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1. Spanish contribution to the development and application of best estimate plus uncertainty methodologies: Past, present and future

Author

Freixa, J., Barrachina, T., Berna, C., Bocanegra, R., Carlos, S., Castro, E., Cuervo, D., Durán-Vinuesa, L.F., Escrivá, A., Feria, F., Cosials, K. Fernández, García-Herranz, N., Herranz, L.E., Jiménez, G., Martínez-Quiroga, V., Martorell, S., Mendizabal, R., Miró, R., Muñoz-Cobo, J.L., Pérez-Ferragut, M., Pericas, R., Queral, C., Reventós, F., Riverola, J., Sánchez, A., and Villanueva, J.F.

Published
2024
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9. Antimicrobial management of Tropheryma whipplei endocarditis: the Spanish Collaboration on Endocarditis (GAMES) experience

Author

Garcia-Alvarez L, Sanz M, Marin M, Farinas M, Montejo M, Goikoetxea J, Garcia R, de Alarcon A, Almela M, Fernandez-Hidalgo N, Socas M, Goenaga M, Navas E, Vicioso L, Oteo J, Adan I, Sanchez F, Noureddine M, Rosas G, Lima J, Aramendi J, Bereciartua E, Boado M, Lazaro M, Goiti J, Hernandez J, Iruretagoyena J, Zuazabal J, Lopez-Soria L, Perez P, Rodriguez R, Voces R, Lopez M, Georgieva R, Solero M, Bailon I, Morales J, Cuende A, Echeverria T, Fuerte A, Gaminde E, Idigoras P, Iribarren J, Yarza A, Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Alvarez N, Bravo-Ferrer J, Castelo L, Cuenca J, Llinares P, Rey E, Mayo M, Sanchez E, Regueiro D, Martinez F, Alonso M, Castro B, Marrero D, Duran M, Gomez M, La Calzada J, Nassar I, Ciezar A, Iglesias J, Alvarez V, Costas C, de la Hera J, Suarez J, Fraile L, Arguero V, Menendez J, Bajo P, Morales C, Torrico A, Palomo C, Martinez B, Esteban A, Asensio M, Ambrosioni J, Armero Y, Azqueta M, Brunet M, Cartana R, Falces C, Fita G, Fuster D, de la Maria C, Gatell J, Perez J, Manzardo C, Marco F, Miro J, Moreno A, Ninot S, Quintana E, Pare C, Pereda D, Pericas J, Pomar J, Ramirez J, Rovira I, Sitges M, Soy D, Tellez A, Vidal B, Vila J, Bermejo J, Bouza E, Cuerpo G, de Egea V, Eworo A, Cruz A, Leoni M, del Vecchio M, Ramallo V, Hernandez M, Martinez-Selles M, Menarguez M, Munoz P, Rincon C, Rodriguez-Abella H, Rodriguez-Creixems M, Pinilla B, Pinto A, Valerio M, Moreno E, Antorrena I, Loeches B, Moreno M, Ramirez U, Baston V, Romero M, Saldana A, Castillo C, Arnaiz A, Berrazueta J, Bellisco S, Belaustegui M, Duran R, Farinas-Alvarez C, Mazarrasa C, Izquierdo R, Rico C, Diez J, Pajaron M, Parra J, Teira R, Zarauza J, Pavia P, Gonzalez J, Orden B, Ramos A, Gonzalez E, Centella T, Hermida J, Moya J, Martin-Davila P, Oliva E, del Rio A, Ruiz S, Tenorio C, de Castro A, de Cueto M, Gallego P, Acebal J, Bano J, Garcia E, Haro J, Lepe J, Lopez F, Luque R, Alonso L, Azcarate P, Gutierrez J, Blanco J, de Benito N, Gurgui M, Pacho C, Pericas R, Pons G, Alvarez M, Fernandez A, Martinez A, Prieto A, Regueiro B, Tijeira E, Vega M, Blasco A, Mollar J, Arana J, Uriarte O, Lopez A, de Zarate Z, Matos J, Nacle M, Sanchez-Porto A, Vallejo L, Leal J, Vazquez E, Torres A, Blazquez A, Valenzuela G, Alonso A, Aramburu J, Calvo F, Rodriguez A, Tarabini-Castellani P, Galvez E, Bellido C, Pau J, Sepulveda M, Sierra P, Iqbal-Mirza S, Alcolea E, Serrano P, Roca J, Escobar E, Monje A, Cabrera V, Garcia D, Luna C, Morcillo J, Seco M, and Spanish Collaboration Endocarditis

Abstract

Objectives: Tropheryma whipplei has been detected in 3.5% of the blood culture-negative cases of endocarditis in Spain. Experience in the management of T. whipplei endocarditis is limited. Here we report the long-term outcome of the treatment of previously reported patients who were diagnosed with infective endocarditis (IE) caused by T. whipplei from the Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en Espana (GAMES) and discuss potential options for antimicrobial therapy for IE caused by T. whipplei. Patients and methods: Seventeen patients with T. whipplei endocarditis were recruited between 2008 and 2014 in 25 Spanish hospitals. Patients were classified according to the therapeutic regimen: ceftriaxone and trimethoprim/sulfamethoxazole, doxycycline + hydroxychloroquine and other treatment options. Results: Follow-up data were obtained from 14 patients. The median follow-up was 46.5months. All patients completed the antibiotic treatment prescribed, with a median duration of 13months. Six patients were treated with ceftriaxone and trimethoprim/sulfamethoxazole (median duration 13months), four with doxycycline + hydroxychloroquine (median duration 13.8months) and four with other treatment options (median duration 22.3months). The follow-up after the end of the treatments was between 5 and 84months (median 24months). Conclusions: All treatment lines were effective and well tolerated. Therapeutic failures were not detected during the treatment. None of the patients died or experienced a relapse during the follow-up. Only six patients received antibiotic treatment in accordance with guidelines. These data suggest that shorter antimicrobial treatments could be effective.

Published
2019

10. Mitral valve repair in infective endocarditis is not inferior to valve replacement: results from a Spanish nationwide prospective registry

Author

Cuerpo G, Valerio M, Pedraz A, Rodriguez-Abella H, Mestres C, Obrador E, Gonzalez-Calle A, Alvarez R, Garcia P, Bouza E, Sanchez F, Noureddine M, Rosas G, Lima J, Aramendi J, Bereciartua E, Blanco M, Blanco R, Boado M, Lazaro M, Crespo A, Goikoetxea J, Iruretagoyena J, Zuazabal J, Lopez-Soria L, Montejo M, Nieto J, Rodrigo D, Rodriguez D, Rodriguez R, Vitoria Y, Voces R, Lopez M, Georgieva R, Ojeda G, Bailon I, Morales J, Cuende A, Echeverria T, Fuerte A, Gaminde E, Goenaga M, Idigoras P, Iribarren J, Yarza A, Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Alvarez N, Bravo-Ferrer J, Castelo L, Cuenca J, Llinares P, Rey E, Mayo M, Sanchez E, Regueiro D, Martinez F, Alonso M, Castro B, Rosado D, Duran M, Gomez M, Lacalzada J, Nassar I, Ciezar A, Iglesias J, Alvarez V, Costas C, de la Hera J, Suarez J, Fraile L, Arguero V, Menendez J, Bajo P, Morales C, Torrico A, Palomo C, Martinez B, Esteban A, Garcia R, Asensio M, Almela M, Ambrosioni J, Azqueta M, Brunet M, Bodro M, Cartana R, Falces C, Fita G, Fuster D, de la Maria C, Hernandez-Meneses M, Perez J, Marco F, Miro J, Moreno A, Nicolas D, Ninot S, Quintana E, Pare C, Pereda D, Pericas J, Pomar J, Ramirez J, Rovira I, Sandoval E, Sitges M, Soy D, Tellez A, Tolosana J, Vidal B, Vila J, Adan I, Bermejo J, Celemin D, Caballero G, Pinto A, Montero A, Cruz A, Mansilla A, Leoni M, Ramallo V, Hernandez M, Hualde A, Marin M, Martinez-Selles M, Menarguez M, Munoz P, Rincon C, Rodriguez-Creixems M, Pinilla B, Vazquez P, Moreno E, Antorrena I, Loeches B, Quiros A, Moreno M, Ramirez U, Baston V, Romero M, Saldana A, Balbin J, Castillo C, Arnaiz A, Revillas F, Belaustegui M, Farinas M, Farinas-Alvarez C, Izquierdo R, Garcia I, Rico C, Gutierrez-Cuadra M, Diez J, Pajaron M, Parra J, Teira R, Zarauza J, Dominguez F, Pavia P, Gonzalez J, Orden B, Ramos A, Centella T, Hermida J, Moya J, Martin-Davila P, Navas E, Oliva E, del Rio A, Ruiz S, Tenorio C, Delia M, Araji O, Barquero J, Jambrina R, de Cueto M, Acebal J, Mendez I, Morales I, Lopez-Cortes L, de Alarcon A, Garcia E, Haro J, Lepe J, Lopez F, Luque R, Alonso L, Azcarate P, Gutierrez J, Blanco J, Villegas A, Garcia-Alvarez L, Oteo J, Sanz M, de Benito N, Gurgui M, Pacho C, Pericas R, Pons G, Alvarez M, Fernandez A, Martinez A, Prieto A, Regueiro B, Tijeira E, Vega M, Blasco A, Mollar J, Arana J, Uriarte O, Lopez A, de Zarate Z, Matos J, Dominguez G, Sanchez-Porto A, Leal J, Vazquez E, Torres A, Blazquez A, Valenzuela G, Alonso A, Aramburu J, Calvo F, Rodriguez A, Tarabini-Castellani P, Galvez E, Bellido C, Pau J, Sepulveda M, Sierra P, Iqbal-Mirza S, Alcolea E, Yanez I, Ballesta A, Escobar E, Monje A, Cabrera V, Garcia D, Asenjo M, Luna C, Morcillo J, Seco M, Gelabert A, Guallar C, Abad N, Mangas P, Adell M, Ruiz M, Porres J, Trigueros N, Espin M, Caro J, Sanchez R, Almazan A, Freire A, Gonzalez M, Ramis P, Bordes E, Bonet L, Munera M, Garaizabal E, Luque J, and GAMEs Study Grp

Subjects
Infectious endocarditis, Mitral valve reparation, Cardiac surgery, Mitral valve replacement
Abstract

IntroductionInfective endocarditis (IE) still carries high morbidity and mortality and frequently requires surgery. The benefit of mitral valve repair (MVr) in the setting of IE is yet to be proven. The goal of this study was to assess the results of MVr in patients with IE after a minimum follow-up of 1year.MethodsThis study is based on a Spanish nationwide prospective registry that included patients operated on for native mitral valve IE. The collaborating Institutions pooled their pre-, peri-, and postoperative data into the database of the GAMES group [Grupo de Apoyo al Manejo de la EndocarditiS (Group for support and management of infective endocarditis)].ResultsData from 27 hospitals were recorded and 3524 cases of active IE identified between 2008 and 2016. There were 1513 cases of mitral IE, of which 898 involved native valves. Of these, 437 patients underwent surgical treatment, and 369 completed the 1-year follow-up. The valve was repaired in 68 cases (18.4%). Preoperative groups were comparable (EuroSCORE MVr 7.7 vs MVR 8.0; p=ns). Mortality in the repair group was inferior to that in the replacement group (16.2% vs 27.2%, p=0.058). At 1year, mortality remained higher in the replacement group: 3.7% vs 2.9%. Relapse of the infection was slightly more frequent in the repair group (7.1% vs 3.7%; p=ns), although this did not lead to higher rates of reintervention (MVr/MVR: 2.9% vs 4.9%).ConclusionMVr is an attractive option for specific patients with IE and does not seem to negatively impact on relapses.

Published
2019

11. Outpatient Parenteral Antibiotic Treatment for Infective Endocarditis: A Prospective Cohort Study From the GAMES Cohort

Author

Llopis J, Gonzalez-Ramallo V, Goenaga M, Garcia-Leoni M, Farinas M, Oteo J, Carrizo E, Reguera-Iglesias J, Hidalgo-Tenorio C, Sanchez F, Noureddine M, Rosas G, Lima J, Blanco R, Boado M, Lazaro M, Crespo A, Goikoetxea J, Iruretagoyena J, Zuazabal J, Lopez-Soria L, Montejo M, Nieto J, Rodrigo D, Rodriguez R, Vitoria Y, Voces R, Lopez M, Georgieva R, Ojeda G, Bailon I, Morales J, Cuende A, Echeverria T, Fuerte A, Gaminde E, Idigoras P, Iribarren J, Yarza A, Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Alvarez N, Bravo-Ferrer J, Castelo L, Cuenca J, Llinares P, Rey E, Mayo M, Sanchez E, Regueiro D, Martinez F, Alonso M, Castro B, Rosado D, Duran M, Gomez M, Lacalzada J, Nassar I, Ciezar A, Iglesias J, Alvarez V, Costas C, de la Hera J, Suarez J, Fraile L, Arguero V, Menendez J, Bajo P, Morales C, Torrico A, Palomo C, Martinez B, Esteban A, Garcia R, Asensio M, Almela M, Ambrosioni J, Azqueta M, Brunet M, Bodro M, Cartana R, Falces C, Fita G, Fuster D, de la Maria C, Garcia-Valls L, Hernandez-Meneses M, Perez J, Marco F, Miro J, Moreno A, Nicolas D, Ninot S, Quintana E, Pare C, Pereda D, Pericas J, Pomar J, Ramirez J, Rovira I, Sandoval E, Sala M, Sitges M, Soy D, Tellez A, Tolosana J, Vidal B, Vila J, Adan I, Bermejo J, Bouza E, Celemin D, Caballero G, Montero A, Cruz A, Mansilla A, Leoni M, Ramallo V, Hernandez M, Hualde A, Marin M, Martinez-Selles M, Menarguez M, Munoz P, Rincon C, Rodriguez-Abella H, Rodriguez-Creixems M, Pinilla B, Pinto A, Valerio M, Vazquez P, Moreno E, Antorrena I, Loeches B, Quiros A, Moreno M, Ramirez U, Baston V, Romero M, Saldana A, Balbin J, Castillo C, Arnaiz A, Revillas F, Belaustegui M, Farinas-Alvarez C, Izquierdo R, Garcia I, Rico C, Gutierrez-Cuadra M, Diez J, Pajaron M, Parra J, Teira R, Zarauza J, Dominguez F, Pavia P, Gonzalez J, Orden B, Ramos A, Centella T, Hermida J, Moya J, Martin-Davila P, Navas E, Oliva E, del Rio A, Stuart J, Rodriguez S, Tenorio C, Delia M, Araji O, Barquero J, Jambrina R, de Cueto M, Acebal J, Mendez I, Morales I, Lopez-Cortes L, de Alarcon A, Garcia E, Haro J, Lepe J, Lopez F, Luque R, Alonso L, Azcarate P, Gutierrez J, Blanco J, Garcia-Alvarez L, Sanz M, de Benito N, Gurgui M, Pacho C, Pericas R, Pons G, Alvarez M, Fernandez A, Martinez A, Prieto A, Regueiro B, Tijeira E, Vega M, Blasco A, Mollar J, Arana J, Uriarte O, Lopez A, de Zarate Z, Matos J, Dominguez G, Sanchez-Porto A, Leal J, Vazquez E, Torres A, Blazquez A, Valenzuela G, Alonso A, Aramburu J, Calvo F, Rodriguez A, Tarabini-Castellani P, Galvez E, Bellido C, Pau J, Sepulveda M, Sierra P, Iqbal-Mirza S, Alcolea E, Serrano P, Roca J, Yanez I, Ballesta A, Soriano V, Escobar E, Monje A, Cabrera V, Garcia D, Asenjo M, Luna C, Morcillo J, Seco M, Gelabert A, Guallar C, Abad N, Mangas P, Adell M, Ruiz M, Porres J, Trigueros N, Espin M, Caro J, Sanchez R, Almazan A, Freire A, Gonzalez M, Ramis P, Blanco M, Bordes E, Bonet L, Munera M, Garaizabal E, Luque J, and Spanish Collaboration Endocarditis

Subjects
infective endocarditis, readmission, outpatient parenteral antibiotic treatment, outcomes, hospitalization
Abstract

Background. Outpatient parenteral antibiotic treatment (OPAT) has proven efficacious for treating infective endocarditis (IE). However, the 2001 Infectious Diseases Society of America (IDSA) criteria for OPAT in IE are very restrictive. We aimed to compare the outcomes of OPAT with those of hospital-based antibiotic treatment (HBAT). Methods. Retrospective analysis of data from a multicenter, prospective cohort study of 2000 consecutive IE patients in 25 Spanish hospitals (2008-2012) was performed. Results. A total of 429 patients (21.5%) received OPAT, and only 21.7% fulfilled IDSA criteria. Males accounted for 70.5%, median age was 68 years (interquartile range [IQR], 56-76), and 57% had native-valve IE. The most frequent causal microorganisms were viridans group streptococci (18.6%), Staphylococcus aureus (15.6%), and coagulase-negative staphylococci (14.5%). Median length of antibiotic treatment was 42 days (IQR, 32-54), and 44% of patients underwent cardiac surgery. One-year mortality was 8% (42% for HBAT; P < .001), 1.4% of patients relapsed, and 10.9% were readmitted during the first 3 months after discharge (no significant differences compared with HBAT). Charlson score (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04-1.42; P = .01) and cardiac surgery (OR, 0.24; 95% CI, .09-.63; P = .04) were associated with 1-year mortality, whereas aortic valve involvement (OR, 0.47; 95% CI, .22-.98; P = .007) was the only predictor of 1-year readmission. Failing to fulfill IDSA criteria was not a risk factor for mortality or readmission. Conclusions. OPAT provided excellent results despite the use of broader criteria than those recommended by IDSA. OPAT criteria should therefore be expanded.

Published
2019

12. Effect of the type of surgical indication on mortality in patients with infective endocarditis who are rejected for surgical intervention

Author

Ramos-Martinez A, Calderon-Parra J, Miro J, Farinas M, Goenaga M, Marcos F, Vinuesa D, Sanchez F, Noureddine M, Rosas G, Lima J, Aramendi J, Blanco M, Blanco R, Boado M, Lazaro M, Crespo A, Goikoetxea J, Iruretagoyena J, Zuazabal J, Lopez-Soria L, Montejo M, Nieto J, Rodrigo D, Rodriguez D, Rodriguez R, Vitoria Y, Voces R, Lopez M, Georgieva R, Ojeda G, Bailon I, Morales J, Cuende A, Echeverria T, Fuerte A, Gaminde E, Idigoras P, Iribarren J, Yarza A, Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Alvarez N, Bravo-Ferrer J, Castelo L, Cuenca J, Llinares P, Rey E, Mayo M, Sanchez E, Regueiro D, Martinez F, Alonso M, Castro B, Rosado D, Duran M, Gomez M, Lacalzada J, Nassar I, Ciezar A, Iglesias J, Alvarez V, Costas C, de la Hera J, Suarez J, Fraile L, Arguero V, Menendez J, Bajo P, Morales C, Torrico A, Palomo C, Martinez B, Esteban A, Garcia R, Asensio M, Almela M, Ambrosioni J, Azqueta M, Brunet M, Bodro M, Cartana R, Falces C, Fita G, Fuster D, de la Maria C, Hernandez-Meneses M, Perez J, Marco F, Moreno A, Nicolas D, Ninot S, Quintana E, Pare C, Pereda D, Pericas J, Pomar J, Ramirez J, Rovira I, Sandoval E, Sitges M, Soy D, Tellez A, Tolosana J, Vidal B, Vila J, Adan I, Bermejo J, Bouza E, Celemin D, Caballero G, Montero A, Cruz A, Mansilla A, Leoni M, Ramallo V, Hernandez M, Hualde A, Marin M, Martinez-Selles M, Menarguez M, Munoz P, Rincon C, Rodriguez-Abella H, Rodriguez-Creixems M, Pinilla B, Pinto A, Valerio M, Vazquez P, Moreno E, Antorrena I, Loeches B, Quiros A, Moreno M, Ramirez U, Baston V, Romero M, Saldana A, Balbin J, Castillo C, Arnaiz A, de las Revillas F, Belaustegui M, Farinas-Alvarez C, Izquierdo R, Garcia I, Rico C, Gutierrez-Cuadra M, Diez J, Pajaron M, Parra J, Teira R, Zarauza J, Dominguez F, Pavia P, Gonzalez J, Orden B, Ramos A, Centella T, Hermida J, Moya J, Martin-Davila P, Navas E, Oliva E, del Rio A, Ruiz S, Tenorio C, Delia M, Araji O, Barquero J, Jambrina R, de Cueto M, Acebal J, Mendez I, Morales I, Lopez-Cortes L, de Alarcon A, Garcia E, Haro J, Lepe J, Lopez F, Luque R, Alonso L, Azcarate P, Gutierrez J, Blanco J, Villegas A, Garcia-Alvarez L, Oteo J, Sanz M, de Benito N, Gurgui M, Pacho C, Pericas R, Pons G, Alvarez M, Fernandez A, Martinez A, Prieto A, Regueiro B, Tijeira E, Vega M, Blasco A, Mollar J, Arana J, Uriarte O, Lopez A, de Zarate Z, Matos J, Gloria G, Antonio S, Leal J, Vazquez E, Torres A, Blazquez A, Valenzuela G, Alonso A, Aramburu J, Calvo F, Rodriguez A, Tarabini-Castellani P, Galvez E, Bellido C, Pau J, Sepulveda M, Sierra P, Iqbal-Mirza S, Alcolea E, Yanez I, Ballesta A, Escobar E, Monje A, Cabrera V, Garcia D, Asenjo M, Luna C, Morcillo J, Seco M, Villoslada A, Guallar A, Abad N, Mangas P, Adell M, Ruiz M, Porres J, Trigueros N, Espin M, Caro J, Sanchez R, Almazan A, Freire A, Gonzalez M, Ramis P, Bordes E, Bonet L, Munera M, Garaizabal E, Luque J, and Spanish Collaboration Endocarditis

Subjects
Endocarditis, Embolism, Heart failure, Bacteremia, Mortality
Abstract

Aim: To evaluate the effect of the type of surgical indication on mortality in infective endocarditis (IE) patients who are rejected for surgery. Methods and results: From January 2008 to December 2016, 2714 patients with definite left-sided IE were attended in the participating hospitals. One thousand six hundred and fifty-three patients (60.9%) presented surgical indications. Five hundred and thirty-eight patients (32.5%) presented surgical indications but received medical treatment alone. The indications for surgery in these patients were uncontrolled infection (366 patients, 68%), heart failure (168 patients, 31.3%) and prevention of embolism (148 patients, 27.6%). One hundred and thirty patients (24.2%) presented more than one indication. The mortality during hospital admission was 60% (323 patients). The in-hospital mortality of patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 75.6%, 61.4% and 54.7%, respectively (p < 0.001). Surgical indications due to heart failure (OR: 3.24; CI 95%: 1.99-5.9) or uncontrolled infection (OR: 1.83; CI 95%: 1.04-3.18) were independently associated with a fatal outcome during hospital admission. Mortality during the first year was 75.4%. The mortality during the first year in patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 85.9%, 76.7% and 72.7%, respectively (p = 0.016). Surgical indication due to heart failure (OR: 3.03; CI 95%: 1.53-5.98) were independently associated with fatal outcome during the first year. Conclusions: The type of surgical indication is associated with mortality in IE patients who are rejected for surgical intervention. (c) 2019 Elsevier B.V. All rights reserved.

Published
2019

19. Main Results of Phase IV BEMUSE Project. Simulation of LBLOCA in a NPP

Author

Pérez, M, Reventós, F, AND PERICAS R, BATET L., Toth, I, AND DE CRÉCY A, BAZIN P., Borisov, S, AND SKOREK T, GLAESER H., AND PROBST P, JOUCLA J., Ui, A, Chung, B, OH D, Y., AND PERNICA R, KYNCL M., Manera, A, D'Auria, FRANCESCO SAVERIO, Petruzzi, A, and DEL NEVO, A.

Published
2008

20. Simulation of a LBLOCA in ZION Nuclear Power Plant - BEMUSE Phase IV Report

Author

Reventos, F., Perez, M., Batet, L., (Coordinators), Pericas R., Toth, I., Bazin, P., De Crecy, A., Borisov, S., Glaeser, H., Skorek, T., Joucla, J., Probst, P., Ui, A., Chung, B., Oh, D., Kyncl, M., Pernica, R., Manera, A., D’Auria, F., Petruzzi, A., and Del Nevo, A.

Subjects
Zion NPP, BEMUSE project (OECD/NEA/CSNI), Zion NPP, Uncertainty method application, uncertainty analysis, BEMUSE project (OECD/NEA/CSNI), Uncertainty method application, uncertainty analysis
Published
2008

25. Main Results of Phase IV BEMUSE Project: Simulation of LBLOCA in an NPP

Author

Pérez, M., primary, Reventós, F., additional, Batet, L., additional, Pericas, R., additional, Toth, I., additional, Bazin, P., additional, de Crécy, A., additional, Germain, P., additional, Borisov, S., additional, Glaeser, H., additional, Skorek, T., additional, Joucla, J., additional, Probst, P., additional, Ui, A., additional, Chung, B., additional, Oh, D. Y., additional, Kyncl, M., additional, Pernica, R., additional, Manera, A., additional, D'Auria, F., additional, Petruzzi, A., additional, and Del Nevo, A., additional

Published
2010
Full Text
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34. [Comparison of the automatized BacT/ALERT blood culture incubation and reading system and a conventional system]

Author

Alonso C, Jordi Rello, Mirelis B, Pericas R, Navarro F, and Prats G

Subjects
Adult, Bacteriological Techniques, Electronic Data Processing, Blood, Time Factors, Humans, False Positive Reactions, Sensitivity and Specificity
Abstract

The aim of the present study was to compare the BacT/ALERT blood culture automatic management and reading system (Organon Teknika) with a conventional, nonautomatic technique (DUO, Bio-Mérieux).1,405 blood cultures were parallel compared. 263 of them were positive; out of these, 148 were considered as indicative of septicaemia, 38 of doubtful clinical significance and 77 as accidental contaminations.No differences were detected between both systems neither in the number of isolates obtained nor in the kind of microorganisms recovered or in the number of false-positive or false-negative readings. The conventional system detected 28% of significant isolates during the first 24 hours, reaching 77% after 48 hours; whereas the BacT/ALERT system had detected 57% of significant isolates after 12 hours, reaching 82% after 24 hours (p0.001).The results obtained and the automatization of the BacT/ALERT system appoint it as a firm candidate to be included into the Clinical Microbiology laboratory routine.

35. Acute rhabdomyolysis and myonecrosis complicating aeromonas bacteremia in neutropenic patients with hematologic malignancies: report of two cases

Author

RODRIGO MARTINO, Santamaría, A., Pericas, R., Sureda, A., and Brunet, S.

Subjects
Adult, Male, Leukemia, Myeloid, Acute, Necrosis, Neutropenia, Acute Disease, Humans, Bacteremia, Female, Aeromonas, Middle Aged, Gram-Negative Bacterial Infections, Rhabdomyolysis
Abstract

Infections by Aeromonas spp. are a rare cause of systemic infection in normal and immunocompromised hosts. We report the cases of two patients with acute non-lymphoblastic leukemia who developed septic shock by Aeromonas species with unusual soft-tissue complications. One patient who was undergoing consolidation chemotherapy developed septic shock by Aeromonas hydrophila with rhabdomyolysis and subsequent soft-tissue destruction consistent with myonecrosis. She recovered with combination antibiotic therapy and supportive care. The second patient developed neutropenia due to ganciclovir treatment for post-allogeneic transplant cytomegalovirus antigenemia. He developed a rapidly progressive septic shock due to Aeromonas sobria with rhabdomyolysis, multi-organ failure and bilateral lower limb myonecrosis, and died within 48 hours. The portal of entry was not identified in either case. These cases confirm the potentially aggressive nature of these bacteria in neutropenic cancer patients with an unusual tendency to produce muscular and soft-tissue destruction.

37. [Etiology of enteritis in a university general hospital in Barcelona (1992-1995)]

Author

Prats G, Llovet T, Muñoz C, Solé R, Mirelis B, Izquierdo C, Rodríguez P, Me, Sabanés, Núria Rabella, Pericas R, Sánchez F, Margall N, Navarro F, and Coll P

Subjects
Adult, Male, Feces, Age Distribution, Adolescent, Risk Factors, Child, Preschool, Infant, Newborn, Humans, Infant, Female, Child, Enteritis
Abstract

The aim of the study was to describe the etiology of enteropathogenic agents over a four-year period (1992-1995) in a University Hospital in Barcelona.We studied 12,793 stool samples, 4519 were obtained from patients under 15 years and 8274 were obtained from patients over 14 years. The specimens were examined for bacteriological, parasitological and virological enteropathogens.In 3380 specimens of 12,793 stool samples studied were identified an enteropathogen (26.4%). Polymicrobial associations were observed in the 6.8% of the cases. Pathogens were identified in 45% of children samples and 16.3% of adults samples. The etiological enteritis agents more frequently detected in the paediatric patients were Campylobacter (13.5%), rotavirus (11.3%) and Salmonella (10.2%); and Salmonella (4.9%), Campylobacter (3.1%) and Giardia intestinalis (2.1%) in adults. Cryptosporidium (13.5%) was the most frequent cause of gastrointestinal tract infections in HIV-infected subjects. In the children with stools positives, the presence of red and white blood cells were more frequent than the adults with stools positives (73% versus 26.6%).The enteropathogenic agents such as Campylobacter, Salmonella, and Giardia were the most frequent cause of gastroenteritis in our environment. In the children, rotavirus infections predominated during the cold months. The most frequent cause of gastroenteritis in HIV-infected patients was Cryptosporidium followed by Campylobacter.

38. Achromobacter xylosoxidans bacteremia in patients with hematologic malignancies

Author

Hernandez, J. -A, RODRIGO MARTINO, Pericas, R., Sureda, A., Brunet, S., and Domingo-Albos, A.

Subjects
Adult, Male, Hematologic Neoplasms, Humans, Female, Alcaligenes, Middle Aged, Gram-Negative Bacterial Infections, Aged, Catheterization
Abstract

We report nine cases of Achromobacter xylosoxidans bacteremia diagnosed in patients with hematologic malignancies. There was not an obvious epidemiologic link between cases and the organism was not isolated from any source. Outcome was cure in all nine cases. In our experience, catheter removal is generally required for eradication of A. xylosoxidans.

39. Enterotoxin-associated DNA sequence homology between Salmonella species and Escherichia coli

Author

Chopra, A.K., Peterson, J.W., Houston, C.W., Pericas, R., and Prasad, R.

Abstract

Multiple HindIII-restriction fragments of Salmonella typhimurium and Salmonella typhi chromosomal DNA exhibited homology with the heat-labile enterotoxin (LT1) gene of Escherichia coli as determined by Southern blot analysis. A 9.4 kb HindIII restriction fragment identified in S. typhimurium and S. typhi chromosomal DNA reacted with both eltA and eltB gene probes. However, the homology of the 9.4 kb DNA fragment from these Salmonella species was greater with eltB than eltA. In addition, a synthetic oligonucleotide probe, made to a portion of the putative GM1-ganglioside binding region of cholera toxin (CT) and LT1, hybridized with the 9.4 kb DNA fragment of S. typhimurium but not with the 9.4 kb fragment found in S. typhi isolates. The hybridization of multiple restriction fragments of Salmonella DNA with eltA and eltB gene sequences further suggests duplication of the stx operon on the chromosome of these bacteria.

Published
1991
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41. Role of age and comorbidities in mortality of patients with infective endocarditis.

Author

Armiñanzas C, Fariñas-Alvarez C, Zarauza J, Muñoz P, González Ramallo V, Martínez Sellés M, Miró Meda JM, Pericás JM, Goenaga MÁ, Ojeda Burgos G, Rodríguez Álvarez R, Castelo Corral L, Gálvez-Acebal J, Martínez Marcos FJ, Fariñas MC, Fernández Sánchez F, Noureddine M, Rosas G, de la Torre Lima J, Aramendi J, Bereciartua E, Blanco MJ, Blanco R, Boado MV, Campaña Lázaro M, Crespo A, Goikoetxea J, Iruretagoyena JR, Irurzun Zuazabal J, López-Soria L, Montejo M, Nieto J, Rodrigo D, Rodríguez D, Rodríguez R, Vitoria Y, Voces R, García López MV, Georgieva RI, Ojeda G, Rodríguez Bailón I, Ruiz Morales J, Cuende AM, Echeverría T, Fuerte A, Gaminde E, Goenaga MÁ, Idígoras P, Iribarren JA, Izaguirre Yarza A, Kortajarena Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Álvarez N, Bravo-Ferrer JM, Castelo L, Cuenca J, Llinares P, Miguez Rey E, Rodríguez Mayo M, Sánchez E, Sousa Regueiro D, Martínez FJ, Alonso MDM, Castro B, García Rosado D, Durán MDC, Miguel Gómez MA, Lacalzada J, Nassar I, Plata Ciezar A, Reguera Iglesias JM, Asensi Álvarez V, Costas C, de la Hera J, Fernández Suárez J, Iglesias Fraile L, León Arguero V, López Menéndez J, Mencia Bajo P, Morales C, Moreno Torrico A, Palomo C, Paya Martínez B, Rodríguez Esteban Á, Rodríguez García R, Telenti Asensio M, Almela M, Ambrosioni J, Azqueta M, Brunet M, Bodro M, Cartañá R, Falces C, Fita G, Fuster D, García de la Mària C, Hernández-Meneses M, Llopis Pérez J, Marco F, Miró JM, Moreno A, Nicolás D, Ninot S, Quintana E, Paré C, Pereda D, Pericás JM, Pomar JL, Ramírez J, Rovira I, Sandoval E, Sitges M, Soy D, Téllez A, Tolosana JM, Vidal B, Vila J, Adán I, Bermejo J, Bouza E, Celemín D, Cuerpo Caballero G, Delgado Montero A, Fernández Cruz A, García Mansilla A, García Leoni ME, González Ramallo V, Kestler Hernández M, Hualde AM, Marín M, Martínez-Sellés M, Menárguez MC, Muñoz P, Rincón C, Rodríguez-Abella H, Rodríguez-Créixems M, Pinilla B, Pinto Á, Valerio M, Vázquez P, Verde Moreno E, Antorrena I, Loeches B, Martín Quirós A, Moreno M, Ramírez U, Rial Bastón V, Romero M, Saldaña A, Agüero Balbín J, Amado C, Armiñanzas Castillo C, Arnaiz García A, Cobo Belaustegui M, Fariñas MC, Fariñas-Álvarez C, Gómez Izquierdo R, García I, González-Rico C, Gutiérrez-Cuadra M, Gutiérrez Díez J, Pajarón M, Parra JA, Sarralde A, Teira R, Zarauza J, Domínguez F, García Pavía P, González J, Orden B, Ramos A, Centella T, Hermida JM, Moya JL, Martín-Dávila P, Navas E, Oliva E, Del Río A, Ruiz S, Hidalgo Tenorio C, Almendro Delia M, Araji O, Barquero JM, Calvo Jambrina R, de Cueto M, Gálvez Acebal J, Méndez I, Morales I, López-Cortés LE, de Alarcón A, García E, Haro JL, Lepe JA, López F, Luque R, Alonso LJ, Azcárate P, Azcona Gutiérrez JM, Blanco JR, García-Álvarez L, Oteo JA, Sanz M, de Benito N, Gurguí M, Pacho C, Pericas R, Pons G, Álvarez M, Fernández AL, Martínez A, Prieto A, Regueiro B, Tijeira E, Vega M, Canut Blasco A, Cordo Mollar J, Gainzarain Arana JC, García Uriarte O, Martín López A, Ortiz de Zárate Z, Urturi Matos JA, García Domínguez G, Sánchez-Porto A, Arribas Leal JM, García Vázquez E, Hernández Torres A, Blázquez A, de la Morena Valenzuela G, Alonso Á, Aramburu J, Calvo FE, Moreno Rodríguez A, Tarabini-Castellani P, Heredero Gálvez E, Maicas Bellido C, Largo Pau J, Sepúlveda MA, Toledano Sierra P, Iqbal-Mirza SZ, Cascales Alcolea E, Egea Serrano P, Hernández Roca JJ, Keituqwa Yañez I, Peláez Ballesta A, Soriano V, Moreno Escobar E, Peña Monje A, Sánchez Cabrera V, Vinuesa García D, Arrizabalaga Asenjo M, Cifuentes Luna C, Núñez Morcillo J, Pérez Seco MC, Villoslada Gelabert A, Aured Guallar C, Fernández Abad N, García Mangas P, Matamala Adell M, Palacián Ruiz MP, Porres JC, Alcaraz Vidal B, Cobos Trigueros N, Del Amor Espín MJ, Giner Caro JA, Jiménez Sánchez R, Jimeno Almazán A, Ortín Freire A, Viqueira González M, Pericás Ramis P, Ribas Blanco MÁ, Ruiz de Gopegui Bordes E, Vidal Bonet L, Bellón Munera MC, Escribano Garaizabal E, Tercero Martínez A, and Segura Luque JC

Subjects
Adult, Aged, Aged, 80 and over, Area Under Curve, Databases, Factual, Endocarditis etiology, Female, Heart Failure mortality, Hospital Mortality, Humans, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, ROC Curve, Risk Factors, Spain epidemiology, Staphylococcal Infections mortality, Age Factors, Comorbidity, Endocarditis mortality
Abstract

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality., Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk., Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32-3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39-1.88),and non-performed surgery (HR:1.64;95% CI:11.16-1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality., Conclusion: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group., (Copyright © 2019. Published by Elsevier B.V.)

Published
2019
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42. Bloodstream infection due to Brachyspira pilosicoli in a patient with multiorgan failure.

Author

Prim N, Pericas R, Español M, Rivera A, Mirelis B, and Coll P

Subjects
Aged, Bacteremia microbiology, Bacteremia pathology, Bacteriological Techniques, Gram-Negative Bacterial Infections microbiology, Gram-Negative Bacterial Infections pathology, Humans, Male, Microscopy, Multiple Organ Failure microbiology, Multiple Organ Failure pathology, Bacteremia complications, Bacteremia diagnosis, Brachyspira isolation & purification, Gram-Negative Bacterial Infections complications, Gram-Negative Bacterial Infections diagnosis, Multiple Organ Failure diagnosis
Abstract

Brachyspira pilosicoli is an etiological agent of human intestinal spirochetosis. Bloodstream infection due to this microorganism is rare. We report a case of B. pilosicoli bacteremia in a 70-year-old patient who presented with multiorgan failure.

Published
2011
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43. Diagnostic accuracy of a 16S ribosomal DNA gene-based molecular technique (RT-PCR, microarray, and sequencing) for bacterial meningitis, early-onset neonatal sepsis, and spontaneous bacterial peritonitis.

Author

Esparcia O, Montemayor M, Ginovart G, Pomar V, Soriano G, Pericas R, Gurgui M, Sulleiro E, Prats G, Navarro F, and Coll P

Subjects
Bacterial Infections microbiology, Humans, Infant, Newborn, Oligonucleotide Array Sequence Analysis, Peritonitis microbiology, Reverse Transcriptase Polymerase Chain Reaction, Sensitivity and Specificity, Sepsis microbiology, Sequence Analysis, DNA, Bacteria genetics, Bacterial Infections diagnosis, Meningitis, Bacterial diagnosis, Molecular Diagnostic Techniques, Peritonitis diagnosis, RNA, Ribosomal, 16S genetics, Sepsis diagnosis
Abstract

The diagnostic accuracy of a 16S ribosomal DNA (rDNA) gene-based molecular technique for bacterial meningitis (BM), early-onset neonatal sepsis (EONS), and spontaneous bacterial peritonitis (SBP) is evaluated. The molecular approach gave better results for BM diagnosis: sensitivity (S) was 90.6% compared to 78.1% for the bacterial culture. Percentages of cases correctly diagnosed (CCD) were 91.7% and 80.6%, respectively. For EONS diagnosis, S was 60.0% for the molecular approach and 70.0% for the bacterial culture; and CCD was 95.2% and 96.4%, respectively. For SPB diagnosis, the molecular approach gave notably poorer results than the bacterial cultures. S and CCD were 48.4% and 56.4% for the molecular approach and 80.6% and 89.1% for bacterial cultures. Nevertheless, bacterial DNA was detected in 53.3% of culture-negative samples. Accuracy of the 16S rDNA PCR approach differs depending on the sample, the microorganisms involved, the expected bacterial load, and the presence of bacterial DNA other than that from the pathogen implied in the infectious disease., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Published
2011
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44. Associations between Fc gamma receptor IIA polymorphisms and the risk and prognosis of meningococcal disease.

Author

Domingo P, Muñiz-Diaz E, Baraldès MA, Arilla M, Barquet N, Pericas R, Juárez C, Madoz P, and Vázquez G

Subjects
Adolescent, Adult, Aged, Case-Control Studies, Child, Child, Preschool, Complement Hemolytic Activity Assay, Complement System Proteins analysis, Female, Humans, Immunoglobulins blood, Infant, Male, Meningococcal Infections epidemiology, Middle Aged, Phagocytosis, Polymorphism, Genetic, Prognosis, Receptors, Immunologic, Risk Factors, Antigens, CD genetics, Meningococcal Infections genetics, Meningococcal Infections physiopathology, Receptors, IgG genetics
Abstract

Background: In vitro studies have shown that the neutrophil Fc gamma receptor IIA (FcgammaRIIA) polymorphism influences the phagocytic capacity of neutrophils and the removal of encapsulated bacteria from the bloodstream. In particular, the R/R131 allotype is associated with less phagocytic activity., Subjects and Methods: We performed a case-control study to determine the influence of the FcgammaRIIA polymorphism (R/R131, R/H131, H/H131) on the risk and outcome of meningococcal disease. The polymorphisms were measured in 130 patients with microbiologically proven meningococcal disease diagnosed from 1987 to 1998 (cases) and 260 asymptomatic sex-matched blood donors (controls). Clinical manifestations and complications of meningococcal disease were recorded, and a prognostic score (based on age, hemorrhagic diathesis, neurologic signs, and the absence of preadmission antibiotic) therapy was calculated., Results: The distributions of FcgammaRIIA allotypes were similar in cases and controls. However, among patients with meningococcal infection, fulminant meningococcal disease (odds ratio [OR] = 3.9; 95% confidence interval [CI]: 1.0 to 16; P = 0.04) and meningococcemia without meningitis (OR = 3.0; 95% CI: 1.4 to 7.8; P = 0.004) were more common in those with the FcgammaRIIA-R/R131 allotype. Complications were also significantly more frequent in these patients. Of the 42 patients with the R/R131 allotype, 31 (74%) had an adverse prognostic score, compared with 7% (4 of 59) of those with the R/H131 allotype and 3% (1 of 29) of those with the H/H131 allotype (P <0.0001)., Conclusion: The FcgammaRIIA-R/R131 allotype is associated with more severe forms of meningococcal disease.

Published
2002
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45. Pacemaker infection by Brucella melitensis: A rare cause of relapsing brucellosis.

Author

Francia E, Domingo P, Sambeat MA, Montiel JA, Pericas R, Sánchez F, and Gurguí M

Subjects
Aged, Agglutination Tests, Brucellosis microbiology, Diagnosis, Differential, Fatal Outcome, Humans, Male, Recurrence, Bacteremia microbiology, Brucella melitensis isolation & purification, Brucellosis diagnosis, Brucellosis etiology, Pacemaker, Artificial microbiology
Published
2000
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46. Bacteremia by gram-negative bacilli in patients with hematologic malignancies. Comparison of the clinical presentation and outcome of infections by enterobacteria and non-glucose-fermenting gram-negative bacilli.

Author

Martino R, Santamaría A, Muñoz L, Pericas R, Altés A, Prats G, and Sierra J

Subjects
Adolescent, Adult, Aged, Female, Fermentation, Glucose metabolism, Gram-Negative Aerobic Bacteria isolation & purification, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Bacteremia complications, Enterobacteriaceae Infections complications, Gram-Negative Bacterial Infections complications, Hematologic Neoplasms microbiology
Abstract

To compare the characteristics of bacteremic infections by different aerobic gram-negative bacilli (GNB) in patients with hematologic malignancies, we studied 54 consecutive monomicrobial bacteremias by Enterobacteriaceae (EB), 15 by Pseudomonas aeruginosa, 43 by other non-glucose-fermenting GNB (NGFGNB) and 11 by other GNB. Patients with EB and P. aeruginosa bacteremia usually developed the infection after intensive chemotherapy for leukemia or during a hematopoietic stem cell transplantation, while most infections in outpatients off therapy were due to NGFGNB. A significant proportion of bacteremias by EB (37%) and P. aeruginosa (40%) were accompanied by severe morbidity (septic shock, pneumonia or deep-seated organ infections) vs. only 7% of other NGFGNB (p < 0.01). Most infections by these latter bacteria were catheter-related bacteremias (80 vs. 2% of EB, p < 0.005), while most EB infections (61%) were uncomplicated bacteremias of unknown source (vs. 14% of other NGFGNB, p < 0.005). Appropriate antibiotics alone cured 98% of EB and 73% of P. aeruginosa bacteremias but only 26% of other NGFGNB (p < 0.005 for both differences), which were cured by catheter removal in 70%, usually after failure of antibiotic treatment. In conclusion, our results suggest that there are significant differences in the patient populations and clinical characteristics of bacteremic infections by the classic GNB (EB and P. aeruginosa) and the new NGFGNB in adults with hematologic malignancies.

Published
1999
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47. [Haemophilus influenzae meningitis in adults: analysis of 12 cases].

Author

Domingo P, Pericas R, Mirelis B, Nolla J, and Prats G

Subjects
Adolescent, Adult, Aged, Female, Humans, Male, Meningitis, Haemophilus cerebrospinal fluid, Meningitis, Haemophilus microbiology, Meningitis, Haemophilus prevention & control
Abstract

Haemophilus influenzae is an infrequent etiologic agent of bacterial meningitis in adult patients. In the last 12 years, it was the cause in 12 out of 238 cases (5.0%) of acute bacterial meningitis in adults. There were 5 men and 7 women with a mean age (SD) of 45.4 (16) years (range: 18-68 years). Seven patients (60%) had a communication between subarachnoid space and skin surface or mucosal cavities, and five (41.7%) had otitis or sinusitis. Most of the strains (9/12) were serotype b. Only one patient (8.3%) developed severe neurologic and extra-neurologic complications, and was the one who died. One of the survivors (9.1%) had partial deafness. H. influenzae is not a negligible cause of bacterial meningitis in adults. Moreover, its detection has been increasing in the last years. Patients with a cerebrospinal fluid leak, otitis or sinusitis are at high risk. The outcome is usually favorable if an early adequate therapy is given.

Published
1998

48. Achromobacter xylosoxidans bacteremia in patients with hematologic malignancies.

Author

Hernández JA, Martino R, Pericas R, Sureda A, Brunet S, and Domingo-Albós A

Subjects
Adult, Aged, Catheterization adverse effects, Female, Hematologic Neoplasms blood, Humans, Male, Middle Aged, Alcaligenes isolation & purification, Gram-Negative Bacterial Infections blood, Hematologic Neoplasms microbiology
Abstract

We report nine cases of Achromobacter xylosoxidans bacteremia diagnosed in patients with hematologic malignancies. There was not an obvious epidemiologic link between cases and the organism was not isolated from any source. Outcome was cure in all nine cases. In our experience, catheter removal is generally required for eradication of A. xylosoxidans.

Published
1998

49. Acute rhabdomyolysis and myonecrosis complicating aeromonas bacteremia in neutropenic patients with hematologic malignancies: report of two cases.

Author

Martino R, Santamaría A, Pericas R, Sureda A, and Brunet S

Subjects
Acute Disease, Adult, Bacteremia pathology, Female, Gram-Negative Bacterial Infections pathology, Humans, Leukemia, Myeloid, Acute pathology, Male, Middle Aged, Necrosis, Neutropenia pathology, Rhabdomyolysis pathology, Aeromonas isolation & purification, Bacteremia etiology, Gram-Negative Bacterial Infections etiology, Leukemia, Myeloid, Acute complications, Neutropenia etiology, Rhabdomyolysis etiology
Abstract

Infections by Aeromonas spp. are a rare cause of systemic infection in normal and immunocompromised hosts. We report the cases of two patients with acute non-lymphoblastic leukemia who developed septic shock by Aeromonas species with unusual soft-tissue complications. One patient who was undergoing consolidation chemotherapy developed septic shock by Aeromonas hydrophila with rhabdomyolysis and subsequent soft-tissue destruction consistent with myonecrosis. She recovered with combination antibiotic therapy and supportive care. The second patient developed neutropenia due to ganciclovir treatment for post-allogeneic transplant cytomegalovirus antigenemia. He developed a rapidly progressive septic shock due to Aeromonas sobria with rhabdomyolysis, multi-organ failure and bilateral lower limb myonecrosis, and died within 48 hours. The portal of entry was not identified in either case. These cases confirm the potentially aggressive nature of these bacteria in neutropenic cancer patients with an unusual tendency to produce muscular and soft-tissue destruction.

Published
1997

50. [Etiology of enteritis in a university general hospital in Barcelona (1992-1995)].

Author

Prats G, Llovet T, Muñoz C, Solé R, Mirelis B, Izquierdo C, Rodríguez P, Sabanés ME, Rabella N, Pericas R, Sánchez F, Margall N, Navarro F, and Coll P

Subjects
Adolescent, Adult, Age Distribution, Child, Child, Preschool, Enteritis microbiology, Enteritis parasitology, Feces microbiology, Feces parasitology, Female, Humans, Infant, Infant, Newborn, Male, Risk Factors, Enteritis etiology
Abstract

Background: The aim of the study was to describe the etiology of enteropathogenic agents over a four-year period (1992-1995) in a University Hospital in Barcelona., Methods: We studied 12,793 stool samples, 4519 were obtained from patients under 15 years and 8274 were obtained from patients over 14 years. The specimens were examined for bacteriological, parasitological and virological enteropathogens., Results: In 3380 specimens of 12,793 stool samples studied were identified an enteropathogen (26.4%). Polymicrobial associations were observed in the 6.8% of the cases. Pathogens were identified in 45% of children samples and 16.3% of adults samples. The etiological enteritis agents more frequently detected in the paediatric patients were Campylobacter (13.5%), rotavirus (11.3%) and Salmonella (10.2%); and Salmonella (4.9%), Campylobacter (3.1%) and Giardia intestinalis (2.1%) in adults. Cryptosporidium (13.5%) was the most frequent cause of gastrointestinal tract infections in HIV-infected subjects. In the children with stools positives, the presence of red and white blood cells were more frequent than the adults with stools positives (73% versus 26.6%)., Conclusions: The enteropathogenic agents such as Campylobacter, Salmonella, and Giardia were the most frequent cause of gastroenteritis in our environment. In the children, rotavirus infections predominated during the cold months. The most frequent cause of gastroenteritis in HIV-infected patients was Cryptosporidium followed by Campylobacter.

Published
1997

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