J.L. del Pozo

Real time monitoring of the impedance characteristics of Staphylococcal bacterial biofilm cultures with a modified CDC reactor system.

Detection of device-associated infectious processes is still an important clinical challenge. Bacteria grow adhered to the device surfaces creating biofilms that are resistant to antimicrobial agents, increasing mortality and morbidity. Thus there is need of a surgical procedure to remove the indwelling infected device. The elevated cost of these procedures, besides patients discomfort and increased risks, highlights the need to develop more efficient, accurate and rapid detection methods. Biosensors integrated with implantable devices will provide an effective diagnostic tool. In vivo, rapid and sensitive detection of bacteria attached to the device surfaces will allow efficient treatments. Impedance spectroscopy technique would be an adequate tool to detect the adherence and the growth of the microorganism by monitoring the impedance characteristics. In this work a label-free interdigitated microelectrode (IDAM) biosensor has been developed to be integrated with implantable devices. Impedance characterization of Staphylococcus epidermidis biofilms has been performed achieving electrical monitoring of the bacterial growths in a few hours from the onset of the infection. This pathogen represents the most common microorganism related to intravascular catheters associated infections. The experimental setup presented in this work, a modified CDC biofilm reactor, simulates the natural environment conditions for bacterial biofilm development. The results prove that the low range of frequency is the most suitable setting for monitoring biofilm development. Our findings prove the effectiveness of this technique which shows variations of 59% in the equivalent serial capacitance component of the impedance.

Daptomycin lock therapy for grampositive long-term catheter-related bloodstream infections

Introduction:  To evaluate the efficacy of Daptomycin (DPT) lock therapy in the treatment of Grampositive long‐term catheter‐related bloodstream infections (LT‐CRBI).

Lysostaphin and clarithromycin: a promising combination for the eradication of Staphylococcus aureus biofilms

1] Hawser SP. Activity of tigecycline against meticillin-resistant Staphylococcus aureus (MRSA) from respiratory tract sources. Int J Antimicrob Agents 2010;35:414–15. 2] Jones RN, Ross JE, Bell JM, Utsuki U, Fumiaki I, Kobayashi I, et al. Zyvox Annual Appraisal of Potency and Spectrum program: linezolid surveillance program results for 2008. Diagn Microbiol Infect Dis 2009;65:404–13. 3] Clinical and Laboratory Standards Institute. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard. 8th ed. Document M07-A8. Wayne, PA: CLSI; 2009. 4] Kunkel M, Chastre JE, Kollef M, Niederman M, Shorr AF, Wunderink RG, et al. Linezolid vs vancomycin in the treatment of nosocomial pneumonia proven due to methicillin-resistant Staphylococcus aureus. In: 48th IDSA, October 21–24, 2010. 2010. Abstr. LB-49. 5] Bounthavong M, Hsu DI. Efficacy and safety of linezolid in methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infection (cSSTI): a meta-analysis. Curr Med Res Opin 2010;26:407–21.

Effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of port-related coagulase-negative staphylococci bacteraemia: a prospective case-series analysis

The aim of this study was to analyse the effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of coagulase-negative staphylococci (CoNS) venous access port-related bloodstream infection (BSI). The study included 44 consecutive patients during a 36-month prospective case-series study. The primary endpoint was failure to cure. Treatment was successful in 39 patients. At the end of the study, the cumulative port survival rate was 100% in the teicoplanin lock group compared with 77% in the vancomycin lock group (P=0.06). In the Cox regression analysis, fever beyond 48 h of treatment was a significant predictor of treatment failure (P=0.02). Use of vancomycin or teicoplanin locks had an effectiveness of 88.6% in the treatment of CoNS port-related BSI. Teicoplanin locks reduced the failure rate from 18.5% to 0% compared with vancomycin locks. The presence of fever after beginning antimicrobial lock therapy was associated with treatment failure.

Linezolid-induced lactic acidosis in two liver transplant patients with the mitochondrial DNA A2706G polymorphism.

ABSTRACT Mitochondrial toxicity has been recently suggested to be the underlying mechanism of long-term linezolid-associated toxicity in patients with 16S rRNA genetic polymorphisms. Here, we report for the first time two cases of lactic acidosis due to long-term linezolid exposure in liver transplant recipients who presented an A2706G mitochondrial DNA polymorphism.

Infecciones más comunes en el paciente trasplantado

Organ transplantation has become one of the most important areas of medical research and, at present, is still the only therapeutical tool for several diseases. However, there are a number of factors related to transplantation, like immunosuppression and prolonged neutropenia that affect the incidence of infection. These infections are somehow peculiar to trasplant recipients. In fact, there are infectious diseases that only occur in immunodepression situations and, moreover, clinical expression of these infectious diseases can be quite different from that in immunocompetent patients. Besides these aspects, some infections, due to the high prevalence described, must be considered for prevention strategies because they continue to be a principal cause of morbidity and mortality, either due to direct effects or to their implication in the pathogenesis of rejection. These strategies commence before trasplantation by active immunization through vaccine administration to the patient and to people in the milieu and continue after trasplantation with prophylaxis or pre-emptive therapy. The importance of infectious diseases in the evolution and prognosis of trasplant recipients gives a special meaning to the understanding of associated infections, their clinical expression and ways of prevention and treatment.

Iliac bone Candida albicans osteomyelitis in a patient with iliac crest bone autograft: a case report and review of the literature

Candida osteomyelitis is a well recognized but infrequent entity. We describe an interesting case of iliac bone C. albicans osteomyelitis as a result of a surgical trauma of an iliac bone for the auto-grafting of a fracture in the lumbar spine. The peri-operative acquisition of Candida was by the inoculation of a yeast colonizing the skin. Remarkably, several risk factors described for Candida infection and candidemia were absent. The patient also presented with a local fistula. The iliac crest was the only bone affected and local pain was the only symptom present in our case. Diagnosis was made by multiple-specimen biopsy obtained by surgery. Treatment with fluconazole was successful.

Enterococcal bloodstream infection. Design and validation of a mortality prediction rule.

To develop a prediction rule to describe the risk of death as a result of enterococcal bloodstream infection.

Antifungal prophylaxis with anidulafungin to minimize drug interactions with an antiepileptic treatment in a hematopoietic stem cell transplant recipient.

Invasive fungal infections are a major cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). This provides a clear rationale for antifungal prophylaxis in this population. A concern is the potential for drug interactions, given that most of antifungals are metabolized through the P450 cytochrome system.

Protocolo terapéutico empírico de las infecciones bucales y faríngeas

Introduction Most oral cavity infections are odontogenic, although they can also affect extradental structures (non-odontogenic infections). Pharyngitis is inflammation and/or infection of the pharynx and /or the peri-tonsillar area. Treatment Both infections are highly prevalent in the population, and one of the most common reasons for consultation and the prescription of antibiotics in primary care clinics. Both infections are usually treated empirically, based on clinical diagnosis and the prevalence and antibiotic sensitivity of the most commonly implicated microorganisms. Resumen Introducción La mayoría de las infecciones de la cavidad bucal son odontogénicas, aunque también pueden afectar a las estructuras extradentales (infecciones no odontogénicas). La faringitis es la inflamación y/o la infección de la faringe y/o área periamigdalar. Tratamiento Ambas infecciones tienen una prevalencia muy alta en la población, siendo uno de los motivos más frecuentes de consulta y prescripción de antibióticos en las consultas de Atención Primaria. El tratamiento de ambas infecciones suele ser empírico, basado en el diagnóstico clínico y la prevalencia y sensibilidad antibiótica de los microorganismos implicados con más frecuencia. Abstract Introduction Most oral cavity infections are odontogenic, although they can also affect extradental structures (non-odontogenic infections). Pharyngitis is inflammation and/or infection of the pharynx and /or the peri-tonsillar area. Treatment Both infections are highly prevalent in the population, and one of the most common reasons for consultation and the prescription of antibiotics in primary care clinics. Both infections are usually treated empirically, based on clinical diagnosis and the prevalence and antibiotic sensitivity of the most commonly implicated microorganisms.