Search Results - (Author, Cooperation:J. M. Mosquera)

2015-04-17

Nature Publishing Group (NPG)

0028-0836

1476-4687

Biology

Chemistry and Pharmacology

Medicine

Natural Sciences in General

Physics

Breast Neoplasms/*classification/*genetics ; Female ; Humans ; Mutation/*genetics ; Translocation, Genetic/*genetics

1432-1238

Coagulase-negative staphylococcus ; Septicemia ; Contaminant blood cultures

Springer Online Journal Archives 1860-2000

Medicine

Abstract Of 2160 intensive care unit patients, 36 patients with positive blood cultures had coagulasenegative staphylococcus in one blood bottle, whereas the organism was present in two or more bottles in 38 cases. The groups were not significantly different in 27 clinical variables, obtained at the time of their first positive blood culture. There was also no significant difference in the antimicrobial sensitivities. No initial clinical data supported the classification of coagulase-negative staphylococcus as either pathogen or contaminant. When the 74 patients with blood culture positive coagulase-negative staphylococcus were compared with three “control groups” (“absent septicemia,” “probable septicemia” and “proven septicemia”) they were not different from those with “probable septicemia”. A discriminant analysis was performed comparing patients with “absent septicemia” and with “proven septicemia” in an attempt to classify patients with isolates of coagulase-negative staphylococcus in one of these groups at an early stage. Patients with two or more positive blood cultures were not statistically classified more frequently as septicemic than patients with one blood bottle positive for this organism. However, patients categorized as septicemic had a significantly higher mortality (59%) than those classified as non-septicemic (35%) (p〈0.05).

Electronic Resource

1432-1238

Bacteriological surveillance ; Septicaemias, incidence, by Serratia sp., by Klebsiella sp., epidemic outbreaks ; Intensive Care Unit

Springer Online Journal Archives 1860-2000

Medicine

Abstract The high rate of septicaemias (20%, 19% and 14%) observed in our Intensive Care Unit (ICU) during the first 3 years was due to an epidemic incidence of Serratia sp. (S) (26% during the first year) and Klebsiella sp. (K) (25% during the third) and decreased significantly in the following 6 years (mean incidence of 11%) (p〈0.01). During this epidemic phase these organisms were isolated quite frequently (between a 14% and a 6%) from all patients admitted. The K was more regularly present, for the mean time intervals free of its bacteriological presence were shorter (11 days) than those of S (27 days) (p〈0.01). The K was isolated in more patients (160) than S (79) (p〈0.01) and in more samples (360) than S (235) (p〈0.01), but caused less secondary septicaemias per colonized patient (7% versus 29%) (p〈0.01). In 59% of all S septicaemias the organism was previously isolated in other culture, while this was observed in only 34% of K septicaemias (x2=3.78, p=0.052). The large variations in the incidence of septicaemias within our ICU, the appearance of sequential epidemic outbreaks, with a different behaviour of S and K and the individual risk of septicaemia of patients colonized by these organisms are noted.

Electronic Resource

1432-1238

Serum albumin ; Hypoalbuminemia ; Infection ; Septicemia ; Mortality on ICU

Springer Online Journal Archives 1860-2000

Medicine

Abstract 214 patients among 282 consecutive admissions had at least one measurement of serum albumin (SA) during their stay on the ICU and were classified according to their stay on the ICU and were classified according to their lowest value of SA. Mean SA was 2.88±0.74 g/100 ml. Survivors had a mean SA (3.18±0.60) higher than non-survivors (2.35±0.68 g/100 ml) (p〈0.05). 64% of patients were admitted with an abnormally low SA (less than 3.5 g/100 ml) and in 56% of these the initial value was higher than the last. Mortality increased in the groups with lower SA and the level of SA was associated with infection (x2=73.9) and mortality (x2=69.7) (p〈0.05). The percentage of infected patients who died increased in groups with lower SA.

Electronic Resource

1432-1238

High frequency jet ventilation ; Bronchopleural fistula

Springer Online Journal Archives 1860-2000

Medicine

Abstract We report a case of bronchopleural fistula (BPF) in a patient submitted to conventional mechanical ventilation in which high frequency jet ventilation (HFJV) was applied during five consecutive days. Gas exchange was adequate, the bronchial secretions could easily be cleared and the patient adapted comfortably to HFJV. In spite of PEEP levels between 4 and 8 mm Hg, the leak through the BPF ceased completely.

Electronic Resource

1432-1238

Septicaemia ; Septic shock ; Serum albumin ; Intensive care unit

Springer Online Journal Archives 1860-2000

Medicine

Abstract Blood cultures were obtained from 39% of all 574 admissions to our Medical Intensive Care Unit (ICU); in 109 (19%) a pathogenic organism was demonstrated. 45% of the septicaemias were detected within the first 48 h of ICU stay and have been considered as “non ICU-acquired”. Septicaemic patients were significantly older, had longer ICU stays and a higher mortality rate (62%) than non septicaemic patients (28%) (p〈0.05). Gram negative organisms (69%) predominated over gram positive (29%) andSerratia marcescens and coagulase positiveStaphyloccoccus were the most frequently isolated. Shock appeared in 32% and had an extremely high mortality (91%) and was associated with the presence of “multiple species septicaemia”. Prior to the septicaemia the survivors differed from the fatalities only in the level of serum albumin; this was significantly lower in patients with gram negative in comparison with gram positive septicaemias and in patients who developed shock. Arterial, pulmonary artery and urinary catheters, and endotracheal devices were used frequently in these patients and were statistically associated with the presence of septicaemia. The airway was the most frequent possible source for the septicaemia.

Electronic Resource