of immersion in FG required for complete disinfection range from 5 to 20 minutes although in most cases only 5 to 10 minutes were needed. CONCLUSIONS: The meticulous cleaning of the FB is essential for correct disinfection. Iodine povidone does not guarantee high level disinfection of the device while fenolate glutaraldehyde and iodine povidone plus fenolate glutaraldehyde may fail versus S. marcescens and P. aeruginosa.

Bronchoscopes↗
PubMed1993

Impact of previous antimicrobial therapy on the etiology and outcome of ventilator-associated pneumonia.

OBJECTIVE: To define the influence of prior antibiotic use on the etiology and mortality of ventilator-associated pneumonia (VAP). SETTING: A university hospital medical-surgical ICU. DESIGN: Prospective clinical study. METHODS: Over a 35-month period, we prospectively studied 129 consecutive episodes of VAP. Etiologic diagnosis was established using a protected specimen brush and quantitative culture techniques. We examined prognostic factors by univariate and multivariate analyses using a statistical software package (SPSS). RESULTS: The rate of VAP caused by Gram-positive cocci or Haemophilus influenzae was statistically lower (p < 0.05) in the patients who had received antibiotics previously, while the rate of VAP caused by Pseudomonas aeruginosa was statistically higher (p < 0.01). Patients died of causes directly related to the infection in 18 (14.0 percent) episodes, P aeruginosa being isolated in 9 of these fatal cases. Indeed, we found that 27.7 percent (15/54) of patients who had received prior antimicrobial therapy before the onset of pneumonia died, compared with only 4.0 percent (3/75) of those who did not. In the univariate analysis, the variables significantly associated with attributable mortality were age older than 45 years, use of corticosteroids, presence of shock, hospital day of VAP over 9, antecedent COPD, and a prior antibiotic use. A step-forward logistic regression analysis defined only prior antibiotic use (p < 0.0001, OR = 9.2) as significantly influencing the risk of death from VAP. The same result was obtained when severity was included in the model. However, prior antibiotic use entirely dropped out as a significant risk factor when the etiologic agent was included in the regression equation. CONCLUSIONS: Distribution of infecting microorganisms responsible for VAP differs in patients who received prior antimicrobial therapy, and this factor determines a higher mortality rate. We suggest a restrictive antibiotic policy in mechanically ventilated patients with the purpose of reducing the risk of death from VAP.

Anti-Bacterial Agents↗
PubMed1992

Nosocomial respiratory tract infections in multiple trauma patients. Influence of level of consciousness with implications for therapy.

A prospective study of 161 multiple trauma patients was carried out to determine the incidence, the causative agents, and the outcome of nosocomial respiratory tract infections in this highly selected population. Thirty-eight (23.6 percent) patients developed a nosocomial pneumonia (NP). In addition, there were four superinfections in three patients, representing an incidence of 26 percent (42 of 161). Incidence of NP was significantly greater among comatose patients (42.2 vs 13.3 percent, p less than 0.05). Furthermore, purulent tracheobronchitis was diagnosed in six patients. The causative agent of NP was identified in 36 (85.7 percent) episodes by means of fiberoptic bronchoscopies with protected specimen brush sampling. Staphylococcus aureus (55.8 percent) was the predominant pathogen isolated in multiple trauma patients in coma (Glasgow coma score [GCS] below 9 during a period greater than 24 h), while aerobic Gram-negative bacilli were responsible for the majority of cases in the remaining population studied. The overall mortality rate was 19.8 percent, but only five deaths were related to NP. We conclude that nosocomial respiratory tract infections are a frequent problem in multiple trauma patients, especially in those with GCS below 9, although this complication is associated with a relatively low mortality. Among patients with GCS below 9, S aureus was a frequent finding; consequently, antimicrobial therapy in this population needs to be different than that for the remaining multiple trauma patients with NP.

Bacteria↗
PubMed1992

[Bacterial pneumonia in the acquired immunodeficiency syndrome].

Sixty five patients with AIDS and clinical and/or radiological evidence of pulmonary infection underwent 78 bronchofibroscopies (BF) with protected brushing and bronchoalveolar washing-out. Out of the 78 BF, bacterial infection was diagnosed in 30 cases and associated opportunistic infection in 12 cases. The 18 cases of exclusively bacterial infection accounted for 23% of the total and most of them were due by H. influenzae and pneumococcus. Just in one patient, the thoracic radiography showed a localized infiltration. Given the high incidence of bacterial infections observed, along with the relevance of myxoid infections (opportunistic and pyogenic bacteria) and the low specificity of the thoracic radiography, bronchoalveolar washing-out and protected brushing in the same BF is a recommended practice.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Protected bronchoalveolar lavage: a new endoscopic method in the diagnosis of bacterial pneumonia].

BACKGROUND: The identification of causative microoganisms in severe pneumonias is a usually difficult problem. Protected brushing (PB) has a good specificity but a limited sensitivity. Conventional bronchoalveolar lavage (BAL-C) has an excellent sensitivity but a doubtful specificity. The investigation of a new technique such as the protected bronchoalveolar lavage (BAL-P) appears as logical, as it should combine the advantages of PB and BAL-C without their drawbacks. METHODS: In 15 patients without bacterial or fungal infections and in 23 with bacterial or fungal pneumonia, quantitative cultures were carried out in the samples obtained with PB, BAL-P and BAL-C. PB and BAL-C were performed with the usual technique. BAL-P was performed through the internal catheter of a telescoped double catheter with reabsorbable distal cap within the fibroscope channel. 40 ml of saline were instillated for the lavage. RESULTS: With BAL-P sensitivity was 95% and specificity 89%. These were, respectively, 55% and 94% with PB, and 95% and 42% with BAL-C. The technique of BAL-P was more complex an longer than that of PB. CONCLUSIONS: If these results are confirmed in further studies, BAL-P might become a method of choice for the bacterial pneumonias where now PB is indicated. However, in patients with hypersecretion or when bronchoscopy should be rapidly carried out, PB is technically more feasible.

Bacterial Infections↗
PubMed1991

Incidence, etiology, and outcome of nosocomial pneumonia in mechanically ventilated patients.

This study assessed the incidence, etiology, and consequences of ventilator-associated pneumonia in 1,000 consecutive patients admitted in a medical-surgical intensive care unit (ICU). A total of 264 patients were submitted to mechanical ventilation (MV) for more than 48 hours. Fifty-eight (21.9 percent) patients developed a bacterial pneumonia after a mean of 7.9 days (range, 2 to 40 days) of MV. In addition, they were ten superinfections in nine patients, raising the mean incidence to 25.7 percent. Five patients developed secondary bacteremia, and another five had septic shock. Identification of the causative agent of pneumonia was possible in 47 episodes by means of highly specific techniques (telescoping plugged catheter, blood cultures, and/or necropsy). Thirteen (27.6 percent) of these cases were polymicrobial. The predominant pathogens isolated in the first episode of pneumonia were Gram-negative bacilli (62.6 percent), but a high incidence of Staphylococcus aureus infection (23.2 percent) was detected. Gram-negative bacilli represented 66.6 percent of the total organisms isolated in superinfections. The mortality rate in the pneumonia group was 42 percent; this percentage is similar to mortality rate among MV patients without pneumonia (37 percent). We conclude that nosocomial pneumonia is a frequent complication of MV in the medical-surgical ICU. Ventilator-associated pneumonia does not appear to increase fatality in critically ill patients with a high mortality rate (38 percent); however, it significantly prolongs the length of stay in the ICU for survivors.

Bacteria↗