Prospective Multicenter Study of Community-Associated Skin and Skin Structure Infections due to Methicillin-Resistant Staphylococcus aureus in Buenos Aires, Argentina

Background. Community-associated methicillin-resistant Staphylococcus aureus(CAMRSA) is now the most common cause of skin and skin structure infections (SSSI) in several world regions. In Argentina prospective, multicenter clinical studies have only been conducted in pediatric populations. Objective. Primary: describe the prevalence, clinical and demographic characteristics of adult patients with community acquired SSSI due to MRSA; secondary: molecular evaluation of CA-MRSA strains. Patients with MRSA were compared to those without MRSA. Material and Methods. Prospective, observational, multicenter, epidemiologic study, with molecular analysis, conducted at 19 sites in Argentina (18 in Buenos Aires)between March 2010 and October 2011. Patients were included if they were ≥ 14 years, were diagnosed with SSSI, a culture was obtained, and there had no significant healthcare contact identified. A logistic regression model was used to identify factors associated with CA-MRSA. Pulse field types, SCCmec, and PVL status were also determined. Results. A total of 311 patients were included. CA-MRSA was isolated in 70% (218/311) of patients. Clinical variables independently associated with CA-MRSA were: presence of purulent lesion (OR 3.29; 95%CI 1.67, 6.49) and age <50 years (OR 2.39; 95%CI 1.22, 4.70). The vast majority of CA-MRSA strains causing SSSI carried PVL genes (95%) and were SCCmec type IV. The sequence type CA-MRSA ST30 spa t019 was the predominant clone. Conclusions. CA-MRSA is now the most common cause of SSSI in our adult patients without healthcare contact. ST30, SCCmec IV, PVL+, spa t019 is the predominant clone in Buenos Aires, Argentina.Fil: Lopez Furst, Maria Jose. Sanatorio Municipal Dr. Julio Méndez, Ciudad Autónoma de Buenos Aires; Argentina;Fil: de Vedia, Lautaro. Gobierno de la Ciudad de Buenos Aires. Htal.de Infecciosas F.j. Muñiz; Argentina;Fil: Fernandez, Silvina. Universidad de Buenos Aires. Facultad de Cs.exactas y Naturales. Departamento de Quimica Biologica. Cat.de Microbiologia; Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina;Fil: Gardella, Noella Mariel. Universidad de Buenos Aires. Facultad de Cs.exactas y Naturales. Departamento de Quimica Biologica. Cat.de Microbiologia; Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina;Fil: Ganaha, Cristina. Pcia. de Buenos Aires. Hospital Vicente López y Planes, Gral. Rodríguez; Argentina;Fil: Prieto, Sergio. Provincia de Buenos Aires. Hospital Nuestra Señora de Luján; Argentina;Fil: Carbone, Edith. Hospital Aeronautico Central; Argentina;Fil: Lista, Nicolás. Gobierno de la Ciudad de Buenos Aires. Htal.de Infecciosas F.j. Muñiz; Argentina;Fil: Rotryng, Flavio. Universidad Abierta Interamericana; Argentina;Fil: Morera, Graciana I.. Hospital Dr. Jose Cullen; Argentina;Fil: Mollerach, Marta Eugenia. Universidad de Buenos Aires. Facultad de Cs.exactas y Naturales. Departamento de Quimica Biologica. Cat.de Microbiologia; Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina;Fil: Stryjewski, Martin E.. Centro de Educaciones Medicas E Investig.Clinica "Norberto Quirno"; Argentina

Impact of influenza in the post-pandemic phase: Clinical features in hospitalized patients with influenza A (H1N1) pdm09 and H3N2 viruses, during 2013 in Santa Fe, Argentina

It is important to characterize the clinical and epidemiological pattern of the influenza A (H1N1) pdm09 virus and compare it with influenza A (H3N2) virus, as surveyed in just a few studies, in order to contribute to the implementation and strengthening of influenza control and prevention strategies. The aims in this study were to describe influenza clinical and epidemiological characteristics in hospitalized patients, caused by influenza A (H1N1)pdm09 and influenza A (H3N2) viruses during 2013, in Santa Fe, Argentina. A retrospective study was conducted over 2013 among hospitalized patients with laboratory-confirmed influenza diagnosis. In contrast to patients with influenza A (H3N2) (20.5%), a higher proportion of hospitalizations associated with influenza H1N1pdm were reported among adults aged 35-65 years (42.8%). Of all patients, 73.6% had an underlying medical condition. Hospitalized patients with H1N1pdm were subject to 2.6 (95%CI, 1.0-6.8) times higher risk of severity, than those hospitalized with influenza A (H3N2). This results demonstrate the impact in the post-pandemic era of H1N1pdm virus, with increased risk of severe disease, in relation to H3N2 virus, both viruses co-circulating during 2013

Impact of influenza in the post-pandemic phase: Clinical features in hospitalized patients with influenza A (H1N1) pdm09 and H3N2 viruses, during 2013 in Santa Fe, Argentina

It is important to characterize the clinical and epidemiological pattern of the influenza A (H1N1) pdm09 virus and compare it with influenza A (H3N2) virus, as surveyed in just a few studies, in order to contribute to the implementation and strengthening of influenza control and prevention strategies. The aims in this study were to describe influenza clinical and epidemiological characteristics in hospitalized patients, caused by influenza A (H1N1)pdm09 and influenza A (H3N2) viruses during 2013, in Santa Fe, Argentina. A retrospective study was conducted over 2013 among hospitalized patients with laboratory-confirmed influenza diagnosis. In contrast to patients with influenza A (H3N2) (20.5%), a higher proportion of hospitalizations associated with influenza H1N1pdm were reported among adults aged 35-65 years (42.8%). Of all patients, 73.6% had an underlying medical condition. Hospitalized patients with H1N1pdm were subject to 2.6 (95%CI, 1.0-6.8) times higher risk of severity, than those hospitalized with influenza A (H3N2). This results demonstrate the impact in the post-pandemic era of H1N1pdm virus, with increased risk of severe disease, in relation to H3N2 virus, both viruses co-circulating during 2013

Investigación de agentes etiológicos de mediastinitis posquirúrgica cardiovascular en un hospital escuela de adultos

La mediastinitis posquirúrgica es una complicación importante que ocurre en 1 a 2 % de las cirugías cardiovasculares (CCV) y posee una alta morbi-mortalidad.Los objetivos del presente trabajo fueron: investigar la etiología bacteriana de las mediastinitis posteriores a CCV, analizar las características feno y genotípicas del agente etiológico prevalente y establecer la relación clonal  entre los distintos aislamientos de este último.Durante el periodo 2013-2016 se registraron 36 casos de mediastinitis en pacientes adultos, 2 de los cuales fueron diagnosticados con criterios clínicos y el resto con documentación microbiológica. De las 34 mediastinitis confirmadas microbiológicamente;  29 resultaron monomicrobianas y 5 polimicrobianas. Se analizaron las monomicrobianas, resultando Staphylococcus aureus  el agente etiológico prevalerte.A 30 pacientes se les realizó además extracción de sangre para cultivo; se obtuvo desarrollo en 13 (43%) hemocultivos y en 10 de éstos (77%) el aislamiento coincidió con el de muestras esternales.Los aislamientos de Sau estudiados fueron en su mayoría meticilino sensible (SAMS) y sólo uno de ellos fue positivo para leucocidina de Panton-Valentine (LPV).Los tipos spa hallados fueron diferentes para cada una de las cepas.En nuestro hospital, el agente etiológico prevalente de mediastinitis posteriores a CCV fue SAMS,  hubo baja portación del gen pvl y gran diversidad genómica de los aislamientos estudiados durante el periodo de cuatro años

Clinical and demographic characteristics in patients with skin and skin structure infections due to community-associated MRSA.

<p>MRSA denotes methicillin-resistant <i>Staphylococcus aureus</i>; CA-MRSA denotes community-associated MRSA; BMI, body mass index.</p><p>Data are displayed with n/N (%), except for continuous variables which are expressed by mean or median (standard deviation or interquartile range).</p><p>Predisposing factors for skin infections as well predisposing factors for Community MRSA displayed in this table were selected from medical literature. Comparisons were exploratory.</p>*<p>Comparing patients with community-associated MRSA vs. those without community-associated MRSA.</p>†<p>Including furunculosis as a predisposing factor.</p>‡<p>From the total of patients with nasal swabs.</p

Most common antibiotic treatments, changes in therapy and drainage in patients with skin and skin structure infections.

<p>MRSA denotes methicillin-resistant <i>Staphylococcus aureus</i>.</p>*<p>Comparing patients infected with community-associated MRSA vs. those patients without community-associated MRSA.</p>†<p>It refers to drainage without incision (e.g. needle drainage).</p

Molecular characteristics of community-associated MRSA in patients with skin and skin structure infections: pulse fieldtypes, sequence types, <i>mec</i> and <i>spa</i> types.

<p>Numbers within parenthesis indicate the number of isolates belonging to each <i>spa</i> type or SCC<i>mec</i> type.</p><p>ST denotes sequence type; ND, not determined; NT, non-typeable.</p>*<p>A representative proportion of isolates from each pulse field type were studied.</p

Pulse field patterns of representative community MRSA isolates in patients with skin and skin structure infections.

<p>Lane 1 and 14, pulse field type A clone (CAA); lane 2, control pulse field type C; lane 5, pulse field type A; lanes 13 and 7 other pulse field types; lanes 3, 4, 6 and 8–12 pulse field type C.</p