José Ramón Yuste

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).

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.

Prolonged use of tedizolid in a pulmonary non-tuberculous mycobacterial infection after linezolid-induced toxicity.

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Executive summary of the diagnosis and treatment of urinary tract infection: Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC)

Most urinary tract infections (UTI) are uncomplicated infections occurring in young women. An extensive evaluation is not required in the majority of cases, and they can be safely managed as outpatients with oral antibiotics. Escherichia coli is by far the most common uropathogen, accounting for >80% of all cases. Other major clinical problems associated with UTI include asymptomatic bacteriuria, and patients with complicated UTI. Complicated UTIs are a heterogeneous group associated with conditions that increase the risk of acquiring infection or treatment failure. Distinguishing between complicated and uncomplicated UTI is important, as it influences the initial evaluation, choice, and duration of antimicrobial therapy. Diagnosis is especially challenging in the elderly and in patients with in-dwelling catheters. The increasing prevalence of resistant uropathogens, including extended-spectrum β-lactamases and carbapenemase-producing Enterobacteriaceae, and other multidrug-resistant Gram-negative organisms further compromises treatment of both complicated and uncomplicated UTIs. The aim of these Clinical Guidelines is to provide a set of recommendations for improving the diagnosis and treatment of UTI.

Daptomycin in the treatment of prosthetic joint infection by Enterococcus faecalis: safety and efficacy of high-dose and prolonged therapy

Enterococci are implicated in less than 2.3% of prosthetic joint infections. These infections can be difficult to treat and therapeutic failures are not uncommon. In these situations, daptomycin is a safe and effective alternative. We present a clinical case with a successful response to the prolonged use of high-dose daptomycin.

Listeria monocytogenes septic arthritis in a patient treated with mycophenolate mofetil for polyarteritis nodosa: a case report and review of the literature

Listeriosis can be a cause of arthritis. Here, we present a case of Listeria monocytogenes septic arthritis of the right hip in a 66-year-old male treated with mycophenolate mofetil for polyarteritis nodosa. So far, septic arthritis due to this microorganism has not been reported in patients treated with mycophenolate mofetil. We review the literature of L. monocytogenes septic arthritis and discuss the role of mycophenolate mofetil treatment in precipitating listeriosis.

Asymptomatic Schistosoma haematobium Infection in a Traveler With Negative Urine Microscopy and Late Seroconversion Presumably Linked to Artemisinin

We describe a Schistosoma haematobium infection with asymptomatic eosinophilia, persistently negative urine microscopy, and late seroconversion (7.5 months) in a traveler returning from Mali. After initial negative parasitological tests, travel history led to diagnostic cystoscopy, allowing final diagnosis with urine microscopy after the bladder biopsy. The patient was successfully treated with praziquantel. Difficulties in making the diagnosis of schistosomiasis in asymptomatic returning travelers are discussed; we propose a trial treatment in these cases.

Adult onset Still's disease after first cycle of pemetrexed and gemcitabine for non-small cell lung cancer

Pemetrexed is a multitargeted antifolate approved for the second-line treatment of locally advanced or metastatic non-small cell lung cancer. The combination of pemetrexed with gemcitabine has been studied in several clinical trials showing a promising antitumor activity with a mild toxicity profile. We present the case of a patient who experienced fever, arthralgia, skin rash and high serum ferritin levels after first cycle of this chemotherapy combination, compatible with an adult onset Stills disease. This adverse event has not been previously reported.

Non-O1 Vibrio cholerae inguinal skin and soft tissue infection with bullous skin lesions in a patient with a penis squamous cell carcinoma.

Vibrio spp. is a pathogen rarely isolated in cancer patients, and in most cases it is associated with haematological diseases. Cutaneous manifestations of this organism are even rarer. We report a case of Non-O1 Vibrio cholerae inguinal skin and soft tissue infection presenting bullous skin lesions in a young type II diabetic patient with a penis squamous cell carcinoma having a seawater exposure history.

Bacillus licheniformis as a cause of a deep skin abscess in a 5-year-old girl: An exceptional case following a plant thorn injury.

Bacillus spp. remain a rare cause of infection and, when this occurs, diagnosis is difficult to establish. Bacillus licheniformis infections have been described mainly in immunocompromised patients. We report an exceptional case of a B. licheniformis deep skin abscess related to a retained plant thorn in an immunologically competent patient. A 5-year-old female was admitted to our hospital with inflammatory signs on her left foot (Fig. 1A). One week earlier, she had suffered a penetrating injury with several plant thorns that were removed from the superficial skin for which she received empirical treatment with amoxicillineclavulanic acid. Nonetheless, she noticed a worsening of symptoms, with suppurative changes. On admission, blood analyses and the C-reactive protein were normal. Radiography was unremarkable (Fig. 1C) and a magnetic resonance imaging (MRI) scan revealed an abscess associated with a 4-cm foreign body deeply embedded between the fourth and fifth toes of the left foot (Fig. 1D). Blood cultures were obtained and the patient underwent surgical examination. During the surgery, a 4-cm plant thorn was removed (Fig. 1B) and the abscess was drained. Urgent Gram stain revealed Gram-positive bacilli (Fig. 1E) and an abscess and thorn cultures showed definitive identification of B. licheniformis 72 hours after admission (Fig. 1F). The antibiogram showed susceptibility to doxycycline, levofloxacin, vancomycin, and trimethoprimesulfamethoxazole; and resistance to penicillin, amoxicillin, and clindamycin. On the basis of susceptibilities, a 10-day course of cotrimoxazole was prescribed and a successful response to the treatment was noted. B. licheniformis has not been reported to invade mucosal barriers of the body without previous injuries. In immunocompetent individuals there is usually a history of