European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
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Eur. J. Clin. Microbiol. Infect. Dis. · Oct 1996
Multicenter StudyFluconazole monotherapy for cryptococcosis in non-AIDS patients.
Treatment with 200 to 400 mg/day fluconazole was evaluated in 44 patients without AIDS who had cryptococcosis (19 with cryptococcal meningitis, 22 with pulmonary cryptococcosis, 3 with other cryptococcal infections). For all patients, the clinical response rate was 89% (48% were clinically cured and 41% clinically improved). ⋯ In the group of patients with cryptococcal meningitis, there was a high rate of agreement between the mycological response to therapy and cryptococcal antigen test results. The use of cryptococcal antigen testing is recommended in all patients with cryptococcosis.
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Eur. J. Clin. Microbiol. Infect. Dis. · Jun 1996
Clinical spectrum of ventilator-associated pneumonia caused by methicillin-sensitive Staphylococcus aureus.
The incidence of tracheal colonization and its association with ventilator-associated pneumonia caused by methicillin-sensitive Staphylococcus aureus (MSSA) was studied prospectively in 530 consecutively admitted mechanically ventilated patients in a general intensive care unit. Furthermore, the clinical spectrum, outcome, and microbiological results of 27 cases of staphylococcal ventilator-associated pneumonia (SVAP) were examined. Ventilator-associated pneumonia was diagnosed by protected specimen brush and/or bronchoalveolar lavage. ⋯ Moreover, patients with a hospital stay of < 48 h before admission to the ICU had a higher incidence of SVAP as compared to those with a longer hospital stay before ICU admission (7% vs. 2%, p < 0.01). Crude infection-related mortality was 26%. Preceding colonization with MSSA in the trachea appears to be an important risk factor for the development of SVAP, and patients with a short duration of hospitalization before intensive care unit admission have the highest incidence of ventilator-associated pneumonia caused by MSSA.
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Eur. J. Clin. Microbiol. Infect. Dis. · May 1996
Case ReportsStaphylococcus lugdunensis as a cause of abscesses in the perineal area.
The first two patients with skin infections in the perineal area due to Staphylococcus lugdunensis are described. One had an abscess of the Bartholin gland, and the other presented with several cutaneous abscesses in the pubic area, which had a prolonged and recurrent clinical course despite appropriate antibiotic treatment. This report emphasizes the pathogenic role of Staphylococcus lugdunensis and the importance of identifying coagulase-negative staphylococci to species level in some instances.
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Eur. J. Clin. Microbiol. Infect. Dis. · Apr 1996
Prospective study of 288 episodes of bacteremia in neutropenic cancer patients in a single institution.
Trends in causative organisms and sources of infection were studied in a series of 288 episodes of bacteremia in neutropenic cancer patients observed in a single institution from 1986 to 1993. The incidence of bacteremia increased significantly from 20 episodes per 1000 admissions in 1986 to 50 episodes per 1000 admissions in 1993 (p = 0.00001). Over the study period, a continuous increment in gram-positive bacteremia, which reached 81% of episodes in 1993 (p = 0.000001), was observed. ⋯ Bacteremia caused by coagulase-negative staphylococci increased from 3 episodes per 1000 admissions to 19 episodes per 1000 admissions (p = 0.0001), and viridans group streptococci bacteremia increased from 0 episodes per 1000 admissions to 19 episodes per 1000 admissions (p = 0.000001). The upward trend in gram-positive bacteremia appeared to be related to a significant increase in both intravascular catheters (p = 0.003) and oral mucositis (p = 0.003) as sources of infection. Specific strategies to prevent chemotherapy-induced mucositis and catheter-related bacteremia merit further investigations.