Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive
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Observational Study
Is there a role for procalcitonin determination in avoiding unnecessary exposure to antibiotics in a non-intensive care setting?
The use of procalcitonin (PCT) as a tool to assist clinicians in using antibiotics in intensive care patients has been postulated. Here we evaluate the efficacy of procalcitonin determination in helping clinicians in the decision to start or discontinue an antibiotic treatment in patients admitted to infectious disease wards. A retrospective observational single centre study was conducted in two infectious disease wards. ⋯ Conversely, in patients with an ongoing antibiotic treatment a statistically significant difference between PCT and CRP AUC in their ability to determine an antibiotic interruption was observed [0.77 (CI 95%: 0.65-0.89) vs 0.59 (CI 95%: 0.45-0.73) (p=0.03)]. PCT determination appeared to be more helpful than CRP in determining discontinuation of an antibiotic treatment in non-intensive care patients. However, PCT should supplement and not supplant a careful clinical evaluation.
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Historical Article
The Knights Hospitaller of Rhodes and the Black Death of 1498: a poetic description of the plague.
The study is a presentation of the sole written testimony of the great plague epidemic that struck the island of Rhodes in 1498, at the time when the Order of the Knights of St. John was settled there. The Greek poem "The Thanatikon (i.e., plague) of Rhodes", which was written by Emmanuel Georgillas Limenitis in the late 15th century and recounts the terrible events of the epidemic, was used as a source of information. ⋯ Within the historical context of the era, evaluation and analysis of the data reveal the correlation between human activities and the physical history of the disease in the Mediterranean during the 15th century. The Plague of Rhodes confirms the value of non-medical sources in the medico-historical and historico-epidemiological study of the evolution of the disease caused by Yersinia pestis while highlighting an enduring intrinsic weakness of surveillance systems. Despite modern means of epidemiological surveillance, the risk of relaxation of a health system after a long period of absence of an infectious disease constitutes a major factor for future resurgence of the specific disease.
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Carrion's disease is a major re-emerging and occupational health disease. This bibliometric study aimed to evaluate scientific production on this disease both globally and in Latin America. SCI-E, MEDLINE/GoPubMed, SCOPUS, ScIELO, and LILACS databases were searched for Carrion's disease-related articles. ⋯ There were 3,802 articles in Medline (1.2% were Peruvian), 35 in SciELO (94.3% were from Peru), and 168 in LILACS (11% were published in 2010-2014; only one article was published in 2015). Scientific production worldwide is led by the USA, and, in Latin America, by Peru and Brazil. However, Latin American scientific production in bibliographic databases is much lower than in other regions, despite being an endemic area for Carrion's disease.
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Predicting methicillin-resistant Staphylococcus aureus (MRSA) in intensive care units (ICUs) avoids inappropriate antimicrobial empirical treatment and enhances infection control. We describe risk factors for colonisation/infection related to MRSA (MRSA-C/I) in critically ill patients once in the ICU and on ICU admission, and search for an easy-to-use predictive model for MRSA colonisation/infection on ICU admission. This multicentre cohort study included 69,894 patients admitted consecutively (stay>24h) in April-June in the five-year period 2006-2010 from 147 Spanish ICUs participating in the National Surveillance Study of Nosocomial Infections in ICUs (ENVIN-HELICS). ⋯ Our conclusion is that clinical-demographic risk factors for colonisation/infection related to MRSA should not be used to accurately identify patients who would benefit from empirical anti-MRSA treatment or from specific preventive measures. Independent risk factors for MRSA colonisation/infection during ICU stay and on ICU admission are described. The latter should be considered in future studies for MRSA prediction.
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The retrospective analysis undertaken by our working group in the sphere of infectious diseases, with particular emphasis on nineteenth-century epidemics, regards influenza, which according to the scholar W. I. ⋯ This part is followed by treatment and remedial action in the nineteenth century. The third, deals with death attributed to influenza and its complications observed in the city of Ferrara in the years when outbreaks occurred, affecting the majority of the populations: 1830-1833, 1836-1837, 1847-1848, 1857-1858, 1873-1875, 1889-1892, the latter known as the great pandemic.