Enfermedades infecciosas y microbiología clínica
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Enferm. Infecc. Microbiol. Clin. · Aug 2014
[Use of procalcitonin and C-reactive protein as infection markers in febrile neutropenic patients undergoing haematopoietic stem cell transplant].
Neutropenia is a frequent sign in patients who are going to have a haematopoietic stem cell transplant (HSCT). Infection is an important complication in these patients, which is favoured by immunosuppression and the degree of neutropenia. This study aims to evaluate the diagnostic usefulness of procalcitonin (PCT) and C-reactive protein (CRP) in onco-haematological patients undergoing chemotherapy and HSCT to determine the origin of the fever. ⋯ The combination of PCT and CRP is an insufficient method to detect bacterial infections and may not replace the proper clinical and microbiological diagnosis.
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Enferm. Infecc. Microbiol. Clin. · Apr 2014
Observational Study[Diagnostic and prognostic power of biomarkers to improve the management of community acquired pneumonia in the emergency department].
To analyse the usefulness and performance of several biomarkers [C-reactive protein (CRP), mid-regional pro-adrenomedullin (MR-proADM), procalcitonin (PCT)] and lactate in predicting short- and medium-term mortality compared with the prognostic severity scales (PSS) usually employed for community-acquired pneumonia (CAP) and in assessing the aetiological suspicion of infection by Streptococcus pneumoniae and bacteraemia. ⋯ MR-proADM and lactate showed a similar or even better performance for 30-day intra-hospital mortality than PSI, CURB-65, STS and CAP severity criteria in patients diagnosed with CAP (P>.05). Furthermore, the MR-proADM capacity to predict 180-day mortality was higher than PSS and the rest of biomarkers (P>.05), and its AUC-ROC increased if it was used in combination with PSI, CURB65 and STS. The determination of PCT has a remarkable diagnostic performance to rule out bacteraemia and to orientate the aetiology towards a S.pneumoniae infection.
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Enferm. Infecc. Microbiol. Clin. · Mar 2014
Review[Usefulness of inflammation and infection biomarkers in the Emergency Department].
Infectious processes account for 10% of patient seen in the emergency department. To administer antibiotics early, and before any other therapeutic-diagnostic decisions (complementary tests, microbiological samples, intensity of hemodynamic support, need for admission, etc.) have direct repercussions on the survival of patients with severe bacterial infections (bacteremia, severe sepsis or septic shock). In this context, the emergency department represents a critical level where the suspicion of infection and it diagnosis is made and treatment is started, and the progression and prognosis will be determined by the speed of this action. ⋯ Inflammation and infection biomarkers have been around for years as helpful tools for improving emergency medical diagnoses and management of infection in the emergency department. The aim of this review is to summarize the published scientific evidence, in order to clarify the existing controversies, comparing the usefulness of the major biomarkers of inflammation and infection. It will alas suggest recommendations for their use in order to improve diagnosis, prognostic evaluation and management of infected patients in the emergency department.
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Enferm. Infecc. Microbiol. Clin. · Mar 2014
Vancomycin-resistant enterococci among haemodialysis patients in Portugal: prevalence and molecular characterization of resistance, virulence and clonality.
Vancomycin-resistant enterococci (VRE) among haemodialysis patients has increased rapidly and, to date, there is no report of this incidence in Portugal. ⋯ Haemodialysis patients in Portugal are colonized with virulent, multi-resistant enterococci from high-risk clonal complexes, representing a public health concern.
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The hospital acquired pneumonia (HAP) is one of the most common infections acquired among hospitalised patients. Within the HAP, the ventilator-associated pneumonia (VAP) is the most common nosocomial infection complication among patients with acute respiratory failure. ⋯ It is very important to know the most common organisms responsible for these infections in each hospital and each Intensive Care Unit, as well as their antimicrobial susceptibility patterns, in order to reduce the incidence of inappropriate antibiotic therapy and improve the prognosis of patients. Additionally, clinical strategies aimed at the prevention of HAP and VAP should be employed in hospital settings caring for patients at risk for these infections.