Intra-abdominal infections in adults caused by Streptococcus pneumoniae: report of 18 cases

Introduction: Streptococcus pneumoniae (Spn) is occasionally implicated as a cause of intra-abdominal infection (IIASpn) that can be 1) spontaneous bacterial peritonitis (SBP) in elderly patients with previous peritoneal disease, associated with cirrhosis, in most of the cases 2) associated or adjac...

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Autores principales: Gasparotto, Ana Maria, Gianecini, Ariel, Kasparian, Andres, Kremer, Luis, Rocchi, Marta, Quinteros Greco, Carlos, Ocaña Carrizo, Ana Valeria, Navarro, Mercedes, Monterisi, Aida
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022
Materias:
Streptococcus pneumoniae
intra-abdominal infections
adults
infecciones intraabdominales
adultos
infecções intra-abdominais
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/36024
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
id I10-R327-article-36024
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Español
format Artículo revista
topic Streptococcus pneumoniae
intra-abdominal infections
adults
Streptococcus pneumoniae
infecciones intraabdominales
adultos
Streptococcus pneumoniae
infecções intra-abdominais
adultos
spellingShingle Streptococcus pneumoniae
intra-abdominal infections
adults
Streptococcus pneumoniae
infecciones intraabdominales
adultos
Streptococcus pneumoniae
infecções intra-abdominais
adultos
Gasparotto, Ana Maria
Gianecini, Ariel
Kasparian, Andres
Kremer, Luis
Rocchi, Marta
Quinteros Greco, Carlos
Ocaña Carrizo, Ana Valeria
Navarro, Mercedes
Monterisi, Aida
Intra-abdominal infections in adults caused by Streptococcus pneumoniae: report of 18 cases
topic_facet Streptococcus pneumoniae
intra-abdominal infections
adults
Streptococcus pneumoniae
infecciones intraabdominales
adultos
Streptococcus pneumoniae
infecções intra-abdominais
adultos
author Gasparotto, Ana Maria
Gianecini, Ariel
Kasparian, Andres
Kremer, Luis
Rocchi, Marta
Quinteros Greco, Carlos
Ocaña Carrizo, Ana Valeria
Navarro, Mercedes
Monterisi, Aida
author_facet Gasparotto, Ana Maria
Gianecini, Ariel
Kasparian, Andres
Kremer, Luis
Rocchi, Marta
Quinteros Greco, Carlos
Ocaña Carrizo, Ana Valeria
Navarro, Mercedes
Monterisi, Aida
author_sort Gasparotto, Ana Maria
title Intra-abdominal infections in adults caused by Streptococcus pneumoniae: report of 18 cases
title_short Intra-abdominal infections in adults caused by Streptococcus pneumoniae: report of 18 cases
title_full Intra-abdominal infections in adults caused by Streptococcus pneumoniae: report of 18 cases
title_fullStr Intra-abdominal infections in adults caused by Streptococcus pneumoniae: report of 18 cases
title_full_unstemmed Intra-abdominal infections in adults caused by Streptococcus pneumoniae: report of 18 cases
title_sort intra-abdominal infections in adults caused by streptococcus pneumoniae: report of 18 cases
description Introduction: Streptococcus pneumoniae (Spn) is occasionally implicated as a cause of intra-abdominal infection (IIASpn) that can be 1) spontaneous bacterial peritonitis (SBP) in elderly patients with previous peritoneal disease, associated with cirrhosis, in most of the cases 2) associated or adjacent to an intra-abdominal organ or postsurgical. (IIAbq) 3) peritonitis in previously healthy young women (PHYW). Our objective is report 18 cases of IIASpn describing: clinical presentation, comorbidities, need for surgery, microbiological findings, sensitivity of Spn to antimicrobials, therapeutic behavior, and evolution. Methods: study of 18 adult patients with IIASpn. Clinical and microbiological characteristics and evolution of infections were analyzed. Results: IIASpn occurred in 9 PHYW, 6 men and 1 woman with SBP, and 2 men with appendicitis. The PHYW were operated on (4 pelviperitonitis, 3 salpingitis, 2 and tubo ovarian abscess) and had a favorable evolution. In the intraoperative samples, pure culture of Spn sensitive to penicillin was isolated. Three of four patients had positive blood culture. Five of seven patients with SBP died and in the peritoneal fluid developed Spn in pure culture. A large percentage of strains presented decreased sensitivity to penicillin. Four of five had a positive blood culture. Patients with appendicitis had favorable evolution. Conclusions: IIASpn in PHYW was the most frequent presentation, surgery played a significant role in treatment and the clinical response was excellent. The second presentation occurred in elderly patients with cirrhosis, most of whom died. Appendicitis was the third presentation in patients who evolved favorably.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2022
url https://revistas.unc.edu.ar/index.php/med/article/view/36024
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spelling I10-R327-article-360242022-09-29T15:08:29Z Intra-abdominal infections in adults caused by Streptococcus pneumoniae: report of 18 cases Infecciones intraabdominales en adultos causadas por Streptococcus pneumoniae: reporte de 18 casos Infecçõesintra-abdominais em adultos causadas por Streptococcu spneumoniae : relato de 18 casos Gasparotto, Ana Maria Gianecini, Ariel Kasparian, Andres Kremer, Luis Rocchi, Marta Quinteros Greco, Carlos Ocaña Carrizo, Ana Valeria Navarro, Mercedes Monterisi, Aida Streptococcus pneumoniae intra-abdominal infections adults Streptococcus pneumoniae infecciones intraabdominales adultos Streptococcus pneumoniae infecções intra-abdominais adultos Introduction: Streptococcus pneumoniae (Spn) is occasionally implicated as a cause of intra-abdominal infection (IIASpn) that can be 1) spontaneous bacterial peritonitis (SBP) in elderly patients with previous peritoneal disease, associated with cirrhosis, in most of the cases 2) associated or adjacent to an intra-abdominal organ or postsurgical. (IIAbq) 3) peritonitis in previously healthy young women (PHYW). Our objective is report 18 cases of IIASpn describing: clinical presentation, comorbidities, need for surgery, microbiological findings, sensitivity of Spn to antimicrobials, therapeutic behavior, and evolution. Methods: study of 18 adult patients with IIASpn. Clinical and microbiological characteristics and evolution of infections were analyzed. Results: IIASpn occurred in 9 PHYW, 6 men and 1 woman with SBP, and 2 men with appendicitis. The PHYW were operated on (4 pelviperitonitis, 3 salpingitis, 2 and tubo ovarian abscess) and had a favorable evolution. In the intraoperative samples, pure culture of Spn sensitive to penicillin was isolated. Three of four patients had positive blood culture. Five of seven patients with SBP died and in the peritoneal fluid developed Spn in pure culture. A large percentage of strains presented decreased sensitivity to penicillin. Four of five had a positive blood culture. Patients with appendicitis had favorable evolution. Conclusions: IIASpn in PHYW was the most frequent presentation, surgery played a significant role in treatment and the clinical response was excellent. The second presentation occurred in elderly patients with cirrhosis, most of whom died. Appendicitis was the third presentation in patients who evolved favorably. Introducción: Streptococcus pneumoniae (Spn) ocasionalmente causa infección intraabdominal (IIASpn) que puede ser: 1) peritonitis bacteriana espontánea (PBE) en paciente añosos con enfermedad peritoneal previa, asociada con cirrosis, en la mayoría de los casos; 2) asociada o adyacente a un órgano intraabdominal o postquirúrgica (IIAbq); 3) peritonitis en mujeres jóvenes previamente sanas (MJPS). Nuestro objetivo es reportar 18 casos de IIASpn describiendo: presentación clínica, comorbilidades, necesidad de cirugía, microbiología y sensibilidad a los antimicrobianos, conducta terapéutica y evolución. Métodos: estudio de 18 pacientes adultos con IIASpn en un período de 23 años. Análisis de las características clínicas, microbiología y evolución de los pacientes. Resultados: las IIASpn ocurrieron en 9 MJPS, 6 varones y una mujer con PBE, y 2 varones con apendicitis. Las MJPS fueron intervenidas quirúrgicamente (4 pelviperitonitis, 3 salpingitis y 2 abscesos tubo ovárico) y evolucionaron favorablemente. En las muestras intraoperatorias se aisló Spn cultivo puro sensible a penicilina. Tres de cuatro pacientes tuvieron hemocultivo positivo. Cinco de siete pacientes con PBE fallecieron y en las muestras de líquido peritoneal desarrolló Spn cultivo puro. Gran porcentaje de cepas presentó sensibilidad disminuida a penicilina. Cuatro de cinco, tuvieron hemocultivo positivo. Los pacientes con apendicitis evolucionaron favorablemente. Conclusiones: La IIASpn en MJPS fue la presentación más frecuente, la cirugía jugó un rol significativo en el tratamiento y la respuesta clínica fue excelente. La segunda presentación ocurrió en pacientes añosos con cirrosis y en su mayoría, fallecieron. La apendicitis fue la tercera presentación en pacientes que evolucionaron favorablemente.  Introdução: Streptococcus pneumoniae (Spn) ocasionalmente causa infecção intra-abdominal (IIASpn) que pode ser: 1) peritonite bacteriana espontânea (PAS) em pacientes idosos com doença peritoneal prévia associada à cirrose, na maioria dos casos; 2) associado ou adjacente a um órgão intra-abdominal ou pós-cirúrgico (IIAbq); 3) peritonite em mulheres jovens previamente saudáveis ​​(MJPS). Nosso objetivo é relatar 18 casos de IIASpn descrevendo: quadro clínico, comorbidades, necessidade de cirurgia, microbiologia e sensibilidade a antimicrobianos, comportamento terapêutico e evolução. Métodos: estudo de 18 pacientes adultos com IIASpn durante um período de 23 anos. Análise das características clínicas, microbiologia e evolução dos pacientes. Resultados: IIASpn ocorreu em 9 MJPS, 6 homens e uma mulher com SBP e 2 homens com apendicite. O MJPS foi operado (4 pelviperitonites, 3 salpingites e 2 abscessos tubulares) e evoluiu favoravelmente. A cultura pura sensível à penicilina foi isolada de amostras intraoperatórias. Três dos quatro pacientes apresentaram hemocultura positiva. Cinco de sete pacientes com PBE morreram e nas amostras de fluido peritoneal desenvolveram cultura pura Spn. Uma grande porcentagem de cepas apresentou diminuição da sensibilidade à penicilina. Quatro de cinco tiveram hemocultura positiva. Os pacientes com apendicite evoluíram favoravelmente. Conclusões: IIASpn em MJPS foi a apresentação mais frequente, a cirurgia teve papel significativo no tratamento e a resposta clínica foi excelente. A segunda apresentação ocorreu em pacientes idosos com cirrose e a maioria deles morreu. A apendicite foi a terceira manifestação em pacientes que evoluíram favoravelmente. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022-09-16 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto text/html application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/36024 10.31053/1853.0605.v79.n3.36024 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 79 No. 3 (2022); 280-284 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 79 Núm. 3 (2022); 280-284 Revista da Faculdade de Ciências Médicas de Córdoba; v. 79 n. 3 (2022); 280-284 1853-0605 0014-6722 10.31053/1853.0605.v79.n3 spa https://revistas.unc.edu.ar/index.php/med/article/view/36024/38747 https://revistas.unc.edu.ar/index.php/med/article/view/36024/38802 Derechos de autor 2022 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0

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