Assuming that seroprevalence indicates level of exposure to Bartonella henselae, these results suggest that this infection is endemic in Chile and, for this reason, the best antibody titer to diagnose acute cat-scratch disease should be higher than the figure recommended by the Centers for Disease Control in the in United States.
Empiema pleural por Streptococcus grupo anginosus en un preescolar y revisión de la literaturaStreptococcus anginosus pleural emphyema in a child. Case report and review Left pneumonectomy in a child with congenital pulmonary malformation was performed two months prior to admission. Within one week he had high fever. Chest CT scan showed massive left pleural effusion. Both Streptococcus anginosus group and Prevotella spp. grew from the fluid obtained by pleural punction. Antimicrobial therapy was immediately initiated with clindamycin and penicillin. Streptococus anginosus group is quite confusing in terms of classification and taxonomy. Now it is well recognized that three species belong to this genera: S. anginosus S. constellatus and S. intermedius. They all are considered normal flora of the oropharynx, nasopharynx, gastrointestinal tract and vagina but also they have been identified as agents of suppurative infections in children and adults. Many reports show adequate response to penicillin, however there is some emerging resistance in strains isolated in other studies. In this article we also suggest some diagnostic and microbiologic recommendations.
RESUMENAntecedentes: Citomegalovirus (CMV) es la infección congénita más frecuente, demostrado en el 1% de recién nacidos en países desarrollados. Es la primera causa de sordera y alteraciones del desarrollo neurológico infantil. Recientes estudios han demostrado que la seropositividad no evita una reinfección materna ni la enfermedad congénita, por lo que la caracterización de la seroprevalencia permite saber si la infección congénita proviene mayoritariamente de primoinfección o de reinfección. Objetivos: Conocer la seroprevalencia al parto en 583 mujeres beneficiarias del Hospital Padre Hurtado durante mayo y junio del 2006. Métodos: Estudio prospectivo, observacional, en que se estudio la presencia de IgG anti CMV en sangre materna al parto. Resultados: Se obtuvo una seroprevalencia de 95%, sin casos de infección sintomática al nacer. Conclusión: La seroprevalencia es elevada, lo que sugiere que la reinfección sería la forma principal de infección congénita. Un estudio en recién nacidos con cultivos virales o PCR permitiría conocer la tasa de infección congénita real, y no un estudio basado en seroconversión pues omitiría todos los casos que reinfección, que serían mayoritarios. SUMMARYBackground: Cytomegalovirus is the most frequent congenital infection, affecting 1% of the population in developed countries, and the leading cause of deafness and brain development abnormalities in children. Recent studies have demonstrated that seropositivity do not avoid reinfection and congenital disease. Objective: To study the seroprevalence in 583 pregnant women at delivery at Padre Hurtado Hospital, during 2006. Methods: Prospective, observational study, in which maternal blood at delivery was studied for the presence of anti CMV IgG. Results: There was 95% seroprevalence, without any case of symptomatic infection. Conclusion: The high prevalence supports that most of the cases of congenital disease would occur in seropositive women, supporting that reinfection is the main way of neonatal compromise. This supports that a study with direct detection in liveborns would be suitable to reveal the impact of cytomegalovirus in our population and not that of seroconversion.
Intravenous antimicrobial use among different hospital in Chile during 2005Intravenous antimicrobial consumption has not been evaluated previously in Chile. In order to know this consumption (in DDD per 100 bed days), associated factors and antimicrobial control systems across the country, a questionnaire was sent to evaluate these features during 2005. A total of 29 public hospitals and private clinics answered this poll, 20 belonging to the public health system (69%). Only 48.1% declared to have an independent antimicrobial committee and 17.2% allowed unrestricted antimicrobial use. Glycopeptides and carbapenems were the most regulated compounds (75.9 and 82.8%, respectively). Antimicrobial controls systems were more frequently declared among public hospitals and only non-public hospitals permitted free use of antimicrobials. Global consumption reached 59.98 DDD per 100 bed-days, with beta-lactams representing 74.3% of this consume (44.57 DDD per 100), and cephalosporins 43% (25.78 DDD per 100). Chloramphenicol, penicillin G and cloxacillin use was significantly higher among public hospitals. The opposite was observed for imipenem-cilastatin, linezolid, cefuroxime and caspofungin with higher consumes observed among nonpublic hospitals. In a multivariate analysis, increased cefazolin use was independently associated with sites allowing unrestricted use, and ciprofloxacin consumption with non-public hospitals. Institutions with decreased susceptibility to imipenem-cilastatin among non-fermentative gram negative bacilli showed a higher use of this compound and linezolid consumption paralleled vancomycin-resistant enterococci prevalence. It is necessary to reinforce governmental regulations about antimicrobial use issued during 1999.
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