7 research outputs found
Evaluación del efecto antifúngico de la sertralina en el tratamiento de la criptococosis menÃngea en pacientes con vih
Cryptococcus spp. es un género de
hongos del filo basidiomiceto compuesto por 70 especies, de las cuales el
complejo Cryptococcus spp. formado por C. neoformans var. neoformans, C.
neoformans var. grubii y C. gatii representan la gran mayorÃa de las infecciones
clÃnicas en humanos. Actualmente, a pesar de los avances en el tratamiento de
las infecciones fúngicas, la meningitis por criptococo sigue siendo una de las
causas principales de meningitis en pacientes con VIH, confiriendo a este grupo
de pacientes una alta mortalidad y morbilidad, sobre todo en paÃses en vÃas de
desarrollo, donde la disponibilidad de los medicamentos de primera lÃnea es
prácticamente nula. En las últimas décadas, ante la ausencia de nuevos
compuestos antimicrobianos, el estudio del reposicionamiento de moléculas ya
conocidas ha permitido explorar el uso de estos medicamentos en la lucha
contra las infecciones fúngicas, destacándose en este segmento el efecto
antifúngico de la sertralina, un medicamento aprobado para su uso en el
trastorno de la ansiedad
Monetary costs and hospital burden associated with the management of invasive fungal infections in Mexico: a multicenter study
Background: Invasive fungal infections (IFIs) affect >1.5 million people per year. Nevertheless, IFIs are usually neglected and underdiagnosed. IFIs should be considered as a public-health problem and major actions should be taken to tackle them and their associated costs. Aim To report the incidence of IFIs in four Mexican hospitals, to describe the economic cost associated with IFIs therapy and the impact of adverse events such as acute kidney injury (AKI), liver damage (LD), and ICU stay. Methods: This was a retrospective, transversal study carried-out in four Mexican hospitals. All IFIs occurring during 2016 were included. Incidence rates and estimation of antifungal therapy's expenditure for one year were calculated. Adjustments for costs of AKI were done. An analysis of factors associated with death, AKI, and LD was performed. Results: Two-hundred thirty-eight cases were included. Among all cases, AKI was diagnosed in 16%, LD in 25%, 35% required ICU stay, with a 23% overall mortality rate. AKI and LD showed higher mortality rates (39% vs 9% and 44% vs 18%, respectively, p < 0.0001). The overall incidence of IFIs was 4.8 cases (95% CI = 0.72–8.92) per 1000 discharges and 0.7 cases (95% CI = 0.03–1.16) per 1000 patients-days. Invasive candidiasis showed the highest incidence rate (1.93 per 1000 discharges, 95% CI = −1.01 to 2.84), followed by endemic IFIs (1.53 per 1000 discharges 95% CI = −3.36 to 6.4) and IA (1.25 per 1000 discharges, 95% CI = −0.90 to 3.45). AKI increased the cost of antifungal therapy 4.3-fold. The total expenditure in antifungal therapy for all IFIs, adjusting for AKI, was 6,224,993 to $773,810,330). Conclusions: IFIs are as frequent as HIV asymptomatic infection and tuberculosis. Costs estimations allow to assess cost-avoidance strategies to increase targeted driven therapy and decrease adverse events and their costs
Monetary costs and hospital burden associated with the management of invasive fungal infections in Mexico: a multicenter study
ABSTRACT Background: Invasive fungal infections (IFIs) affect >1.5 million people per year. Nevertheless, IFIs are usually neglected and underdiagnosed. IFIs should be considered as a public-health problem and major actions should be taken to tackle them and their associated costs. Aim To report the incidence of IFIs in four Mexican hospitals, to describe the economic cost associated with IFIs therapy and the impact of adverse events such as acute kidney injury (AKI), liver damage (LD), and ICU stay. Methods: This was a retrospective, transversal study carried-out in four Mexican hospitals. All IFIs occurring during 2016 were included. Incidence rates and estimation of antifungal therapy's expenditure for one year were calculated. Adjustments for costs of AKI were done. An analysis of factors associated with death, AKI, and LD was performed. Results: Two-hundred thirty-eight cases were included. Among all cases, AKI was diagnosed in 16%, LD in 25%, 35% required ICU stay, with a 23% overall mortality rate. AKI and LD showed higher mortality rates (39% vs 9% and 44% vs 18%, respectively, p < 0.0001). The overall incidence of IFIs was 4.8 cases (95% CI = 0.72–8.92) per 1000 discharges and 0.7 cases (95% CI = 0.03–1.16) per 1000 patients-days. Invasive candidiasis showed the highest incidence rate (1.93 per 1000 discharges, 95% CI = −1.01 to 2.84), followed by endemic IFIs (1.53 per 1000 discharges 95% CI = −3.36 to 6.4) and IA (1.25 per 1000 discharges, 95% CI = −0.90 to 3.45). AKI increased the cost of antifungal therapy 4.3-fold. The total expenditure in antifungal therapy for all IFIs, adjusting for AKI, was 6,224,993 to $773,810,330). Conclusions: IFIs are as frequent as HIV asymptomatic infection and tuberculosis. Costs estimations allow to assess cost-avoidance strategies to increase targeted driven therapy and decrease adverse events and their costs
A case report of small bowel perforation secondary to cytomegalovirus related immune reconstitution inflammatory syndrome in an AIDS patient
Non-traumatic small bowel perforation is rare in adults but carries a high morbidity and mortality. The diagnosis is made on clinical suspicion, and the most common causes in developing countries are infectious diseases, being cytomegalovirus infection in immunocompromised patients the main etiology. We describe a patient with a recently diagnosed advanced stage HIV infection and an intestinal perforation associated with cytomegalovirus immune reconstitution inflammatory syndrome after highly active antiretroviral therapy initiation.•Cytomegalovirus (CMV) is the main etiology of non-traumatic perforation of the small bowel in immunocompromised individuals.•We describe a case of CMV associated Immune reconstitution inflammatory syndrome.•To our knowledge this is the first case of small bowel perforation due to IRIS related CMV.•It is of importance for the clinician to consider CMV related IRIS as a cause of acute abdomen