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D Mariscal

Publications and source records attributed to D Mariscal.

22 records · Page 2Linked to original sources
PubMedDate not supplied

[An outbreak of gram-negative bacteremia (GNB), especially enterobacter cloacae, in patients with long-term tunnelled haemodialysis catheters].

Vascular access through a venous catheter for haemodialysis is associated with increased risk of thrombosis, central venous stenosis, short access survival and inadequate dialysis. The most important catheter-related complications, which determine method survival, are infection and dysfunction. In particular, infectious episodes are in some studies the leading cause for untimely catheter removal and for catheter-related morbidity but also for morbidity in dialysis patients. Double-lumen central venous catheters used for haemodialysis, are common causes of septicaemia. Most cases are caused by staphylococci. Episodes of gram-negative bacteriemia have been traced to bacterial contamination of water and/or dialysate, errors in dialyzer reprocessing, and improper setup procedures. In this paper, we describe and outbreak of gram-negative bacteremia, firstly E. cloacae, in an outpatients haemodialysis unit, in the patients with long-term tunnelled haemodialysis catheters. We describe the epidemic investigation that we achieved to identify the source of contaminating bacteria and the route by which bacteria gained access to the bloodstream. We prove the contamination by gram-negative bacterium of the water-distribution lines and haemodialysis machines. Moreover, E. cloacae strains isolated from the lines and machines are genotypically identical to the isolated from the patients. Also, we prove that the hands of health care personnel are unintentional carriers. The outbreak was finished when decontamination of dialysis machines was enhanced and dialyzer-priming fluid was modified.

Aged↗
PubMedDate not supplied

[Prevalence of Neisseria meningitidis carriers among the population of Cerdanyola (Barcelona)].

OBJECTIVE: To determine the prevalence of Neisseria meningitidis (N. meningitidis) from healthy carriers and its resistance to penicillin in Cerdanyola population. To asses which risk factors were associated with healthy carriers and compare some epidemiologic characteristics between people with penicillin sensitive and penicillin resistant strains. METHODS: Cross-sectional seasonal study of 1500 individuals selected from day care centers, schools, colleges, cultural and working centers, located in different areas of Cerdanyola. We performed throat smears and immediate culture onto selective media for isolation of N. meningitidis. Data were evaluated by univariate and multivariate statistical analysis using the SPSS statistical package. RESULTS: One hundred and ninety-one (12.7%) individuals harbored N. meningitidis strains. In logistic regression multivariate analysis, meningococcal carriage significantly increased for the age group 14-18 years (OR = 4.55 with respect to the reference group, 0-3 years), in the spring (OR = 2.29), male sex (OR = 1.67), and active smoking (OR = 1.45, intervals of 10 cigarettes/day), while meningococcal carriage significantly decreased in the group under 4 years at age (OR = 0.55), with prior use of antibiotics (OR = 0.58) and with bigger housing space (OR = 0.84 for 10 m2/person). A 42% of N. meningitidis strains in carriers from this population showed decreased sensitivity to penicillin (MIC > 0.1 microgram/ml). We have not found significantly association between the variables studied and penicillin resistance among carriers of N. meningitidis. CONCLUSIONS: Age, spring season, sex, active smoking and overcrowded housing are significantly associated to carrier state. Prior use of antibiotics decreased to carrier state. According to our findings, reducing smoking habits and improving housing conditions may be useful measures to reduce the prevalence of carriers.

Adolescent↗