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2 results on '"Orellana MA"'

1. [Which is the best empirical treatment in patients with urethritis?].

Author

Orellana MA and Gómez-Lus ML

Subjects
Adolescent, Adult, Aged, Bacteria drug effects, Drug Resistance, Bacterial, Exudates and Transudates microbiology, Female, Gonorrhea drug therapy, Gonorrhea microbiology, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Spain, Urethritis microbiology, Urethritis virology, Young Adult, Anti-Bacterial Agents therapeutic use, Antifungal Agents therapeutic use, Antiviral Agents therapeutic use, Urethritis drug therapy
Abstract

Objective: To know the best empirical treatment of urethritis in patients at the City Center of Madrid., Methods: 2.021 urethral exudates were analyzed in men between January 2003-December 2007. In addition to the traditional cultures, it was determined the presence of Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Trichomonas vaginalis and Herpes simplex. The susceptibility of N.gonorrhoeae and Haemophilus spp was performed by disk diffusion method and U. urealyticum by Mycoplasma IST., Results: The percentage of positive samples was: 30.6%. The most frequently isolated microorganisms were: U. urealyticum 9.9%, N. gonorrhoeae 7.4%, C. trachomatis 5.1% and Haemophilus spp 3.8%. The resistance of N. gonorrhoeae in the first period was: penicillin 11.8%, tetracycline 5.9%, ciprofloxacin 8.8% and presence of betalactamase 11.8%. In the second period: penicillin 9.7%, amoxicillin/clavulanic acid 1.4%, tetracycline 8.3%, ciprofloxacin 23.6% and presence of betalactamase 10.5%. Resistance to ciprofloxacin in non-MSM (men having sex with men) was 20% and in MSM 56.2%. Resistance of Haemophilus spp in the first period was: 38.2% ampicillin, amoxicillin/clavulanic acid 8.8%, clarithromycin 35.3%, cotrimoxazole 64.7%, cefuroxime 5.9%, ciprofloxacin 8.8%, tetracycline 12.1% and presence of betalactamase 26.5%. In the second period:presence of betalactamase 41.9%, ampicillin 53.1%, amoxicillin/clavulanic acid 9.4%, cefuroxime 9.4%, clarithromycin 18.7%, tetracycline 34.4%, ciprofloxacin 15.6%, and cotrimoxazole 68.7%. Resistance of U. urealyticum was: ciprofloxacin 80.7%, ofloxacin 32.4%, erythromycin 17.5%, azithromycin 9.6%, tetracycline 3.5% and doxycycline 0.8%., Conclusions: N. gonorrhoeae showed a level of resistance to tetracycline and ciprofloxacin higher in the second period, being significant for ciprofloxacin. Quinolone resistance was higher in MSM. Haemophilus spp showed a level of resistance to ampicillin, ciprofloxacin and tetracycline higher in the second period, being significant for tetracycline. U.urealyticum showed high level of resistance to ciprofloxacin (80.7%)and ofloxacin (32.4%) and low level of resistance to doxycycline (0.8%) and tetracycline (3.5%).

Published
2011

2. High MICs for Vancomycin and Daptomycin and Complicated Catheter-Related Bloodstream Infections with Methicillin-Sensitive Staphylococcus aureus

Author

Elena Loza, Miquel Pujol, Elena Resino-Foz, Rafael San-Juan, Antonio Lalueza, Fernando Chaves, Carmen Ardanuy, María Pilar Romero, Marina de Cueto, Mario Fernández-Ruiz, Esther Viedma, José María Aguado, Alicia Rico, Isabel Fernández Morales, María Ángeles Orellana, Jesús Fortún, Alejandra Morales-Cartagena, Francisco López-Medrano, [San-Juan,R, Viedma,E, Chaves,F, Lalueza,A, Resino-Foz,E, Morales-Cartagena,A, Orellana,MA, López-Medrano,F, Fernández-Ruiz,M, Aguado,JM] University Hospital–Research Institute 12 de Octubre, Madrid, Spain. [Fortún,J, Loza,E] Hospital Universitario Ramón y Cajal, Madrid, Spain. [Pujol,M, Ardanuy,C] University Hospital–Bellvitge Institute for Biomedical Research, Barcelona, Spain. [Morales,I, de Cueto,M] Hospital Universitario Virgen de la Macarena, Seville, Spain. [Rico,A, Romero,MP] Hospital Universitario La Paz, Madrid. Spain., and Universitat de Barcelona

Subjects
catheter-related bloodstream infection, Male, Epidemiology, daptomycin, vancomycin, Bacteremia, Comorbidity, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Diseases::Bacterial Infections and Mycoses::Infection::Catheter-Related Infections [Medical Subject Headings], bacteria, Geographicals::Geographic Locations::Europe::Spain [Medical Subject Headings], Factors de risc en les malalties, Hazard ratio, Staphylococcal Infections, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Microbiological Techniques::Microbial Sensitivity Tests [Medical Subject Headings], Blood, Staphylococcus aureus, cardiovascular system, Vancomycin, complicated bacteremia, Microbiology (medical), Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, Efecte dels medicaments sobre els microorganismes, Risk factors in diseases, 030106 microbiology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variance::Multivariate Analysis [Medical Subject Headings], Microbial Sensitivity Tests, MSSA, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Daptomycin, Drug Resistance, Bacterial, Humans, Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Staphylococcal Infections [Medical Subject Headings], lcsh:R, biochemical phenomena, metabolism, and nutrition, medicine.disease, bacterial infections and mycoses, septic thrombophlebitis, chemistry, Infecciones relacionadas con catéteres, Linezolid, Daptomicina, Meticilina, 0301 basic medicine, lcsh:Medicine, Sang, Kaplan-Meier Estimate, medicine.disease_cause, Catheter-related bloodstream infection, High MICs for Vancomycin and Daptomycin and Complicated Catheter-Related Bloodstream Infections with Methicillin-Sensitive Staphylococcus aureus, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], chemistry.chemical_compound, Risk Factors, polycyclic compounds, 030212 general & internal medicine, MIC, Methicillin-sensitive Staphylococcus aureus, Oxacilina, Organisms::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus::Staphylococcus aureus [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia [Medical Subject Headings], Disease Management, Middle Aged, Anti-Bacterial Agents, Infectious Diseases, surgical procedures, operative, Treatment Outcome, Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Penicillins::Methicillin [Medical Subject Headings], Female, medicine.drug, Chemicals and Drugs::Polycyclic Compounds::Macrocyclic Compounds::Peptides, Cyclic::Daptomycin [Medical Subject Headings], Bacterial diseases, Staphylococcal infections, CRBI, Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Penicillins::Oxacillin [Medical Subject Headings], Complicated bacteremia, methicillin-sensitive Staphylococcus aureus, Internal medicine, Análisis multivariante, medicine, lcsh:RC109-216, cardiovascular diseases, Septic thrombophlebitis, Vancomicina, Malalties bacterianes, business.industry, Research, Methicillin-resistant Staphylococcus aureus, Surgery, Spain, Chemicals and Drugs::Carbohydrates::Glycoconjugates::Glycopeptides::Vancomycin [Medical Subject Headings], Catheter-Related Infections, Effect of drugs on microorganisms, Bacteriemia, business
Abstract

Patients infected with these bacteria were more likely to have local endovascular complications., We investigated the prognostic role of high MICs for antistaphylococcal agents in patients with methicillin-sensitive Staphylococcus aureus catheter-related bloodstream infection (MSSA CRBSI). We prospectively reviewed 83 episodes from 5 centers in Spain during April 2011–June 2014 that had optimized clinical management and analyzed the relationship between E-test MICs for vancomycin, daptomycin, oxacillin, and linezolid and development of complicated bacteremia by using multivariate analysis. Complicated MSSA CRBSI occurred in 26 (31.3%) patients; MICs for vancomycin and daptomycin were higher in these patients (optimal cutoff values for predictive accuracy = 1.5 μg/mL and 0.5 μg/mL). High MICs for vancomycin (hazard ratio 2.4, 95% CI 1.2–5.5) and daptomycin (hazard ratio 2.4, 95% CI 1.1–5.9) were independent risk factors for development of complicated MSSA CRBSI. Our data suggest that patients with MSSA CRBSI caused by strains that have high MICs for vancomycin or daptomycin are at increased risk for complications.

Published
2016

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