RESUMEN
AIM: to evaluate bacteremias caused during endoscopic examination of the digestive tract. PATIENTS AND METHODS: prospective study of randomly selected patients who underwent digestive system endoscopic examination. Emergency endoscopic examinations were excluded. RESULTS: a total of 102 patients were analyzed. Of 44 patients who underwent gastroscopy, 11 (25%) subsequently had positive blood culture, and Staphylococcus spp and Streptococcus spp were isolated. Of 30 patients who underwent colonoscopy, 3 (10%) had positive blood cultures, and Staphylococcus spp were isolated. Of 28 patients who underwent endoscopic retrograde cholangiopancreatography, 11 (39.2%) had positive blood cultures, and Escherichia coli, Morganella morganii, Staphylococcus spp and Streptococcus spp were isolated. No deaths, endocarditis or other septic phenomena were attributed to bacteremia. CONCLUSIONS: the incidence of bacteremia ranged from 10% to 39% depending on the type of endoscopy. The microorganisms that were isolated most frequently were Staphylococcus spp and Streptococcus spp. Gram-negative bacilli and enterobacteria were isolated in patients who had undergone endoscopic retrograde cholangiopancreatography.
Asunto(s)
Bacteriemia/etiología , Endoscopía del Sistema Digestivo/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/sangre , Bacteriemia/microbiología , Bacterias/aislamiento & purificación , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Colangiopancreatografia Retrógrada Endoscópica/estadística & datos numéricos , Endoscopía del Sistema Digestivo/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de TiempoAsunto(s)
Infecciones Oportunistas Relacionadas con el SIDA , Criptosporidiosis , Enfermedades Pulmonares Parasitarias , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Adulto , Criptosporidiosis/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Enfermedades Pulmonares Parasitarias/diagnóstico , Masculino , Persona de Mediana EdadAsunto(s)
Aneurisma de la Aorta Abdominal/complicaciones , Plexo Lumbosacro , Enfermedad Aguda , Anciano , Aneurisma de la Aorta Abdominal/diagnóstico , Humanos , Masculino , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Enfermedades del Sistema Nervioso Periférico/etiología , Negativa del Paciente al TratamientoRESUMEN
OBJECTIVES: Analyze the decision to enact or to refrain from chemoprophylaxis (CP) with isoniazide (INH) in patients who are intravenous drug users (IVDU) in Spain infected by the human immunodeficiency virus (HIV), either classified or not with hypersensitive skin tests. METHODS: With the bibliographic information available and the help of decision tree, an analysis of the effectiveness and of the consequences of drug costs of CP with INH in those patients is performed. RESULTS: Overall, the HIV+ IVDU benefit from CP is an increase in survival of 80 days, with a savings of 7,252 pesetas per patient. The intradermal reaction with PPD and the retarded hypersensitivity tests (HCR) allow us to classify them in three subgroups: a) PPD+ where CP is universally admitted and thus corroborates our study; b) PPD-/HCR- where CP increases survival 201 days and saves 20,616 pesetas per patient; and c) PPD-/HCR+ where survival is increased 33 days and the pharmacological costs increase 1,536 pesetas per patient under CP. CONCLUSIONS: For the present situation in Spain, CP with INH is effective in HIV+ IVDU patients, independent of the results of the intradermal reaction skin tests.