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Carvajal M, Jeldres P, Vergara A, Lobaina E, Olivares M, Meza D, Velásquez A, Dorta F, Jorquera F, Seeger M, Cereceda-Balic F, Fadic X. Bioremoval of copper by filamentous fungi isolated from contaminated soils of Puchuncaví-Ventanas Central Chile. Environ Geochem Health 2023:10.1007/s10653-023-01493-z. [PMID: 36729229 DOI: 10.1007/s10653-023-01493-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
Pollution represents a high risk to plants, animals, and human beings, causing an imbalance and affecting the environment. Soil is considered a universal sink, containing the highest load of environmental pollution. Puchuncaví-Ventanas sector, decreed as a saturated contamination zone in 1993, is considered one of the most affected areas by industrial pollution and belongs to one of the 5 sacrifice zones of Chile. The localities of Puchuncaví and Ventanas have heavy metal pollution levels that exceed up to 99% of the limits allowed by Canadian standards. The objective of this study was to characterize heavy metal tolerance and removal potential of filamentous fungi isolated from polluted soils for their use in decontamination systems and in situ soil improvement. Six fungal strains were selected based on their tolerance and a high capability to accumulate heavy metals, achieving copper bioaccumulation of 84% (Mortierella sp. strain LG01), 49% (Clonostachys sp. strain CQ23) and 48-77.5% (Trichoderma sp. strain LM01A). Trichoderma sp. strain LM01A was able to remove 41% of copper from contaminated soil under ex situ conditions. Some fungal strains belong to beneficial fungal genera, which are used as bioproducts in agriculture. The results of this study highlighted the use of Trichoderma sp. in soils contaminated, which may be of special interest in agriculture due to the large amounts of copper sulfate still applied as a pesticide in Chile and the world.
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Affiliation(s)
- M Carvajal
- Center of Biotechnology "Dr. Daniel Alkalay Lowitt", Universidad Técnica Federico Santa María, General Bari 699, Valparaíso, Chile
- Molecular Microbiology and Environmental Biotechnology Laboratory, Department of Chemistry, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile
| | - P Jeldres
- Center of Biotechnology "Dr. Daniel Alkalay Lowitt", Universidad Técnica Federico Santa María, General Bari 699, Valparaíso, Chile
| | - A Vergara
- Center of Biotechnology "Dr. Daniel Alkalay Lowitt", Universidad Técnica Federico Santa María, General Bari 699, Valparaíso, Chile
- Molecular Microbiology and Environmental Biotechnology Laboratory, Department of Chemistry, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile
| | - E Lobaina
- Center of Biotechnology "Dr. Daniel Alkalay Lowitt", Universidad Técnica Federico Santa María, General Bari 699, Valparaíso, Chile
- Molecular Microbiology and Environmental Biotechnology Laboratory, Department of Chemistry, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile
| | - M Olivares
- Center of Biotechnology "Dr. Daniel Alkalay Lowitt", Universidad Técnica Federico Santa María, General Bari 699, Valparaíso, Chile
| | - D Meza
- Center of Biotechnology "Dr. Daniel Alkalay Lowitt", Universidad Técnica Federico Santa María, General Bari 699, Valparaíso, Chile
| | - A Velásquez
- Molecular Microbiology and Environmental Biotechnology Laboratory, Department of Chemistry, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile
- Department of Ecology, Pontificia Universidad Católica de Chile, Alameda 340, Santiago, Chile
| | - F Dorta
- Center of Biotechnology "Dr. Daniel Alkalay Lowitt", Universidad Técnica Federico Santa María, General Bari 699, Valparaíso, Chile
| | - F Jorquera
- Center of Biotechnology "Dr. Daniel Alkalay Lowitt", Universidad Técnica Federico Santa María, General Bari 699, Valparaíso, Chile
| | - M Seeger
- Center of Biotechnology "Dr. Daniel Alkalay Lowitt", Universidad Técnica Federico Santa María, General Bari 699, Valparaíso, Chile
- Molecular Microbiology and Environmental Biotechnology Laboratory, Department of Chemistry, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile
| | - F Cereceda-Balic
- Centre for Environmental Technologies CETAM, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile
- Department of Chemistry, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile
| | - X Fadic
- Centre for Environmental Technologies CETAM, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile.
- Department of Chemistry, Universidad Técnica Federico Santa María, Avenida España 1680, Valparaíso, Chile.
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D'Alto M, Di Maio M, Romeo E, Argiento P, Di Vilio A, Blasi E, Vergara A, Rea G, D'Andrea A, Golino P, Naeije R. Echocardiographic probability of pulmonary hypertension according to the old and the new definition: a validation study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
According to current guidelines, the diagnosis of pulmonary hypertension (PH) relies on echocardiographic probability followed by right heart catheterization. How echocardiography predicts PH recently re-defined by a mean pulmonary artery pressure (mPAP) >20 mmHg instead of ≥25 mmHg and pulmonary vascular disease defined by a pulmonary vascular resistance (PVR) >3 or >2 Wood units has not been established.
Methods
A total of 278 patients referred for PH underwent a comprehensive echocardiography followed by a right heart catheterization. Fifteen patients (5.4%) were excluded because of insufficient quality echocardiography.
Results
With PH defined by a mPAP >20 mmHg, 23 patients had no PH, 146 had pre-capillary and 94 post-capillary PH. At univariate analysis, maximum velocity of tricuspid regurgitation (TRV) ≥2.9 and ≤3.4 m/s, left ventricle (LV) eccentricity index >1.1, right ventricle (RV) outflow tract (OT) notching or acceleration time <105 ms, RV-LV basal diameter >1 and PA diameter predicted PH, whereas inferior vena cava diameter and right atrial area did not. At multivariable analysis, only TRV ≥2.9 m/s independently predicted PH. Additional independent prediction of PVR >3 Wood units was offered by LV eccentricity index >1.1 and RVOT acceleration time <105 ms and/or notching, but with no improvement of optimal combination of specificity and sensibility or positive prediction. The areas under the ROC curves for different cut-off values of TRV for the prediction of mPAP >20 mmHg, mPAP ≥25 mmHg, mPAP >20 mmHg + PVR >2 Wood units and mPAP ≥25 mmHg + PVR >3 Wood units are illustrated in Figure 1A–D.
Conclusions
Echocardiography as recommended in current guidelines can be used to assess the probability of re-defined PH in a referral center. However, the added value of indirect signs is modest and sufficient quality echocardiographic signals may not be recovered in some patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M D'Alto
- AORN Ospedali dei Colli - Monaldi Hospital , Naples , Italy
| | - M Di Maio
- Umberto I Nocera Inferiore Hospital, Cardiology , Nocera Inferiore , Italy
| | - E Romeo
- AORN Ospedali dei Colli - Monaldi Hospital , Naples , Italy
| | - P Argiento
- AORN Ospedali dei Colli - Monaldi Hospital , Naples , Italy
| | - A Di Vilio
- AORN Ospedali dei Colli - Monaldi Hospital , Naples , Italy
| | - E Blasi
- AORN Ospedali dei Colli - Monaldi Hospital , Naples , Italy
| | - A Vergara
- AORN Ospedali dei Colli - Monaldi Hospital , Naples , Italy
| | - G Rea
- AORN Ospedali dei Colli - Monaldi Hospital , Naples , Italy
| | - A D'Andrea
- Umberto I Nocera Inferiore Hospital, Cardiology , Nocera Inferiore , Italy
| | - P Golino
- AORN Ospedali dei Colli - Monaldi Hospital , Naples , Italy
| | - R Naeije
- Erasme Hospital, Department of Pathophysiology , Bruxelles , Belgium
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Fimiani F, Gragnano F, Cesaro A, Vergara A, De Pasquale A, Blasi E, Calabro' P. Biochemical role of lipoprotein screening in patients with premature miocardial infarction and elite athletes. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vergara A, Mergudich T, Rojas N, Pesse D, Soto M, Avila J, Ledezma C, Ortiz R, Ortiz A, Barrientos S. P-080 Intrauterine insemination (IUI) success rates in patients with suboptimal total processed motile sperm count (TPMSC) using a second consecutive semen sample. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Is it effective to request a second consecutive semen sample in patients with less than 1 million TPMSC in a first semen sample for IUI?
Summary answer
In men with TPMSC under one million, the issuing of a second consecutive sample reached pregnancy rates similar to those published for IUI.
What is known already
IUI offers a comparable cumulative live birth rate in 3-4 cycles compared to IVF and can be preferred as a cost-effective first-line treatment in mild male factor or unexplained infertility. The quality of the processed semen sample is an important factor for the IUI success.
The WHO recommends an abstinence period to ensure best quality of semen samples. However, it has been observed that when men with moderate male factor who are unable to meet the minimum requirements for IUI are asked to produce a second sample better counts are obtained; questioning the time correlation between abstinence and semen quality.
Study design, size, duration
This was a retrospective study conducted in the reproductive medicine unit of a private hospital in Chile between July 2015 and March 2021. All patients who underwent IUI in the study period that had an TPMSC less than 1 million in the eyaculate and to whom a second consecutive sample was requested were included.
Participants/materials, setting, methods
118 patients who underwent 140 IUI cycles were included in the study. All the patients with an PMSC under 1 million at the time of the IUI were requested a second consecutive semen sample within an hour or two from the previous eyaculate. The second samples were processed and used for insemination. The primary outcome was pregnancy rate. The secondary outcomes were semen quality (TPMSC of first and second semen samples).
Main results and the role of chance
Between 2015 and 2021 there were 140 IUI cycles in which a second consecutive semen sample was requested, including 118 patients. Overall 17 pregnancies were achieved. The pregnancy rate per cycle was 12,14% and the pregnancy rate per patient was 14,4%. The live birth rate per patient was 10,2%.
Regarding the sperm sample analysis, the median TPMSC of the first semen sample was 261.437. The median PMSC of the second consecutive sample was 7.315.000. 126 patients had an TPMSC of 0 in the first semen sample while only 9 patients had an IMSC of 0 in the second sample. In five cases a third consecutive sample was requested of which 4 patients had their cycles canceled because they did not meet the target PMSC. One patient had an TPMSC of 1.687.000 in the third sample.
Finally, of the 118 patients who did not meet the requirements for IUI with the first sample, only 19 cycles were canceled.
Limitations, reasons for caution
The study has the limitation of being a retrospective and descriptive study with no contol group. Also the group is heterogeneous because it includes patients with different female factors for infertility.
Wider implications of the findings
In developing countries and low-income settings the IUI remains a more accessible alternative in patients with infertility. Routinely recollecting a second semen sample in men with TPMSC <1 million would reduce cycle cancellation rates due to not achieving an optimal TPMSC, reaching pregnancy rates similar to those published for IUI.
Trial registration number
Not applicable
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Affiliation(s)
- A Vergara
- Pontificia Universidad Católica de Chile, Ginecología y Obstetricia , Santiago, Chile
| | - T Mergudich
- Pontificia Universidad Católica de Chile, Ginecología y Obstetricia , Santiago, Chile
| | - N Rojas
- Pontificia Universidad Católica de Chile, Ginecología y Obstetricia , Santiago, Chile
| | - D Pesse
- Pontificia Universidad Católica de Chile, Ginecología y Obstetricia , Santiago, Chile
| | - M.J Soto
- Pontificia Universidad Católica de Chile, Ginecología y Obstetricia , Santiago, Chile
| | - J Avila
- Pontificia Universidad Católica de Chile, Ginecología y Obstetricia , Santiago, Chile
| | - C Ledezma
- Pontificia Universidad Católica de Chile, Ginecología y Obstetricia , Santiago, Chile
| | - R Ortiz
- Pontificia Universidad Católica de Chile, Ginecología y Obstetricia , Santiago, Chile
| | - A Ortiz
- Pontificia Universidad Católica de Chile, Ginecología y Obstetricia , Santiago, Chile
| | - S Barrientos
- Pontificia Universidad Católica de Chile, Ginecología y Obstetricia , Santiago, Chile
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Bury R, Leon Roman J, Casteras A, Vergara A, Biagetti B, García-Carro C, Cordero-Vazquez E, Hernández Hernández I, Agraz I, Soler MJ. [Malignant hypertension and pheochromocytoma: a case report]. Hipertens Riesgo Vasc 2021; 38:201-205. [PMID: 34238673 DOI: 10.1016/j.hipert.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 11/19/2022]
Abstract
Malignant arterial hypertension is defined by extremely high levels of pressure associated with organ damage. It is a cause of hypertensive emergency and is defined by the coexistence of high blood pressure and bilateral retinal haemorrhage or exudates (grade III hypertensive retinopathy), with or without papilloedema (grade IV hypertensive retinopathy) currently associated with organ damage such as renal or cardiac failure. Around 1% of malignant arterial hypertension is secondary to endocrinological causes, including the most common: pheochromocytoma, which is classically characterized by the triad: headache, sweating and palpitations. However, there is no single clinical finding that is of significant value in its diagnosis. We now present the case of a 23-year-old patient with a hypertensive emergency, an adrenal mass associated with grade IV hypertensive retinopathy.
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Affiliation(s)
- R Bury
- Servicio de Nefrología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - J Leon Roman
- Servicio de Nefrología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - A Casteras
- Servicio de Endocrinología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - A Vergara
- Servicio de Nefrología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - B Biagetti
- Servicio de Endocrinología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - C García-Carro
- Servicio de Nefrología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - E Cordero-Vazquez
- Servicio de Endocrinología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | | | - I Agraz
- Servicio de Nefrología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - M J Soler
- Servicio de Nefrología, Hospital Universitario Vall d'Hebron, Barcelona, España.
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Vergara A, Moreno-Morales J, Roca I, Pitart C, Kostyanev T, Rodriguez-Baño J, Goossens H, Marco F, Vila J. A comparative study between real-time PCR and loop-mediated isothermal amplification to detect carbapenemase and/or ESBL genes in Enterobacteriaceae directly from bronchoalveolar lavage fluid samples. J Antimicrob Chemother 2021; 75:1453-1457. [PMID: 32073602 DOI: 10.1093/jac/dkaa031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To evaluate and compare the efficacy of real-time PCR (Xpert Carba-R) and loop-mediated isothermal amplification (Eazyplex® SuperBug CRE) for detecting carbapenemase carriage in Enterobacteriaceae directly from bronchoalveolar lavage (BAL). METHODS Negative BAL samples were spiked with 21 well-characterized carbapenemase-producing Enterobacteriaceae strains to a final concentration of 102-104 cfu/mL. Xpert Carba-R (Cepheid, Sunnyvale, CA, USA), which detects five targets (blaKPC, blaNDM, blaVIM, blaOXA-48 and blaIMP-1), and the Eazyplex® SuperBug CRE system (Amplex-Diagnostics GmbH, Germany), which detects seven genes (blaKPC, blaNDM, blaVIM, blaOXA-48, blaOXA-181, blaCTXM-1 and blaCTXM-9), were evaluated for the detection of these genes directly from BAL samples. RESULTS Xpert Carba-R showed 100% agreement with carbapenemase characterization by PCR and sequencing for all final bacteria concentrations. Eazyplex® SuperBug CRE showed 100%, 80% and 27% agreement with PCR and sequencing when testing 104, 103 and 102 cfu/mL, respectively. False negative results for Eazyplex® SuperBug CRE matched the highest cycle threshold values for Xpert Carba-R. Hands-on time for both assays was about 15 min, but Eazyplex® SuperBug CRE results were available within 30 min, whereas Xpert Carba-R took around 50 min. CONCLUSIONS We here describe the successful use of two commercial diagnostic tests, Xpert Carba-R and Eazyplex® SuperBug CRE, to detect bacterial carbapenem resistance genes directly in lower respiratory tract samples. Our results could be used as proof-of-concept data for validation of these tests for this indication.
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Affiliation(s)
- A Vergara
- Department of Clinical Microbiology - CDB, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - J Moreno-Morales
- Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - I Roca
- Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - C Pitart
- Department of Clinical Microbiology - CDB, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - T Kostyanev
- Department of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - J Rodriguez-Baño
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena/Departamento de Medicina, Universidad de Sevilla/Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
| | - H Goossens
- Department of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.,Laboratory of Medical Microbiology, University Hospital Antwerp, Antwerp, Belgium
| | - F Marco
- Department of Clinical Microbiology - CDB, Hospital Clínic, University of Barcelona, Barcelona, Spain.,Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - J Vila
- Department of Clinical Microbiology - CDB, Hospital Clínic, University of Barcelona, Barcelona, Spain.,Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
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Molina-Van den Bosch M, Jacobs-Cachá C, Vergara A, Serón D, Soler MJ. [The renin-angiotensin system and the brain]. Hipertens Riesgo Vasc 2021; 38:125-132. [PMID: 33526381 DOI: 10.1016/j.hipert.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/14/2020] [Accepted: 12/20/2020] [Indexed: 12/17/2022]
Abstract
The renin-angiotensin-aldosterone (RAAS) system and its effects on blood pressure and the regulation of water and electrolyte balance have been studied focusing on the cardiovascular and renal system. The activation of RAAS in other organs has local and systemic repercussions by modeling the macro- and microvasculture of peripheral organs. The brain RAAS influence on systemic blood pressure through the sympathetic nervous system. The angiotensin converting enzyme/angiotensin II/angiotensin 1 receptor axis (ACE/AngII/AT1), classical pathway, and angiotensin converting enzyme type 2/angiotensin (1-7)/Mas receptor (ACE2/Ang (1-7)/MasR), non-classical pathway, are involved in the modulation of the sympathetic response. The imbalance of these two axes with subsequently Ang II accumulation promote neurogenic hypertension and other vascular pathologies. The aminopeptidase/angiotensin IV/angiotensin 4 receptor (AMN/Ang IV/AT4) axis, which is exclusive of the brain, acts on cerebral microvasculature and participates in cognition, memory, and learning. The aim of this review is to decipher the major central RAAS mechanisms involved in blood pressure regulation. In addition, paracrine functions of brain RAAS and its role in neuroprotection and cognition are also described in this review.
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Affiliation(s)
- M Molina-Van den Bosch
- Grup de Nefrología, Vall d'Hebron Institut de Recerca (VHIR), Servei de Nefrología, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital, Barcelona, España
| | - C Jacobs-Cachá
- Grup de Nefrología, Vall d'Hebron Institut de Recerca (VHIR), Servei de Nefrología, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital, Barcelona, España
| | - A Vergara
- Grup de Nefrología, Vall d'Hebron Institut de Recerca (VHIR), Servei de Nefrología, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital, Barcelona, España
| | - D Serón
- Grup de Nefrología, Vall d'Hebron Institut de Recerca (VHIR), Servei de Nefrología, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital, Barcelona, España
| | - M J Soler
- Grup de Nefrología, Vall d'Hebron Institut de Recerca (VHIR), Servei de Nefrología, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital, Barcelona, España.
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Perello R, Vergara A, Monclus E, Jimenez S, Montero M, Saubi N, Moreno A, Eto Y, Inciarte A, Mallolas J, Martínez E, Marcos MA. Cytomegalovirus infection in HIV-infected patients in the era of combination antiretroviral therapy. BMC Infect Dis 2019; 19:1030. [PMID: 31801482 PMCID: PMC6894188 DOI: 10.1186/s12879-019-4643-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 11/20/2019] [Indexed: 12/20/2022] Open
Abstract
Background Cytomegalovirus infection dramatically decreased with the introduction of antiretroviral therapy. Whether incidence, clinical characteristics and prognosis of cytomegalovirus in HIV infected patients, has changed over time is. scarcely known. Methods Retrospective single-center study. Patients included in this study were all HIV infected patients that went to our center for any disease, and were diagnosed with cytomegalovirus, during the period 2004–2015. epidemiological, clinical and laboratory patients variables were collected in a clinical database. Clinical characteristics, incidence of cytomegalovirus and predictors of mortality during the study were assessed. Results were considered statistically significant when p < 0.05. All statistical analyses were calculated by SPSS version 20.0 (Chicago, IL,USA). Results Fifty-six cases of cytomegalovirus infection, in HIV infected patients were identified during the study period (incidence rate-1.7 cases per 1000 persons/year). The most frequent presentation was systemic illness in 43% of cases. Of note,no patients presented with ophthalmic manifestations. The 30-days mortality was 18%. Predictors of mortality were, in the univariate analysis, admission to the intensive care unit OR 32.4 (3.65–287.06) p = 0.0001, and mechanic ventilation 84 OR (8.27–853.12) p = 0.0001, and ART OR 4.1 (0.97–17.31) p = 0.044. These variables were assessed by multivariate analysis, and only mechanical ventilation was statistically significant (p < 0.05) Conclusion Incidence of cytomegalovirus infection was higher than described in the antiretroviral therapy era. Clinical presentation has changed. Mechanic ventilation predicted mortality.
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Affiliation(s)
- R Perello
- Servicio de Urgencias, Hospital Clínic, Barcelona, Spain.
| | - A Vergara
- Servicio de Microbiología, CDB, Hospital Clínic, Barcelona, Spain
| | - E Monclus
- Servicio de Urgencias, Hospital Clínic, Barcelona, Spain
| | - S Jimenez
- Servicio de Urgencias, Hospital Clínic, Barcelona, Spain
| | - M Montero
- Servicio de Urgencias, Hospital Clínic, Barcelona, Spain
| | - N Saubi
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - A Moreno
- Servicio de Microbiología, CDB, Hospital Clínic, Barcelona, Spain
| | - Y Eto
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - A Inciarte
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - J Mallolas
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - E Martínez
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - M A Marcos
- Servicio de Microbiología, CDB, Hospital Clínic, Barcelona, Spain
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Fernández-Hernando J, Carrillo D, Ciusa G, Liu Y, Prieto-Díaz I, Pedica R, Sayas S, Soni J, Vergara A. The ITER interlock system. Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2018.02.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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10
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Carrasco P, Carrillo M, Bazley K, Vergara A, Contreras A. Foros virtuales y construcción de conocimiento en profesionales de la salud. Enfermería Universitaria 2017. [DOI: 10.1016/j.reu.2017.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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de Vries PC, Pautasso G, Humphreys D, Lehnen M, Maruyama S, Snipes JA, Vergara A, Zabeo L. Requirements for Triggering the ITER Disruption Mitigation System. Fusion Science and Technology 2017. [DOI: 10.13182/fst15-176] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- P. C. de Vries
- ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul-lez-Durance, France
| | - G. Pautasso
- Max-Planck-Institut für Plasmaphysik, 85748 Garching, Germany
| | - D. Humphreys
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608
| | - M. Lehnen
- ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul-lez-Durance, France
| | - S. Maruyama
- ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul-lez-Durance, France
| | - J. A. Snipes
- ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul-lez-Durance, France
| | - A. Vergara
- ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul-lez-Durance, France
| | - L. Zabeo
- ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul-lez-Durance, France
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12
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Santolaya ME, Alvarez AM, Acuña M, Avilés CL, Salgado C, Tordecilla J, Varas M, Venegas M, Villarroel M, Zubieta M, Toso A, Bataszew A, Farfán MJ, de la Maza V, Vergara A, Valenzuela R, Torres JP. Efficacy and safety of withholding antimicrobial treatment in children with cancer, fever and neutropenia, with a demonstrated viral respiratory infection: a randomized clinical trial. Clin Microbiol Infect 2017; 23:173-178. [PMID: 27856269 PMCID: PMC7129180 DOI: 10.1016/j.cmi.2016.11.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/03/2016] [Accepted: 11/04/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine efficacy and safety of withholding antimicrobials in children with cancer, fever and neutropenia (FN) with a demonstrated respiratory viral infection. METHODS Prospective, multicentre, randomized study in children presenting with FN at five hospitals in Santiago, Chile, evaluated at admission for diagnosis of bacterial and viral pathogens including PCR-microarray for 17 respiratory viruses. Children positive for a respiratory virus, negative for a bacterial pathogen and with a favourable evolution after 48 h of antimicrobial therapy were randomized to either maintain or withhold antimicrobials. Primary endpoint was percentage of episodes with uneventful resolution. Secondary endpoints were days of fever/hospitalization, bacterial infection, sepsis, admission to paediatric intensive care unit (PICU) and death. RESULTS A total of 319 of 951 children with FN episodes recruited between July 2012 and December 2015 had a respiratory virus as a unique identified microorganism, of which 176 were randomized, 92 to maintain antimicrobials and 84 to withdraw. Median duration of antimicrobial use was 7 days (range 7-9 days) versus 3 days (range 3-4 days), with similar frequency of uneventful resolution (89/92 (97%) and 80/84 (95%), respectively, not significant; OR 1.48; 95% CI 0.32-6.83, p 0.61), and similar number of days of fever (2 versus 1), days of hospitalization (6 versus 6) and bacterial infections throughout the episode (2%-1%), with one case of sepsis requiring admission to PICU in the group that maintained antimicrobials, without any deaths. CONCLUSIONS The reduction of antimicrobials in children with FN and respiratory viral infections, based on clinical and microbiological/molecular diagnostic criteria, should favour the adoption of evidence-based management strategies in this population.
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Affiliation(s)
- M E Santolaya
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - A M Alvarez
- Department of Paediatrics, Hospital San Juan de Dios, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - M Acuña
- Department of Paediatrics, Hospital Dr Roberto del Río, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - C L Avilés
- Department of Paediatrics, Hospital San Borja Arriarán, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - C Salgado
- Department of Paediatrics, Hospital Dr Exequiel González Cortés, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - J Tordecilla
- Department of Paediatrics, Hospital Dr Roberto del Río, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - M Varas
- Department of Paediatrics, Hospital San Juan de Dios, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - M Venegas
- Department of Paediatrics, Hospital San Juan de Dios, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - M Villarroel
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - M Zubieta
- Department of Paediatrics, Hospital Dr Exequiel González Cortés, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - A Toso
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - A Bataszew
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - M J Farfán
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - V de la Maza
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - A Vergara
- Centre for Molecular Studies, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - R Valenzuela
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - J P Torres
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
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13
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Cobos-Triguero N, Zboromyrska Y, Morata L, Alejo I, De La Calle C, Vergara A, Cardozo C, Arcas MP, Soriano A, Marco F, Mensa J, Almela M, Martínez JA. Time-to-positivity, type of culture media and oxidase test performed on positive blood culture vials to predict Pseudomonas aeruginosa in patients with Gram-negative bacilli bacteraemia. Rev Esp Quimioter 2017; 30:9-13. [PMID: 27897434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The aim of this study was to determine the usefulness of oxidase test and time-to-positivity (TTP) in aerobic and anaerobic blood culture vials to detect the presence of Pseudomonas aeruginosa in patients with Gram-negative bacilli (GNB) bacteraemia. METHODS TTP was recorded for each aerobic and anaerobic blood culture vial of monomicrobial bacteraemia due to GNB. Oxidase test was performed in a pellet of the centrifuged content of the positive blood culture. An algorithm was developed in order to perform the oxidase test efficiently taking into account TTP and type of vial. RESULTS A total of 341 episodes of GNB bacteraemia were analysed. Sensitivity, specificity, positive predictive value and negative predictive value of the oxidase test performed on positive vials with GNB to predict P. aeruginosa were 95%, 99%, 91%, and 99%, respectively. When growth was first or exclusively detected in anaerobic vials, P. aeruginosa was never identified hence the performance of the oxidase test could be avoided. When growth was only or first detected in aerobic vials, a TTP≥8h predicted P. aeruginosa in 37% or cases (63 of 169), therefore oxidase test is highly recommended. CONCLUSIONS Oxidase test performed onto positive blood culture vials previously selected by TTP and type of vials is an easy and inexpensive way to predict P. aeruginosa. In most cases, this can lead to optimization of treatment in less than 24 hours.
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Affiliation(s)
- N Cobos-Triguero
- Nazaret Cobos-Trigueros. Department of Infectious Diseases, Hospital Clínic. Villarroel 170, 08036, Barcelona, Spain.
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14
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Zboromyrska Y, Rubio E, Alejo I, Vergara A, Mons A, Campo I, Bosch J, Marco F, Vila J. Development of a new protocol for rapid bacterial identification and susceptibility testing directly from urine samples. Clin Microbiol Infect 2016; 22:561.e1-6. [PMID: 26899829 DOI: 10.1016/j.cmi.2016.01.025] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/23/2015] [Accepted: 01/28/2016] [Indexed: 01/21/2023]
Abstract
The current gold standard method for the diagnosis of urinary tract infections (UTI) is urine culture that requires 18-48 h for the identification of the causative microorganisms and an additional 24 h until the results of antimicrobial susceptibility testing (AST) are available. The aim of this study was to shorten the time of urine sample processing by a combination of flow cytometry for screening and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) for bacterial identification followed by AST directly from urine. The study was divided into two parts. During the first part, 675 urine samples were processed by a flow cytometry device and a cut-off value of bacterial count was determined to select samples for direct identification by MALDI-TOF-MS at ≥5 × 10(6) bacteria/mL. During the second part, 163 of 1029 processed samples reached the cut-off value. The sample preparation protocol for direct identification included two centrifugation and two washing steps. Direct AST was performed by the disc diffusion method if a reliable direct identification was obtained. Direct MALDI-TOF-MS identification was performed in 140 urine samples; 125 of the samples were positive by urine culture, 12 were contaminated and 3 were negative. Reliable direct identification was obtained in 108 (86.4%) of the 125 positive samples. AST was performed in 102 identified samples, and the results were fully concordant with the routine method among 83 monomicrobial infections. In conclusion, the turnaround time of the protocol described to diagnose UTI was about 1 h for microbial identification and 18-24 h for AST.
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Affiliation(s)
- Y Zboromyrska
- Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain; ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - E Rubio
- Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain
| | - I Alejo
- Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain
| | - A Vergara
- Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain
| | - A Mons
- Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain
| | - I Campo
- Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain
| | - J Bosch
- Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain; ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - F Marco
- Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain; ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - J Vila
- Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain; ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, University of Barcelona, Barcelona, Spain.
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Neto A, Arshad S, Sartori F, Vayakis G, Ambrosino G, Batista A, Bas I, Campagnolo R, Carvalho B, De Magneval G, De Tommasi G, Dominguez O, Fernandez-Hernando J, Pironti A, Simrock S, Sousa J, Sterle C, Vergara A, Winter A, Zabeo L. Conceptual architecture of the plant system controller for the magnetics diagnostic of the ITER tokamak. Fusion Engineering and Design 2015. [DOI: 10.1016/j.fusengdes.2015.06.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Alejo-Cancho I, Bosch J, Vergara A, Mascaro JM, Marco F, Vila J. Dermatitis by Dermatophilus congolensis. Clin Microbiol Infect 2015; 21:e73-4. [PMID: 26100375 DOI: 10.1016/j.cmi.2015.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 06/12/2015] [Accepted: 06/12/2015] [Indexed: 11/16/2022]
Affiliation(s)
- I Alejo-Cancho
- Department of Clinical Microbiology, Hospital Clinic-ISGlobal-University of Barcelona, Barcelona, Spain.
| | - J Bosch
- Department of Clinical Microbiology, Hospital Clinic-ISGlobal-University of Barcelona, Barcelona, Spain
| | - A Vergara
- Department of Clinical Microbiology, Hospital Clinic-ISGlobal-University of Barcelona, Barcelona, Spain
| | - J M Mascaro
- Department of Dermatology, Hospital Clinic-ISGlobal-University of Barcelona, Barcelona, Spain
| | - F Marco
- Department of Clinical Microbiology, Hospital Clinic-ISGlobal-University of Barcelona, Barcelona, Spain
| | - J Vila
- Department of Clinical Microbiology, Hospital Clinic-ISGlobal-University of Barcelona, Barcelona, Spain
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Tesser R, Vitiello R, Carotenuto G, Garcia Sancho C, Vergara A, Maireles Torres P, Li C, Di Serio M. Niobia supported on silica as a catalyst for Biodiesel production from waste oil. ACTA ACUST UNITED AC 2015. [DOI: 10.1515/cse-2015-0002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractThe activity and stability of niobia supported
on silica catalyst have been tested in continuous
micro-pilot reactors, for biodiesel production starting
from acid vegetable oils. A catalyst was prepared
by the impregnation of silica pellets with a loading
of 12% of Nb and was extensively characterized.
The activity of this catalyst in both esterification and
transesterification was tested in a continuous micro-pilot
laboratory plant in which acid oil was fed (FFA 10% w/w)
at a temperature of 220°C and at a pressure of 60 bar.
The niobia based catalyst resulted in a very active
catalyst in both esterification (FFA conversion =
95-90%) and transesterification reactions (FAME
yield = 80-90%), and the activity remained
quite constant for more than 100 h on stream.
Notwithstanding this stability, a non-negligible leaching
phenomena has been detected, in the case of long-time
continuous runs, as the Nb concentration on the spent
catalyst resulted lower than that on the fresh one. The
obtained result confirms that the leaching of the active
specie is one of the most strong problem in heterogeneous
catalysis for biodiesel production.
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Affiliation(s)
- R. Tesser
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
- 2CIRCC, Italy
| | - R. Vitiello
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
- 2CIRCC, Italy
| | - G. Carotenuto
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
| | - C. Garcia Sancho
- 3University of Málaga, Faculty of Sciences, Department of Inorganic Chemistry, Crystallography and Mineralogy
| | - A. Vergara
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
| | - P.J. Maireles Torres
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
- 3University of Málaga, Faculty of Sciences, Department of Inorganic Chemistry, Crystallography and Mineralogy
| | | | - M. Di Serio
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
- 2CIRCC, Italy
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Di Ciccio P, Vergara A, Festino A, Paludi D, Zanardi E, Ghidini S, Ianieri A. Biofilm formation by Staphylococcus aureus on food contact surfaces: Relationship with temperature and cell surface hydrophobicity. Food Control 2015. [DOI: 10.1016/j.foodcont.2014.10.048] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Garcia-Fernandez S, Morosini MI, Marco F, Gijon D, Vergara A, Vila J, Ruiz-Garbajosa P, Canton R. Evaluation of the eazyplex(R) SuperBug CRE system for rapid detection of carbapenemases and ESBLs in clinical Enterobacteriaceae isolates recovered at two Spanish hospitals. J Antimicrob Chemother 2014; 70:1047-50. [DOI: 10.1093/jac/dku476] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Conter M, Di Ciccio P, Zanardi E, Ghidini S, Borracci G, Vergara A, Ianieri A. METHICILLIN - RESISTANT STAPHYLOCOCCUS AUREUS IN PIG PRODUCTION CHAIN. Ital J Food Saf 2012. [DOI: 10.4081/ijfs.2012.3.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Paludi D, Vergara A, Festino AR, Di Ciccio P, Costanzo C, Conter M, Zanardi E, Ghidini S, Ianieri A. Antimicrobial resistance pattern of methicillin-resistant Staphylococcus aureus in the food industry. J BIOL REG HOMEOS AG 2011; 25:671-677. [PMID: 22218000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
There is increasing concern about the impact on public health of methicillin-resistant Staphylococcus aureus (MRSA) associated with animal food products. MRSA remains a serious problem because of the high incidence and multidrug resistance of the strains, even for strains isolated from foods, food environments and food handlers. The objectives of this study are: (i) to evaluate the susceptibility of S. aureus strains isolated from food, food handlers and food-processing environments to 14 antibiotics currently used in veterinary and human therapy; (ii) to assess the presence of the mecA gene. A total of 1007 samples were collected from food, food handlers, and environments and were analyzed for the presence of S. aureus. S. aureus was present in 165 of the 1007 samples. A total of 157 isolates were methicillin-susceptible S. aureus (MSSA) and 8 isolates were MRSA. In particular, out of 8 MRSA strains detected, 4 strains harboured the mecA gene. All MRSA strains were resistant to at least one of the tested antibiotics and 6 strains demonstrated multi-resistance. Considering the high level of resistances in S. aureus and the isolation of MRSA strains, the surveillance of antimicrobial resistance and the spreading of this pathogen is of crucial importance in the food production chain. These data are useful in improving background data on antimicrobial resistance of S. aureus isolated from food, processing environments and food handlers, supporting the prudent use of antibiotics and the development of international control programs.
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Affiliation(s)
- D Paludi
- Department of Food Science, University of Teramo, Teramo, Italy.
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Pica A, Merlino A, Balsamo A, Mazzarella L, Vergara A. Raman assisted X-ray crystallographic study of nitric oxide binding to deoxygenated hemoglobins. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311086016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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23
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Pennisi L, Sili F, Costanzo C, Vergara A. SURVEY ON SOLIDARITY GROUPS OF BUYERS: CRITICAL ISSUES. Ital J Food Saf 2011. [DOI: 10.4081/ijfs.2011.2.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Belmar P, de Eusebio E, Sánchez C, Vergara A, Martín A, Juanes A, Jiménez E, Diez E, Pastor MA, Olivares M. [Paramedian forehead flap for the reconstruction of extensive nasal defects]. Actas Dermosifiliogr 2011; 102:187-92. [PMID: 21377637 DOI: 10.1016/j.ad.2010.10.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 09/19/2010] [Accepted: 10/01/2010] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Department of Dermatology at Hospital Universitario de Guadalajara in Spain is a referral center for Mohs micrographic surgery. Consequently, we are regularly faced with the problem of repairing large surgical defects on the nose. The paramedian forehead flap is currently one of the techniques of choice for the repair of such defects. MATERIALS AND METHODS We review our experience in the repair of nasal defects using the paramedian forehead flap over the period from 2004 to 2008. We describe the surgical technique, complications, and final results. RESULTS Ten patients (mean age, 75.1 years) were treated using this flap. Two patients also required cartilage grafts and reconstruction of the internal nasal lining. The most common complications were bleeding (60%) and partial necrosis (10%). The final cosmetic and functional results were considered good or excellent in 90% of cases. CONCLUSIONS The forehead flap continues to be one of the best options for the closure of surgical defects of the nasal pyramid larger than 2 cm. Adequate knowledge and careful application of the technique allows excellent results to be obtained with few complications.
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Affiliation(s)
- P Belmar
- Servicio de Dermatología, Hospital Universitario de Guadalajara, Universidad de Alcalá de Henares, España.
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Belmar P, de Eusebio E, Sánchez C, Vergara A, Martín A, Juanes A, Jiménez E, Diez E, Pastor M, Olivares M. Paramedian Forehead Flap for the Reconstruction of Extensive Nasal Defects. Actas Dermo-Sifiliográficas (English Edition) 2011. [DOI: 10.1016/s1578-2190(11)70783-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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26
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Vergara A, Festino A, Di Ciccio P, Pennisi L, Conter M, Costanzo C, Ianieri A. THE MANAGEMENT OF THE DOMESTIC REFRIGERATION: HYGIENIC AND SANITARY CHARACTERISTICS OF REFRIGERATORS FROM NORTHEN AND CENTRAL ITALY. Ital J Food Saf 2010. [DOI: 10.4081/ijfs.2010.8.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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27
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Suarez-Lozano I, Viciana P, Lacalle JR, Teira R, Lozano F, Lopez-Aldeguer J, Pedrol E, Domingo P, Cosin J, Roca B, Geijo P, Fuente B, Vergara A, Ribera E, Galindo MJ, Zapata A, Sanchez T, Vidal F, Munoz-Sanz A, Munoz-Sanchez J, Garrido M. The relationship between antiretroviral prescription patterns and treatment guidelines in treatment-naïve HIV-1-infected patients. HIV Med 2009; 10:573-9. [DOI: 10.1111/j.1468-1293.2009.00731.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pennisi L, Olivieri V, Vergara A, Ianieri A. SHELF –LIFE OF SEA BREAM (SPARUS AURATA) PACKAGED IN MODIFIED ATMOSPHERE: RELATIONSHIPs BETWEEN SENSORY AND MICROBIOLOGICAL PARAMETERS. Ital J Food Saf 2009. [DOI: 10.4081/ijfs.2008.3.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Verde C, Giordano D, Russo R, Riccio A, Vergara A, Mazzarella L, di Prisco G. Hemoproteins in the cold. Mar Genomics 2009; 2:67-73. [DOI: 10.1016/j.margen.2009.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 01/16/2009] [Accepted: 03/02/2009] [Indexed: 11/25/2022]
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Crespo M, Ribera E, Suarez-Lozano I, Domingo P, Pedrol E, Lopez-Aldeguer J, Munoz A, Vilades C, Sanchez T, Viciana P, Teira R, Garcia-Alcalde ML, Vergara A, Lozano F, Galindo MJ, Cosin J, Roca B, Terron A, Geijo P, Vidal F, Garrido M. Effectiveness and safety of didanosine, lamivudine and efavirenz versus zidovudine, lamivudine and efavirenz for the initial treatment of HIV-infected patients from the Spanish VACH cohort. J Antimicrob Chemother 2008; 63:189-96. [DOI: 10.1093/jac/dkn450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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D’Orio V, Festino A, Costanzo C, Di Ciccio P, Colavita G, Vergara A. BIOMOLECULAR IDENTIFICATION OF METHICILLIN-RESISTANT STRAINS OF STAPHYLOCOCCUS AUREUS (MRSA) ISOLATED FROM MEAT AND MEAT PROCESSING ENVIRONMENTS. Ital J Food Saf 2008. [DOI: 10.4081/ijfs.2008.1.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Castillo Pineda JCDLC, Figueredo Grijalva R, Dugloszewski C, Díaz Reynoso JASR, Spolidoro Noroña JV, Matos A, Carrasco F, Chirife G, Vergara A, Moya Rodríguez J, Loyola G, Alvarez A, Barozzi C, Vargas M, García de Lorenzo A. [The Cancun Declaration: the Cancun International Declaration on the Right at the hospital]. NUTR HOSP 2008; 23:413-417. [PMID: 19160890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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Merlino A, Russo Krauss I, Castellano I, De Vendittis E, Vergara A, Sica F. Structure, stability and flexibility of a psychrophilic iron superoxide dismutase. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308090697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mazzarella L, Vitagliano L, Vergara A, Merlino A, Verde C, Di Prisco G. Multiple coordination and quaternary states of fish hemoglobin re-open the root effect question. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308087904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Vergara A, Isarría MJ, Rodríguez-Peralto JL, Guerra A. [Disseminated lobular capillary hemangiomas]. Actas Dermosifiliogr 2008; 99:494-496. [PMID: 18558064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
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Di Bonaventura G, Piccolomini R, Paludi D, D’Orio V, Vergara A, Conter M, Ianieri A. Influence of temperature on biofilm formation by Listeria monocytogenes on various food-contact surfaces: relationship with motility and cell surface hydrophobicity. J Appl Microbiol 2008; 104:1552-61. [DOI: 10.1111/j.1365-2672.2007.03688.x] [Citation(s) in RCA: 284] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Teira R, Geijo P, Cosín J, Muñoz-Sanz A, Viciana P, Suarez-Lozano I, López-Aldeguer J, Pedrol E, Vidal F, Sanchez T, Lozano F, Terron A, Vergara A, Galindo MJ, Domingo P, Ribera E, Roca B, Garcia-Alcalde ML, Garrido M, Muñoz-Sanchez P. Risk factors for end-stage liver disease among HIV and hepatitis C virus co-infected patients in the Spanish VACH Cohort. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Vergara A, Isarría M, Rodríguez-Peralto J, Guerra A. Disseminated Lobular Capillary Hemangiomas. Actas Dermo-Sifiliográficas (English Edition) 2008. [DOI: 10.1016/s1578-2190(08)70300-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Colavita G, Rotili M, Leone A, Vergara A, Sammarco ML, Ripabelli G. Identification of Emesis-causing Bacillus cereus Strains by Polymerase Chain Reaction: Preliminary Results. Vet Res Commun 2007; 31 Suppl 1:351-3. [PMID: 17682912 DOI: 10.1007/s11259-007-0035-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- G Colavita
- Department of Agri-food, Environmental and Microbiological Sciences and Technologies, University of Molise, Campobasso, Italy.
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Mallolas J, Blanco J, Labarga P, Vergara A, Ocampo A, Sarasa M, Arnedo M, López-Púa Y, García J, Juega J, Guelar A, Terrón A, Dalmau D, García I, Zárraga M, Martínez E, Carné X, Pumarola T, Escayola R, Gatell J. Inhibitory quotient as a prognostic factor of response to a salvage antiretroviral therapy containing ritonavir-boosted saquinavir. The CIVSA Study. HIV Med 2007; 8:226-33. [PMID: 17461850 DOI: 10.1111/j.1468-1293.2007.00464.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The addition of a low dose of ritonavir to protease inhibitors (PIs) has become a widespread strategy to improve PI pharmacokinetics. As resistance is a major barrier to long-term suppression, in salvage therapy genotype and/or phenotype scoring is currently used to predict the response. We evaluated the relationship between the saquinavir (SQV) inhibitory quotient (IQ) (virtual and genotypic) and virological response. METHODS Eligible patients were on a PI-containing highly active antiretroviral therapy (HAART) regimen excluding SQV and had a viral load >5000 HIV-1 RNA copies/mL. The PI was switched to SQV/ritonavir (RTV) 1000/100 mg twice a day (bid) and the same two backbone nucleoside reverse transcriptase inhibitors (NRTIs) were maintained at least until week 4, when the resistance test results became available. Genotype and virtual phenotype were determined at baseline, while the SQV trough plasma concentration was determined at week 4. RESULTS Fifty-three patients were included in the study. Mean baseline viral load and CD4 count were 137,693 copies/mL and 263 cells/microL, respectively, the mean number of previous PIs was 2.3 and the mean number of protease gene mutations (PGMs) was 4.1. Using an on-treatment analysis, at week 16 the mean increase in CD4 count was 70.9 cells/microL, viral load was <200 copies/mL in 17 out of 37 patients (45.9%), and 30 out of 45 patients (66.7%) were considered virological responders (VRs) (viral load <200 copies/mL or viral load declined > or =1 log(10) at week 16). Median virtual phenotype was 1.3 (0.6-6.9). Baseline differences were detected between VR and non-VR populations: the mean numbers of PGMs were 3.2 and 5.8 (P<0.05), the mean numbers of SQV-associated mutations were 2 and 3.8 (P<0.05), and the mean CD4 counts were 365.9 and 184.3 cells/microL (P<0.05), respectively. Mean SQV trough concentrations at week 4 were 1.1 and 1.0 microg/mL (not significant), and mean virtual IQs were 0.7 and 0.1 (P<0.01), respectively. Multivariate analysis showed that baseline PGMs >5 or SQV-associated mutations>5, virtual phenotype, baseline viral load >50,000 copies/mL, and virtual IQ <0.5, but not genotypic IQ, were the variables independently associated with non-VR. CONCLUSION In heavily pretreated patients, the use of SQV virtual IQ or alternatively virtual phenotype, as well as PGMs, is a useful tool for the prediction of virological response.
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Vergara A, Arrue I, Dominuez JD, Vanaclocha F. Generalized pustular psoriasis precipitated by aceclofenac. J Eur Acad Dermatol Venereol 2006; 20:1028-9. [PMID: 16922973 DOI: 10.1111/j.1468-3083.2006.01622.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Losito P, Vergara A, Muscariello LT, Ianieri A. Antimicrobial susceptibility of environmental Staphylococcus aureus strains isolated from a pigeon slaughterhouse in Italy. Poult Sci 2006; 84:1802-7. [PMID: 16463981 DOI: 10.1093/ps/84.11.1802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
No information is available concerning the antimicrobial susceptibility of Staphylococcus aureus isolated from pigeon slaughterhouses. In the present study, 59 staphylococcal strains isolated from a pigeon slaughterhouse in central Italy were compared according to their antibiotic resistance. On the basis of cultural and biochemical properties, all isolates could be identified as S. aureus. The strains were checked for the productions of enterotoxins A, B, C, D by reversed passive latex agglutination. Resistance to 26 antibiotics was also determined paying particular attention to resistance to those antimicrobial agents frequently used in human medicine and in poultry breeding. Only one strain was positive for the production of enterotoxins type C and D. It was isolated from the evisceration tube after slaughtering. Enterotoxin B was produced by 2 strains isolated from the eyebrows and conjunctivas of the worker operating the crop rinsing tube. As to the susceptibility to antibiotics, all strains were sensitive to amoxicillin/clavulanic acid, bacitracin, cephalothin, fusidic acid, gentamicin, kanamycin, linezolid, oxacillin, quinupristin/dalfopristin, rifampicin, tobramycin, trimethoprim-sulfamethoxazole, vancomycin. Some (15.2%) of the strains were resistant to ampicillin and to penicillin G; 6.8% were resistant to chloramphenicol, 20.3% to enrofloxacin, 16.9% to erythromycin and to ciprofloxacin, 8.5% to clindamycin, and 11.9% to lincomycin. The highest percentages of strains were resistant to tetracycline and oleandomicin (37.3 and 25.4% respectively). Methicillin-resistant staphylococci were also found (3.4%). Only one strain had a multiple antibiotic resistance index > 0.30. The results were statistically analyzed and clustered in 6 groups. This work provides the antibiotic resistance pattern of S. aureus strains isolated from a pigeon slaughtering plant and represents a study on a quite unknown field in meat production.
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Affiliation(s)
- P Losito
- Dipartimento di Scienze Degli Alimenti, Università di Teramo, 64100 Teramo, Italy
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López-Medrano F, Vergara A, García-Donoso C, Menassa A, Aguado JM. Mujer proveniente de Bolivia con fiebre, exantema y «signo del torniquete» positivo. A propósito de un caso de dengue. Rev Clin Esp 2006; 206:212. [PMID: 16750102 DOI: 10.1157/13086813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Vitagliano L, Bonomi G, Franzese M, Merlino A, Vergara A, Verde C, di Prisco G, Mazzarella L. Structural characterization of the oxidation pathway of antarctic fish hemoglobins. Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305090859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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López-Medrano F, Vergara A, García-Donoso C, Menassa A, San Juan R, Aguado J. Caso 4. Mujer proveniente de Bolivia con fiebre, exantema y «signo del torniquete» positivo. Rev Clin Esp 2005. [DOI: 10.1016/s0014-2565(05)72593-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Affiliation(s)
- G Colavita
- Department of Agri-Food Environmental and Microbiological Science and Technology, University of Molise, Campobasso, Italy
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Affiliation(s)
- A Vergara
- Dipartimento di Scienze degli Alimenti, Teramo, Italy.
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Castagnolo D, Vergara A, Paduano L, Sartorio R, Annunziata O. Analysis of the influence of coupled diffusion on transport in protein crystal growth for different gravity levels. Acta Crystallogr D Biol Crystallogr 2002; 58:1633-7. [PMID: 12351876 DOI: 10.1107/s0907444902014361] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2002] [Accepted: 08/07/2002] [Indexed: 02/26/2023]
Abstract
Diffusion has a central role in protein crystal growth both in microgravity conditions and on ground. Recently several reports have been focused on the importance to use the generalized Fick's equations in n-component systems where crystals grow. In these equations the total flux of each component is produced by the own concentration gradient (main flow) and by the concentration gradient of the other components (cross-flow) present in the system. However in literature the latter effect is often neglected, and the so-called pseudo-binary approximation is used. Lin et al. (1995) proposed a mathematical model to evaluate the concentration profile of the species present around a growing protein crystal. Although the model is reliable, it suffers of the pseudo-binary approximation (neglecting cross term diffusion coefficients and using binary diffusion coefficients), probably because of the lack of multicomponent diffusion data. The present model is based on the experimental set-up proposed by Lin et al. (1995). Nevertheless we have included the coupled diffusion effects, according to the correct description of the matter transport through the generalized Fick's equations. The crystal growth rate is calculated for different gravity levels. The model has been applied to the ternary lysozyme-NaCl-water and quaternary lysozyme-poly(ethylene glycol) (PEG)-NaCl-water systems using recent diffusion data.
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Affiliation(s)
- D Castagnolo
- MARS Center, via E Gianturco 31, 80146 Naples, Italy.
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Torres-Tortosa M, Canueto J, Bascuñana A, Vergara A, Sánchez-Porto A, Moreno-Maqueda I, López-Suárez A, González-Serrano M, Cruz E. Prognostic evaluation of bacteremia and fungemia in patients with acquired immunodeficiency syndrome. Eur J Clin Microbiol Infect Dis 2002; 21:262-8. [PMID: 12072936 DOI: 10.1007/s10096-002-0700-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
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.
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Affiliation(s)
- M Torres-Tortosa
- Infectious Diseases Section, Hospital Punta de Europa,Carretera de Getares s/n, 11207 Algeciras, spain.
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