RESUMEN
During the period of 1979 to 1983, 38 patients with cystic fibrosis (CF) at the CF center of St. Christopher's Hospital for Children in Pennsylvania developed respiratory tract colonization with Pseudomonas cepacia. Seventeen (45%) of the patients with colonization died. Yearly incidence rates of P. cepacia colonization fluctuated between 1.3% and 6.1%, suggesting an endemic phenomenon. Case-control studies showed that severe underlying CF, use of aminoglycosides, and having a sibling with CF and P. cepacia colonization were significant risk factors for P. cepacia colonization. Once colonized with P. cepacia, patients with CF were likely to be hospitalized longer (P = 0.008) and to die sooner (P = 0.0001) than control patients with CF. Environmental and microbiologic studies did not identify a common source or mode of transmission of P. cepacia among patients. The results of this investigation suggest that P. cepacia colonization of patients with CF was endemic in the hospital, occurred more frequently in those with severe disease, and was associated with adverse clinical outcome.
Asunto(s)
Infección Hospitalaria/microbiología , Fibrosis Quística/microbiología , Infecciones por Pseudomonas/microbiología , Adolescente , Adulto , Niño , Preescolar , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/etiología , Fibrosis Quística/complicaciones , Fibrosis Quística/tratamiento farmacológico , Femenino , Humanos , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Admisión del Paciente , Pseudomonas/crecimiento & desarrollo , Pseudomonas/aislamiento & purificación , Infecciones por Pseudomonas/tratamiento farmacológico , Infecciones por Pseudomonas/etiología , RiesgoRESUMEN
A retrospective case-control study was conducted to identify risk factors, other than contact with infected animal tissues, for infection caused by Yersinia pestis in non-Indian residents of areas with endemic sylvatic plague in New Mexico. The study group consisted of 16 persons who had bacteriologically confirmed cases of plague in the period 1975-1976 and 45 controls who were matched by age, sex, and location of residence. Participants were questioned about outdoor activities, environmental conditions in and around the home, procedures of pet care, exposure to animals and insects, and medical history. The availability of harborage and food sources for wild rodents as a result of human activity in the immediate home environment was associated with risk of infection. Failure to take steps to control fleas on dogs and cats also appeared to be a possible risk factor. No other significant differences were found between patients and controls. Plague in New Mexico appears to result primarily from entry of the reservoir host into the habitat of the human rather than from entry of the human into the sylvatic habitat of the reservoir host.