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Shaw E, Gomila A, Piriz M, Perez R, Cuquet J, Vazquez A, Badia JM, Lérida A, Fraccalvieri D, Marron A, Freixas N, Castro A, Cruz A, Limón E, Gudiol F, Biondo S, Carratalà J, Pujol M. Multistate modelling to estimate excess length of stay and risk of death associated with organ/space infection after elective colorectal surgery. J Hosp Infect 2018; 100:400-405. [PMID: 30125586 DOI: 10.1016/j.jhin.2018.08.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 06/20/2018] [Accepted: 08/10/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Accounting for time-dependency and competing events are strongly recommended to estimate excess length of stay (LOS) and risk of death associated with healthcare-associated infections. AIM To assess the effect of organ/space (OS) surgical site infection (SSI) on excess LOS and in-hospital mortality in patients undergoing elective colorectal surgery (ECS). METHODS A multicentre prospective adult cohort undergoing ECS, January 2012 to December 2014, at 10 Spanish hospitals was used. SSI was considered the time-varying exposure and defined as incisional (superficial and deep) or OS. Discharge alive and death were the study endpoints. The mean excess LOS was estimated using a multistate model which provided a weighted average based on the states patients passed through. Multivariate Cox regression models were used to assess the effect of OS-SSI on risk of discharge alive or in-hospital mortality. FINDINGS Of 2778 patients, 343 (12.3%) developed SSI: 194 (7%) OS-SSI and 149 (5.3%) incisional SSI. Compared to incisional SSI or no infection, OS-SSI prolonged LOS by 4.2 days (95% confidence interval (CI): 4.1-4.3) and 9 days (8.9-9.1), respectively, reduced the risk of discharge alive (adjusted hazard ratio (aHR): 0.36 (95% CI: 0.28-0.47) and aHR: 0.17 (0.14-0.21), respectively), and increased the risk of in-hospital mortality (aHR: 8.02 (1.03-62.9) and aHR: 10.7 (3.7-30.9), respectively). CONCLUSION OS-SSI substantially extended LOS and increased risk of death in patients undergoing ECS. These results reinforce OS-SSI as the SSI with the highest health burden in ECS.
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Affiliation(s)
- E Shaw
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; Epidemiologia de les infeccions bacterianes, Patologia Infecciosa i Transplantament, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; VINCat Programme, Barcelona, Spain.
| | - A Gomila
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; Epidemiologia de les infeccions bacterianes, Patologia Infecciosa i Transplantament, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; VINCat Programme, Barcelona, Spain
| | - M Piriz
- VINCat Programme, Barcelona, Spain; Infection Control, Corporació Sanitària Parc Taulí, Barcelona, Spain
| | - R Perez
- VINCat Programme, Barcelona, Spain; Department of Internal Medicine, Fundació Althaia de Manresa, Barcelona, Spain
| | - J Cuquet
- VINCat Programme, Barcelona, Spain; Department of Internal Medicine, Hospital General de Granollers, Barcelona, Spain
| | - A Vazquez
- Servei d'Estadística Aplicada, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J M Badia
- VINCat Programme, Barcelona, Spain; Department of General Surgery, Hospital General de Granollers, Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain
| | - A Lérida
- VINCat Programme, Barcelona, Spain; Department of Internal Medicine, Hospital de Viladecans, Barcelona, Spain
| | - D Fraccalvieri
- VINCat Programme, Barcelona, Spain; Department of General Surgery, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - A Marron
- VINCat Programme, Barcelona, Spain; Department of Internal Medicine, Consorci Sanitari de l'Anoia, Barcelona, Spain
| | - N Freixas
- VINCat Programme, Barcelona, Spain; Department of Infectious Diseases, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - A Castro
- VINCat Programme, Barcelona, Spain; Department of Internal Medicine, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - A Cruz
- VINCat Programme, Barcelona, Spain; Department of Infectious Diseases, Parc Sanitari Sant Joan de Déu de Sant Boi, Barcelona, Spain
| | - E Limón
- VINCat Programme, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - F Gudiol
- VINCat Programme, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - S Biondo
- VINCat Programme, Barcelona, Spain; Department of General Surgery, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - J Carratalà
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; Epidemiologia de les infeccions bacterianes, Patologia Infecciosa i Transplantament, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; VINCat Programme, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - M Pujol
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; Epidemiologia de les infeccions bacterianes, Patologia Infecciosa i Transplantament, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; VINCat Programme, Barcelona, Spain
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Gomila A, Carratalà J, Biondo S, Badia JM, Fraccalvieri D, Shaw E, Diaz-Brito V, Pagespetit L, Freixas N, Brugués M, Mora L, Perez R, Sanz C, Arroyo N, Iftimie S, Limón E, Gudiol F, Pujol M. Predictive factors for early- and late-onset surgical site infections in patients undergoing elective colorectal surgery. A multicentre, prospective, cohort study. J Hosp Infect 2017; 99:24-30. [PMID: 29288776 DOI: 10.1016/j.jhin.2017.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 11/13/2017] [Accepted: 12/20/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Surgical site infections (SSIs) are the leading cause of healthcare-associated infections in acute care hospitals in Europe. However, the risk factors for the development of early-onset (EO) and late-onset (LO) SSI have not been elucidated. AIM This study investigated the predictive factors for EO-SSI and LO-SSI in a large cohort of patients undergoing colorectal surgery. METHODS We prospectively followed-up adult patients undergoing elective colorectal surgery in 10 hospitals (2011-2014). Patients were divided into three groups: EO-SSI, LO-SSI, or no infection (no-SSI). The cut-off defining EO-SSI and LO-SSI was seven days (median time to SSI development). Different predictive factors for EO-SSI and LO-SSI were analysed, comparing each group with the no-SSI patients. FINDINGS Of 3701 patients, 320 (8.6%) and 349 (9.4%) developed EO-SSI and LO-SSI, respectively. The rest had no-SSI. Patients with EO-SSI were mostly males, had colon surgery and developed organ-space SSI whereas LO-SSI patients frequently received chemotherapy or radiotherapy and had incisional SSI. Male sex (odds ratio (OR): 1.92; P < 0.001), American Society of Anesthesiologists' physical status >2 (OR: 1.51; P = 0.01), administration of mechanical bowel preparation (OR: 0.7; P = 0.03) and stoma creation (OR: 1.95; P < 0.001) predicted EO-SSI whereas rectal surgery (OR: 1.43; P = 0.03), prolonged surgery (OR: 1.4; P = 0.03) and previous chemotherapy (OR: 1.8; P = 0.03) predicted LO-SSI. CONCLUSION We found distinctive predictive factors for the development of SSI before and after seven days following elective colorectal surgery. These factors could help establish specific preventive measures in each group.
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Affiliation(s)
- A Gomila
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain; VINCat Program, Spain.
| | - J Carratalà
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain; VINCat Program, Spain; University of Barcelona, Spain
| | - S Biondo
- VINCat Program, Spain; University of Barcelona, Spain; Department of General Surgery, Hospital Universitari de Bellvitge, Spain
| | - J M Badia
- VINCat Program, Spain; Department of General Surgery, Hospital General de Granollers, Spain; Universitat Internacional de Catalunya, Spain
| | - D Fraccalvieri
- VINCat Program, Spain; Department of General Surgery, Hospital Universitari de Bellvitge, Spain
| | - E Shaw
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain; VINCat Program, Spain
| | - V Diaz-Brito
- VINCat Program, Spain; Department of Infectious Diseases, Parc Sanitari Sant Joan de Déu de Sant Boi, Spain
| | - L Pagespetit
- VINCat Program, Spain; Department of Infectious Diseases, Consorci Sanitari de Terrassa, Spain
| | - N Freixas
- VINCat Program, Spain; Department of Infectious Diseases, Hospital Universitari Mútua de Terrassa, Spain
| | - M Brugués
- VINCat Program, Spain; Department of Internal Medicine, Consorci Sanitari de l'Anoia, Spain
| | - L Mora
- VINCat Program, Spain; Department of General Surgery, Corporació Sanitària Parc Taulí, Spain
| | - R Perez
- VINCat Program, Spain; Department of Internal Medicine, Fundació Althaia, Spain
| | - C Sanz
- VINCat Program, Spain; Department of Internal Medicine, Hospital de Viladecans, Spain
| | - N Arroyo
- VINCat Program, Spain; Department of General Surgery, Hospital General de Granollers, Spain
| | - S Iftimie
- VINCat Program, Spain; Department of Internal Medicine, Hospital Universitari Sant Joan de Reus, Spain
| | - E Limón
- VINCat Program, Spain; University of Barcelona, Spain
| | - F Gudiol
- VINCat Program, Spain; University of Barcelona, Spain
| | - M Pujol
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain; VINCat Program, Spain
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Boix-Palop L, Nicolás C, Xercavins M, Riera M, Prim N, Freixas N, Pérez J, Calbo E. Bacillus species pseudo-outbreak: construction works and collateral damage. J Hosp Infect 2016; 95:118-122. [PMID: 27856013 DOI: 10.1016/j.jhin.2016.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 06/15/2016] [Accepted: 10/10/2016] [Indexed: 11/18/2022]
Abstract
We describe the investigation and management of a pseudo-outbreak of Bacillus spp. bacteraemia associated with construction work in an emergency department (ED). During the pseudo-outbreak period 59 out of 3469 (1.7%) blood cultures yielded Bacillus spp. versus 24 out of 7628 (0.31%) in 2012. Material, surfaces, and air samples showed environmental contamination. Cases rapidly declined following the implementation of infection control measures and the end of construction. Construction works at the ED caused environmental contamination that most probably led to the pseudo-outbreak of Bacillus bacteraemia. In hospital settings, the lack of correctly implemented effective barriers during construction may place patients and healthcare providers at risk as well as lead to pseudo-outbreaks.
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Affiliation(s)
- L Boix-Palop
- Internal Medicine Department, Infectious Diseases Unit, Hospital Universitari Mútua Terrassa, Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain.
| | - C Nicolás
- Infection Control Nurse, Hospital Universitari Mútua Terrassa, Barcelona, Spain
| | | | - M Riera
- Infection Control Nurse, Hospital Universitari Mútua Terrassa, Barcelona, Spain
| | - N Prim
- Microbiology Department, Hospital de Sant Pau, Barcelona, Spain
| | - N Freixas
- Infection Control Nurse, Hospital Universitari Mútua Terrassa, Barcelona, Spain
| | - J Pérez
- Microbiology, Catlab, Barcelona, Spain
| | - E Calbo
- Internal Medicine Department, Infectious Diseases Unit, Hospital Universitari Mútua Terrassa, Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain
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Freixas N, Bella F, Limón E, Pujol M, Almirante B, Gudiol F. Impact of a multimodal intervention to reduce bloodstream infections related to vascular catheters in non-ICU wards: a multicentre study. Clin Microbiol Infect 2013; 19:838-44. [DOI: 10.1111/1469-0691.12049] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Monistrol O, Calbo E, Riera M, Nicolás C, Font R, Freixas N, Garau J. Impact of a hand hygiene educational programme on hospital-acquired infections in medical wards. Clin Microbiol Infect 2012; 18:1212-8. [DOI: 10.1111/j.1469-0691.2011.03735.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Calbo E, Freixas N, Xercavins M, Riera M, Nicolas C, Monistrol O, Sole MDM, Sala MR, Vila J, Garau J. Foodborne Nosocomial Outbreak of SHV1 and CTX-M-15-producing Klebsiella pneumoniae: Epidemiology and Control. Clin Infect Dis 2011; 52:743-9. [DOI: 10.1093/cid/ciq238] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Calbo E, Valdés E, Ochoa de Echagüen A, Fleites A, Molinos L, Xercavins M, Freixas N, Rodríguez-Carballeira M, Garau J. Bacteraemic pneumococcal pneumonia in COPD patients: better outcomes than expected. Eur J Clin Microbiol Infect Dis 2009; 28:971-6. [PMID: 19360444 DOI: 10.1007/s10096-009-0737-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2008] [Accepted: 03/23/2009] [Indexed: 11/26/2022]
Abstract
The purpose of the study was to compare the clinical characteristics and outcomes of bacteraemic pneumococcal pneumonia (BPP) in chronic obstructive pulmonary disease (COPD) and non-COPD patients. A case-control study was conducted. Cases were any adult with BPP and forced expiratory volume in 1 second (FEV(1)) <80% and FEV(1)/forced expiratory vital capacity (FVC) <70%. Controls were patients with BPP without clinical diagnosis of COPD matched 1:2 by age, gender and date of isolation. Variables included co-morbidities, serotypes, pneumonia severity index (PSI), treatment and mortality. There were 45 cases and 90 controls. No significant differences were found in Charlson scores, antibiotic treatment, serotype distribution and severity. Malignancy, shock and mechanical ventilation were less frequent in COPD patients. One patient died vs 14 controls (p = 0.02). In univariate analysis, shock, multilobar involvement, Charlson score, heart failure and absence of COPD were associated with mortality. After adjustment for the presence of shock there were no differences in mortality. BPP presents less frequently with shock and has a lower mortality rate in COPD patients than in non-COPD patients.
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Affiliation(s)
- E Calbo
- Infection Control Department, Infectious Disease Unit, Service of Internal Medicine, Hospital Universitari Mutua de Terrassa, Plaza Dr Robert 5, 08221 Terrassa, Barcelona, Spain.
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Vallés J, Calbo E, Anoro E, Fontanals D, Xercavins M, Espejo E, Serrate G, Morera M, Freixas N, Font B, Bella F, Segura F, Garau X. P958 Risk factors for inadequate antimicrobial treatment in patients with bloodstream infection. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70799-9] [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: 11/16/2022]
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Salvadó M, Garcia-Vidal C, Martinez-Lacasa J, Rodriguez-Carballeira M, Freixas N, Riera M, Nicolás C, Garau J. O470 Tuberculosis in the very old: a ten-year experience. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70314-x] [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: 10/23/2022]
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Tubau A, Grau J, Filgueira A, Juan M, Estremera A, Ferrer MI, Dorao M, Hernández MI, Ferragut MA, Freixas N. Prenatal and postnatal imaging in isolated interruption of the inferior vena cava with azygos continuation. Prenat Diagn 2006; 26:872-4. [PMID: 16941517 DOI: 10.1002/pd.1516] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
The objective of this study was to increase our understanding of the importance of members of the Streptococcus milleri (SM) group as respiratory pathogens, by studying the epidemiological and clinical features of thoracic infections caused by this group and comparing the epidemiology and prognosis of empyema caused by SM with cases of pneumococcal aetiology. The clinical histories and microbiology reports were reviewed in 27 cases of thoracic infection caused by SM over a period of 8 yrs. Cases of pneumococcal empyema that occurred during the same period were also analysed. Diagnoses were made of cases of empyema, including six with pneumonia and one with pulmonary abscess, three cases of pneumonia and two of mediastinitis. In 17 cases, SM was the only pathogen isolated. There was a history of instrument or surgical procedures on the digestive or respiratory tract in 59%. Secondary bacteraemia was documented in three cases. The treatment administered, a combination of antibiotics and surgery, was successful in 22 of 27 (81%) of cases. All strains were susceptible to penicillin. When the characteristics of the empyemas caused by monomicrobial SM infection were compared with those of pneumococcal aetiology from the same period of study, significant differences were found with respect to age, origin of the infection and the need for surgery. In conclusion, thoracic infections caused by Streptococcus milleri are largely pleural. They are polymicrobial in one-third of cases, commonly acquired in hospital and, in most patients, associated with major surgery and/or surgical procedures of the respiratory or digestive tract. The empyema frequently requires thoracotomy for complete resolution.
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Affiliation(s)
- G Porta
- Internal Medicine Service, Hospital Mútua de Terrassa, University of Barcelona, Spain
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Xercavins M, Llovet T, Navarro F, Morera MA, Moré J, Bella F, Freixas N, Simó M, Echeita A, Coll P, Garau J, Prats G. Epidemiology of an unusually prolonged outbreak of typhoid fever in Terrassa, Spain. Clin Infect Dis 1997; 24:506-10. [PMID: 9114207 DOI: 10.1093/clinids/24.3.506] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
An unusually prolonged outbreak of typhoid fever, from 1988 to 1994, in Terrassa (Barcelona, Spain), was caused by a casual food handler who was a carrier. The pattern of this outbreak suggested intermittent low-level exposure to Salmonella typhi. We found 70 patients with S. typhi infections, 52 of whom were available for study. Medical records were reviewed and patients were interviewed with use of a standard questionnaire. Phage typing and pulsed-field gel electrophoresis (PFGE) for strain subtyping were used to confirm the epidemiological data. The 27 outbreak strains shared the same phage type and the same PFGE pattern. Four sporadic strains shared the same phage type as the outbreak strain. PFGE was found to be useful for differentiating strains for epidemiological purposes.
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Affiliation(s)
- M Xercavins
- Servei de Microbiologia and Servei de Medicina Interna, Hospital Mutua de Terrassa, Spain
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Salavert M, Gómez L, Rodriguez-Carballeira M, Xercavins M, Freixas N, Garau J. Seven-year review of bacteremia caused by Streptococcus milleri and other viridans streptococci. Eur J Clin Microbiol Infect Dis 1996; 15:365-71. [PMID: 8793393 DOI: 10.1007/bf01690091] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [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: 02/02/2023]
Abstract
The Streptococcus milleri group is associated with a spectrum of serious suppurative infections that have not been well defined. The purposes of this study were to ascertain the clinical significance of Streptococcus milleri bacteremia and to determine the epidemiological, clinical, and microbiological features of these infections compared to those caused by other viridans streptococci. All cases of streptococcal bacteremia observed in a Spanish hospital in the period from January 1988 to December 1994 were reviewed. Of 137 cases of Streptococcus milleri infection, 33 (24%) were documented cases of bacteremia. Twenty-four patients were men (mean age 57.8 +/- 17.4 years). The majority of infections were abdominal in origin (20/33), the most frequent diagnoses being cholangitis/cholecystitis (18%) and appendicitis (12%). The origin of infection could not be established in three cases. Nine cases of bacteremia (27%) were polymicrobial. Six patients (18%) had septic shock; in four the infection was polymicrobial, and in two the infection was of abdominal origin. Eighteen of the 33 patients (54%) required surgery. Five patients died. All 33 Streptococcus milleri isolates were susceptible to penicillin. Twenty-two cases of bacteremia caused by other viridans streptococci were observed during the same period. There were no statistically significant differences between the two groups in terms of age, sex, mortality, rate of polymicrobial infection, rate of nosocomial acquisition of bacteremia, or the occurrence of shock. An abdominal origin of infection was more frequent in Streptococcus milleri bacteremia (p = 0.0001); a cardiovascular origin was more frequent in the viridans group (p = 0.01), as was a diagnosis of endocarditis (p = 0.004). Four patients with viridans streptococci bacteremia required surgery versus 18 patients with Streptococcus milleri bacteremia (p = 0.01). Viridans streptococci were notably less susceptible to penicillin (89%), clindamycin (79%), and erythromycin (79%).
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Affiliation(s)
- M Salavert
- Department of Internal Medicine, Hospital Mútua de Terrassa, Universidad de Barcelona, Spain
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Sánchez C, García-Restoy E, Garau J, Bella F, Freixas N, Simó M, Lite J, Sánchez P, Espejo E, Cobo E. Ciprofloxacin and trimethoprim-sulfamethoxazole versus placebo in acute uncomplicated Salmonella enteritis: a double-blind trial. J Infect Dis 1993; 168:1304-7. [PMID: 8228368 DOI: 10.1093/infdis/168.5.1304] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [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: 01/29/2023] Open
Abstract
The role of ciprofloxacin and trimethoprim-sulfamethoxazole (TMP-SMZ) was evaluated in empiric treatment of uncomplicated Salmonella enteritis in a comparative, double-blind trial. Patients were randomized to receive ciprofloxacin (500 mg), TMP-SMZ (160/800 mg), or placebo orally twice daily for 5 days. There were 65 evaluatable patients with acute, uncomplicated, culture-confirmed Salmonella enteritis. Duration of diarrhea, abdominal pain, or vomiting and time to defervescence were not significantly different for patients treated with ciprofloxacin, TMP-SMZ, or placebo; there also were no significant differences with respect to full resolution of symptoms for ciprofloxacin versus placebo (point estimate, 0.2 days; 95% confidence interval [CI], -0.5 to 0.9 days) or for TMP-SMZ versus placebo (point estimate, 0.2 days; 95% CI, -1.0 to 0.6 days). The rate of clearance of salmonellae from stools was not significantly different among the groups.
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Affiliation(s)
- C Sánchez
- Dept. of Medicine, Hospital de Mútua de Terrassa, Barcelona, Spain
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