Scandinavian journal of infectious diseases
-
Scand. J. Infect. Dis. · Jan 2002
ICU-acquired nosocomial infection: impact of delay of adequate antibiotic treatment.
In order to measure the impact on survival of the early introduction of adequate antibiotic treatment for nosocomial bacteremia and pneumonia, a retrospective, cohort study was carried out over a period of 17 months in a 6-bed respiratory ICU. All patients presenting with a first episode of ICU-acquired nosocomial bacteremic infection (Centers for Disease Control criteria) or pneumonia [BAL culture > or = 10(4) colony-forming units (CFU)/ml or protected specimen brush culture > or = 10(3) CFU/ml] were included. The organ failure score (Fagon criteria) was recorded on the day of diagnosis. ⋯ On the day of diagnosis, a failure score > 2 was associated with increased mortality (p = 0.009). After adjusting for the number of organ failures, the length of time without adequate antibiotic treatment remained associated with mortality (< or = 2 organ failures, p < 0.02; > 2 organ failures, p = 0.05). This study suggests that, during the course of nosocomial pneumonia and bacteremia, the time at which adequate antibiotic treatment is started is a key factor influencing survival.
-
Scand. J. Infect. Dis. · Jan 2002
Review Case ReportsPichia ohmeri prosthetic valve endocarditis and review of the literature.
Fungal prosthetic valve endocarditis (PVE) is a serious complication of valve replacement surgery. We report the first case of documented Pichia ohmeri PVE in an immunocompetent man who was successfully treated with valve replacement and antifungal therapy with amphotericin B.
-
Scand. J. Infect. Dis. · Jan 2002
Comparative StudyComparison of procalcitonin with CRP and differential white blood cell count for diagnosis of culture-proven neonatal sepsis.
We analysed the utility of procalcitonin (PCT) assay, either alone or in combination with 2 simple blood assays, for the diagnosis of culture-proven neonatal septicaemia. Tests for serum PCT concentration, serum CRP concentration and blood immature to total neutrophil leucocyte ratio all had reasonable (58-77%) sensitivity, reasonable (62-84%) specificity, good (94-97%) negative predictive value and poor (16-24%) positive predictive value for the diagnosis of sepsis. Algorithms combining various tests produced slight improvements in sensitivity or specificity. Although the PCT test appeared to be useful for the diagnosis of neonatal sepsis in this small study, it did not offer any significant advantages over traditional tests for the diagnosis of infection.
-
Scand. J. Infect. Dis. · Jan 2002
Case ReportsStreptococcus bovis meningitis in a healthy adult patient.
We describe the first case in the English language of Streptococcus bovis meningitis in a 45-y-old patient without any underlying disease or predisposing condition. S. bovis biotype II was isolated from his spinal fluid and blood. ⋯ The patient was cured after 10 d of therapy with ceftriaxone and, 2.5 y later, is currently healthy. As a result of this case and a similar case published recently in the Spanish literature we conclude that S. bovis should be considered a microorganism capable of causing meningitis in the absence of any underlying condition or clear focus of infection.