Enfermedades infecciosas y microbiología clínica
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Enferm. Infecc. Microbiol. Clin. · Oct 2012
[Clinico-epidemiological characteristics of HIV-positive immigrants: study of 371 cases].
The number of HIV-positive immigrants have increased in Spain in the last few years, and now represent a significant proportion of the epidemic. Our objective is to describe the clinico-epidemiological characteristics of HIV-positive immigrants seen in a specialist unit in Madrid. ⋯ Immigrants represent a significant proportion of new HIV-positive patients. It is a very heterogeneous group according to their clinical and epidemiological characteristics.
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Enferm. Infecc. Microbiol. Clin. · Aug 2012
Review[Infective endocarditis in the XXI century: epidemiological, therapeutic, and prognosis changes].
Infective endocarditis (IE) is an uncommon and severe disease. Nowadays, in developed countries, IE patients are older, usually have a degenerative heart valve disease, and up to 30% acquire this infection within the health care system. In consequence, staphylococci species are the most frequently isolated microorganisms. ⋯ Despite improvements in the diagnosis, and medical and surgical treatment of IE, this disease continues to be associated with high rates of in-hospital mortality. At present, due to epidemiological changes, antimicrobial prophylaxis can avoid few cases of IE. Prevention of nosocomial bacteremia, an early diagnosis of IE, prompt identification of IE patients at a higher risk of mortality, and a multidisciplinary approach of this disease could be valid strategies in order to improve the outcome of these patients.
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Enferm. Infecc. Microbiol. Clin. · Jun 2012
Comparative StudySurveillance of surgical site infections in elective colorectal surgery. Results of the VINCat Program (2007-2010).
The VINCat Program is a standardized surveillance program of healthcare infections in Catalonia, Spain. This program includes monitoring of surgical site infections (SSI) of elective colorectal surgery. The aim of this study was to define SSI rates in colorectal surgery among VINCat hospitals over a period of 4 years. ⋯ However, no changes were observed in mean surgery duration, ASA score and degree of surgical contamination. The VINCat Program incorporated a large number of Catalan hospitals that participated in standardized monitoring of colorectal surgery. The cumulative incidence rate of SSI for colorectal surgery was 20.8%, although there were large variations between hospitals.
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Enferm. Infecc. Microbiol. Clin. · Jun 2012
Comparative StudyDevice-associated infection rates in Adult Intensive Care Units in Catalonia: VINCat Program findings.
Hospital-acquired infections are a leading cause of morbidity and mortality, especially in the intensive care unit (ICU). Surveillance of device-associated infections plays a major role in infection control programs. In 2006, the Surveillance Program of Nosocomial Infections in Catalonia (VINCat Program) was started, with the major aim of reducing infection rates through a process of active monitoring. ⋯ Incidence rates of VAP ranged from 7.2 ± 3.7 to 10.7 ± 9.6 episodes of VAP/1000 ventilator days. Incidence rates of CVC-BSl ranged from 1.9 ± 1.6 to 2.7 ± 2.0 episodes of CVC-associated bloodstream infection/1000 central venous catheter days. The implementation of the VINCat Program allowed monitoring of nosocomial device-associated infections in ICUs in Catalonia and enabled corrective measures in ICUs with increased incidences of device-associated infections.
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Enferm. Infecc. Microbiol. Clin. · Jun 2012
Practice Guideline[Consensus document of Gesida and Spanish Secretariat for the National Plan on AIDS (SPNS) regarding combined antiretroviral treatment in adults infected by the human immunodeficiency virus (January 2012)].
This consensus document has been prepared by a panel consisting of members of the AIDS Study Group (Gesida) and the Spanish Secretariat for the National Plan on AIDS (SPNS) after reviewing the efficacy and safety results of clinical trials, cohort and pharmacokinetic studies published in medical journals, or presented in medical scientific meetings. Gesida has prepared an objective and structured method to prioritise combined antiretroviral treatment (cART) in naïve patients. Recommendations strength (A, B, C) and the evidence which supports them (I, II, III) are based on a modification of the Infectious Diseases Society of America criteria. ⋯ Adverse events are a fading problem of ART. Guidelines in acute HIV infection, in women, in pregnancy, and to prevent mother-to-child transmission and pre- and post-exposition prophylaxis are commented upon. Management of hepatitis B or C co-infection, other co-morbidities, and the characteristics of ART in HIV-2 infection are included.