Browsing by Author "Noriega, Luis"
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Item Bacteriemia en daño hepático crónico(2011) Munita, José; Araos, Rafael; Pérez, Jorge; Alvarez, Alejandra; Canals, Magdalena; Contreras, Jorge; Marcotti, Alejandra; Thompson, Luis; Noriega, LuisBacteremic infections are more frequent in patients with cirrhosis, as their immune system is compromised. Series of cirrhotic patients with bacteremia has seldom been reported in Chile. We retrospectively collected, from 2005 to 2008, 59 episodes of bacteremia in cirrhotics representing 9% of the overall number of bacteremic episodes seen in our center in the period. Spontaneous bacteremia accounted for 29% followed by those of pulmonary origin (22%). Grampositive cocci and gramnegative bacilli were responsible in 52% and 48% respectively, however gramnegative rods predominated in nosocomial bacteremias. Overall, the most frequent organisms were Staphylococcus aureus (24%) and Escherichia coli (22%). Mortality in bacteremic patients was significantly higher compared with all cirrhotic patients hospitalized in the period (37.0 vs 9.4%; p < 0.001) and MELD score was significantly correlated with mortality. Conclusion: bacteremia is a severe complication of cirrhosis and MELD score could be a useful tool to stratify risk in these patients.Item Breakthrough bacteremia due to clostridium tertium in a patient with neutropenic fever, and identification by MALDI-TOF mass spectrometry.(Elsevier, 2013) Salvador, Francisco; Porte, Lorena; Duran, Luisa; Marcotti, Alejandra; Pérez, Jorge; Thompson, Luis; Noriega, Luis; Lois, Vivianne; Weitzel, ThomasClostridium tertium is rare in a human clinical specimen and its pathogenicity is often uncertain. However, the organism has been increasingly recognized as a cause of bacteremia and other infections in immunocompromised patients, especially those with hematologic malignancies. The diagnosis and treatment of C. tertium are difficult due to its growth pattern, micromorphology, and antibiotic resistance. The organism can easily be misidentified as Gram-positive aerobic rods such as Bacillus species, usually considered as a contaminant. Furthermore, it is not covered by empirical treatment with many broad-spectrum antibiotics. Here we report a case of breakthrough bacteremia due to C. tertium that occurred in a patient with acute leukemia and neutropenic fever, who was treated with an empirical regimen of ceftazidime and amikacin. The bacterium was rapidly identified by new mass spectrometry technology (MALDI-TOF MS) and the patient recovered under meropenem and vancomycin treatment, without complications.Item Infecciones respiratorias bacteriémicas por Neisseria meningitidis serogrupo W(Sociedad Chilena de Infectología, 2015) Rosas, Reinaldo; Solar, Sebastián; Durán, Luisa; Noriega, Luis; Thompson, Luis; Marcotti, Alejandra; Pérez, Jorge; Weitzel, ThomasN. meningitidis serogroup W has recently been introduced into Chile. This serogroup has been associated with hypervirulent strains capable of causing outbreaks. Furthermore, there is data suggesting that the spectrum of clinical manifestations varies among different serogroups. Here we describe three cases of community acquired respiratory infections caused by N. meningitidis W, which were diagnosed by blood culture during 2013 in our hospital.